INJURY SURVEILLANCE INJURY SURVEILLANCE IN TRINIDAD - The San IN TRINIDAD - The San

Fernando General Hospital Fernando General Hospital ExperienceExperience

Roanna BynoeRoanna BynoeSeptember 7, 2006September 7, 2006

History of Surveillance System History of Surveillance System Surveillance System initiated in December 2001 Surveillance System initiated in December 2001

with grant from IDRCwith grant from IDRC

Joint initiative of the CAREC, SWRHA and the Joint initiative of the CAREC, SWRHA and the Rotary Club, San Fernando SouthRotary Club, San Fernando South

Data collection commenced in February 2002Data collection commenced in February 2002

Collaboration with Mc Laughlin Centre, Ottawa Collaboration with Mc Laughlin Centre, Ottawa in 2005in 2005

ANALYSISANALYSIS

February 2002- December 2005February 2002- December 2005

Catchment population: 500, 000Catchment population: 500, 000

23.5% of all A&E Department Visits23.5% of all A&E Department Visits

Total Injuries by year 2002-2005Total Injuries by year 2002-2005

0

2000

4000

6000

8000

10000

12000

14000

16000

2002 2003 2004 2005

TOTA

L IN

JUR

IES

MaleFemale

Unknown: 171

Age GroupAge Group

25 - 4433.8%

45 - 6417.2%

15 - 2423.3%

0 - 1417.7%

Unknown2.6%65+

5.5%

IntentIntentIntentional self-

harm1.0%

Intentional Interpersonal

17.3%

Unknown3.5%

Unintentional78.2%

Intentional Interpersonal InjuriesIntentional Interpersonal Injuries Quarrel - predominant context of injury Quarrel - predominant context of injury

Leading context in the 25 – 44 age Leading context in the 25 – 44 age category with men twice likely to be at risk category with men twice likely to be at risk than female counterpart. than female counterpart.

The predominant object used during a The predominant object used during a Quarrel was Bodily force and predominant Quarrel was Bodily force and predominant location is home, 2location is home, 2ndnd leading location is leading location is street/highway.street/highway.

Intentional Interpersonal InjuriesIntentional Interpersonal Injuries

The predominant Victim/Perpetrator The predominant Victim/Perpetrator Relationship was a friend/ acquaintance Relationship was a friend/ acquaintance and leading age group is 25 – 44 years, and leading age group is 25 – 44 years, 22ndnd leading age group is 15 – 24 years leading age group is 15 – 24 years

Predominant Object Used is bodily force Predominant Object Used is bodily force especially with 25 – 44 and 15 – 24 age especially with 25 – 44 and 15 – 24 age groups.groups.

Mechanism of Injury 2002-2005Mechanism of Injury 2002-2005

30.6

24.9

11.6 10.4

4.8

0

5

10

15

20

25

30

35

% of Injuries

Fall Other BluntForce

TrafficInjury

Stab/ Cut Poisoning

Mechanism of InjuryMechanism of Injury Falls accounted for 32.5% of the Level IV Falls accounted for 32.5% of the Level IV

injuries whilst Other Blunt Force accounted for injuries whilst Other Blunt Force accounted for 26.8% of the Level IV injuries26.8% of the Level IV injuries

The predominant mode of transportation is the The predominant mode of transportation is the private car, 2private car, 2ndnd leading mode of transport is the leading mode of transport is the pedestrianpedestrian

The leading type of road user is the passenger, The leading type of road user is the passenger, next predominant road user is the driver.next predominant road user is the driver.

Clinical OutcomeClinical Outcome

Discharged68.4%

Unknown0.8%Died

0.1% LWB10.9%

Admitted19.9%

Clinical OutcomeClinical Outcome <1% of persons sustaining an unintentional <1% of persons sustaining an unintentional

injury died in the A&E Departmentinjury died in the A&E Department

72.1% of persons discharged sustained an 72.1% of persons discharged sustained an intentional interpersonal injuryintentional interpersonal injury

<20% of persons sustaining a fall were admitted <20% of persons sustaining a fall were admitted to hospitalto hospital

17.9% of traffic injuries admitted to hospital 17.9% of traffic injuries admitted to hospital

System LimitationsSystem Limitations Injury surveillance system exists only in South Injury surveillance system exists only in South

West RegionWest Region

Profile of injuries may differ substantially across Profile of injuries may differ substantially across different Health Regionsdifferent Health Regions

System does not capture injuries presenting at: System does not capture injuries presenting at: Private FacilitiesPrivate Facilities Health CentersHealth Centers

Under-representation of fatal injuriesUnder-representation of fatal injuries

Next StepsNext Steps Develop and implement intervention strategies Develop and implement intervention strategies

with key stakeholderswith key stakeholders

Training and sensitisation of staffTraining and sensitisation of staff

Expansion of the system to other A&E Expansion of the system to other A&E Departments within the SWRHADepartments within the SWRHA

National expansion of the systemNational expansion of the system

AcknowledgementsAcknowledgements

Caribbean Epidemiology Centre Caribbean Epidemiology Centre South West Regional Health Authority South West Regional Health Authority

(data collection and entry, nursing staff, (data collection and entry, nursing staff, medical staff, hospital administration)medical staff, hospital administration)

Ministry of HealthMinistry of Health Rotary Club, San Fernando SouthRotary Club, San Fernando South PAHO (biennial funds)PAHO (biennial funds) Health CanadaHealth Canada