Emergency care in 59 low- and middle-income countries: a systematic review

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dc.contributor.authorObermeyer, Ziad
dc.contributor.authorAbujaber, Samer
dc.contributor.authorMakar, Maggie
dc.contributor.authorStoll, Samantha
dc.contributor.authorKayden, Stephanie R
dc.contributor.authorWallis, Lee A
dc.contributor.authorReynolds, Teri A
dc.date.accessioned2021-10-08T06:54:59Z
dc.date.available2021-10-08T06:54:59Z
dc.date.issued2015
dc.description.abstractAbstractObjectiveTo conduct a systematic review of emergency care in low- and middle-income countries (LMICs).MethodsWe searched PubMed, CINAHL and World Health Organization (WHO) databases for reports describing facility-based emergency care and obtained unpublished data from a network of clinicians and researchers. We screened articles for inclusion based on their titles and abstracts in English or French. We extracted data on patient outcomes and demographics as well as facility and provider characteristics. Analyses were restricted to reports published from 1990 onwards.FindingsWe identified 195 reports concerning 192 facilities in 59countries. Most were academically-affiliated hospitals in urban areas. The median mortality within emergency departments was 1.8% (interquartile range, IQR: 0.2–5.1%). Mortality was relatively high in paediatric facilities (median: 4.8%; IQR: 2.3–8.4%) and in sub-Saharan Africa (median: 3.4%; IQR: 0.5–6.3%). The median number of patients was 30 000per year (IQR: 10 296–60 000), most of whom were young (median age: 35years; IQR: 6.9–41.0) and male (median: 55.7%; IQR: 50.0–59.2%). Most facilities were staffed either by physicians-in-training or by physicians whose level of training was unspecified. Very few of these providers had specialist training in emergency care.ConclusionAvailable data on emergency care in LMICs indicate high patient loads and mortality, particularly in sub-Saharan Africa, where a substantial proportion of all deaths may occur in emergency departments. The combination of high volume and the urgency of treatment make emergency care an important area of focus for interventions aimed at reducing mortality in these settings.
dc.identifier.apacitationObermeyer, Z., Abujaber, S., Makar, M., Stoll, S., Kayden, S. R., Wallis, L. A., & Reynolds, T. A. (2015). Emergency care in 59 low- and middle-income countries: a systematic review. <i>Bulletin of the World Health Organization</i>, 93(8), 577 - 586G. http://hdl.handle.net/11427/34388en_ZA
dc.identifier.chicagocitationObermeyer, Ziad, Samer Abujaber, Maggie Makar, Samantha Stoll, Stephanie R Kayden, Lee A Wallis, and Teri A Reynolds "Emergency care in 59 low- and middle-income countries: a systematic review." <i>Bulletin of the World Health Organization</i> 93, 8. (2015): 577 - 586G. http://hdl.handle.net/11427/34388en_ZA
dc.identifier.citationObermeyer, Z., Abujaber, S., Makar, M., Stoll, S., Kayden, S.R., Wallis, L.A. & Reynolds, T.A. 2015. Emergency care in 59 low- and middle-income countries: a systematic review. <i>Bulletin of the World Health Organization.</i> 93(8):577 - 586G. http://hdl.handle.net/11427/34388en_ZA
dc.identifier.issn0042-9686
dc.identifier.issn0366-4996
dc.identifier.issn1564-0604
dc.identifier.ris TY - Journal Article AU - Obermeyer, Ziad AU - Abujaber, Samer AU - Makar, Maggie AU - Stoll, Samantha AU - Kayden, Stephanie R AU - Wallis, Lee A AU - Reynolds, Teri A AB - AbstractObjectiveTo conduct a systematic review of emergency care in low- and middle-income countries (LMICs).MethodsWe searched PubMed, CINAHL and World Health Organization (WHO) databases for reports describing facility-based emergency care and obtained unpublished data from a network of clinicians and researchers. We screened articles for inclusion based on their titles and abstracts in English or French. We extracted data on patient outcomes and demographics as well as facility and provider characteristics. Analyses were restricted to reports published from 1990 onwards.FindingsWe identified 195 reports concerning 192 facilities in 59countries. Most were academically-affiliated hospitals in urban areas. The median mortality within emergency departments was 1.8% (interquartile range, IQR: 0.2–5.1%). Mortality was relatively high in paediatric facilities (median: 4.8%; IQR: 2.3–8.4%) and in sub-Saharan Africa (median: 3.4%; IQR: 0.5–6.3%). The median number of patients was 30 000per year (IQR: 10 296–60 000), most of whom were young (median age: 35years; IQR: 6.9–41.0) and male (median: 55.7%; IQR: 50.0–59.2%). Most facilities were staffed either by physicians-in-training or by physicians whose level of training was unspecified. Very few of these providers had specialist training in emergency care.ConclusionAvailable data on emergency care in LMICs indicate high patient loads and mortality, particularly in sub-Saharan Africa, where a substantial proportion of all deaths may occur in emergency departments. The combination of high volume and the urgency of treatment make emergency care an important area of focus for interventions aimed at reducing mortality in these settings. DA - 2015 DB - OpenUCT DP - University of Cape Town IS - 8 J1 - Bulletin of the World Health Organization LK - https://open.uct.ac.za PY - 2015 SM - 0042-9686 SM - 0366-4996 SM - 1564-0604 T1 - Emergency care in 59 low- and middle-income countries: a systematic review TI - Emergency care in 59 low- and middle-income countries: a systematic review UR - http://hdl.handle.net/11427/34388 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34388
dc.identifier.vancouvercitationObermeyer Z, Abujaber S, Makar M, Stoll S, Kayden SR, Wallis LA, et al. Emergency care in 59 low- and middle-income countries: a systematic review. Bulletin of the World Health Organization. 2015;93(8):577 - 586G. http://hdl.handle.net/11427/34388.en_ZA
dc.language.isoeng
dc.publisher.departmentDivision of Emergency Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.sourceBulletin of the World Health Organization
dc.source.journalissue8
dc.source.journalvolume93
dc.source.pagination577 - 586G
dc.source.urihttps://dx.doi.org/10.2471/BLT.14.148338
dc.subject.otherAdolescent
dc.subject.otherAdult
dc.subject.otherAfrica South of the Sahara
dc.subject.otherChild
dc.subject.otherChild, Preschool
dc.subject.otherClinical Competence
dc.subject.otherDatabases, Factual
dc.subject.otherDeveloping Countries
dc.subject.otherEmergency Medical Services
dc.subject.otherEmergency Medicine
dc.subject.otherFemale
dc.subject.otherGlobal Health
dc.subject.otherHospital Mortality
dc.subject.otherHospitalization
dc.subject.otherHumans
dc.subject.otherLatin America
dc.subject.otherMale
dc.titleEmergency care in 59 low- and middle-income countries: a systematic review
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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