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  Impact of Injuries in Egypt

A) Impact of Injuries from All Causes: human trauma is one of the leading causes of death and disability in the world and disproportionately affects individuals in developing countries.1 As a lower middle-income country, Egypt’s burden from injuries is significant. There were an estimated 24,222 deaths from injuries in Egypt in 1999, placing injuries as the 6th leading cause of death. However, while mortality is an important marker of the magnitude of the health problem caused by injuries, there are other important health indicators when discussing the burden of this grave problem. For each death from injury, there are substantially more individuals whose traumatic experience results in treatment in emergency departments, in hospitalization, or in acute surgical intervention. These individuals may sustain injuries that result in lifelong disability. These non-fatal outcomes from injuries must be taken into consideration when developing policy and research programs on injury control. In Egypt, there were approximately 127,216 hospitalizations from all types of injuries in 1999 leading to an estimated 847,912 disability adjusted life years (see preliminary data below). Injuries are the one of the single largest factors contributing to disability among Egyptians. The majority of these injuries occurred in males between the ages of 15 and 44.

B) Impact of Injuries from Motor Vehicle Collisions: While there are many causes of both intentional and unintentional injuries, morbidity and mortality from motor vehicle collisions (road traffic collisions) are consistently a significant problem in developing countries. 2 Throughout the latter part of the 1970s and throughout the entire 1980s, the numbers of motor vehicles in Egypt steadily increased. However, the numbers of injuries and fatalities have remained relatively stable, leading to a fall in the number of deaths per 100,000 motor vehicles registered (Table 1). Nevertheless, the deaths per 100,000 population did not substantially improve over this 15-year period. The overall burden from motor vehicle injuries remained substantially unchanged with the annual number of individuals injured from motor vehicle collisions consistently between 20,000 and 25,000, and the number killed predominantly between 4,500 and 5,500 (Figure 1). Obtaining accurate, comprehensive and current data on road traffic injuries remains problematic.

 

Table 1: Motor vehicle registration, injuries, and fatalities. Egypt, 1975-1990

Source: Injury in Egypt MOHP, 1990

C) The Burden of Injuries On Egyptian Society: Years of Lost Life (YLLs), Years Lived with Disability (YLDs) and Disability Adjusted Life Years (DALYs) : Measuring specific cause mortality is relatively straight forward compared to evaluating the societal impact of nonfatal injuries and the resulting disabilities. One acceptable measure for defining the disability impact of a disease is to calculate the disability-adjusted life years (DALYs) caused by this disease. This measure can be developed by adding the years of life lived with disability (YLDs) from a disease plus the years of lost life (YLL) (i.e.: premature mortality) due to the disease. In other words: DALYs = YLDs + YLLs. However, it should be noted that DALYs does not fully cover the burden posed by injuries, such as the mental health problems or infections resulting from intentional trauma such as rape.

Unlike mortality and hospital discharge data, information about disabilities from injuries in Egypt is more heterogeneous and comes from different sources, such as health unit registration data and health surveys. Table 2 shows the estimated years of life lost due to premature mortality (YLLs), years of life lived with disability (YLDs) and disability adjusted life years lost (DALYs) due to injuries, divided by males and females and for all age groups. When looking at both men and women throughout all the age groups, it can be seen that there were an estimated 847,912 DALYs indicating a significant societal burden from nonfatal injuries.

 Table 2: Years of Lost Life (YLLs), Years Lived with a Disability (YLDs) & Disability Adjusted Life Years(DALYs) from injuries by sex & age group, Egypt 1999

 References

1-Mock CN, Jurkovich GJ, nii-Amon-Kotei D, Arreola-Risa C, Maier RV. Trauma mortality patterns in three nations at different economic levels: implications for global trauma system development. J Trauma. 1998 May;44(5):804-12; discussion 812-4.
2-Dahl R. Vehicular manslaughter: the global epidemic of traffic deaths. Environ Health Perspect. 2004 Aug;112(11):A628-31.