D. G. LeBrun1,2, J. D. Kelly10, S. Wren8,9, D. A. Spiegel3, N. Mkandawire7, R. A. Gosselin11, A. L. Kushner4,5,6 10University Of Pennsylvania,Sports Medicine, Orthopaedic Surgery,Philadelphia, PA, USA 11University Of California – San Francisco,Orthopaedic Surgery,San Francisco, CA, USA 1Harvard School Of Public Health,Epidemiology,Boston, MA, USA 2University Of Pennsylvania,Perelman School Of Medicine,Philadelphia, PA, USA 3Children’s Hospital Of Philadelphia,Orthopaedic Surgery,Philadelphia, PA, USA 4Columbia University College Of Physicians And Surgeons,Surgery,New York, NY, USA 5Johns Hopkins Bloomberg School Of Public Health,International Health,Baltimore, MD, USA 6Surgeons OverSeas,New York, NY, USA 7University Of Malawi,Orthopaedic Surgery,Blantyre, , Malawi 8VA Palo Alto Healthcare Systems,General Surgery,Palo Alto, CA, USA 9Stanford University,Surgery,Palo Alto, CA, USA
Introduction:
Injuries comprise a major portion of the global burden of disease among adolescents. In particular, injuries sustained while playing sports are extremely common with many requiring surgical management. However, the extent to which sports injuries contribute to the burden of injury in low- and middle-income countries (LMICs) is unknown. The goal of this study was to determine the burden of sports injuries among adolescents in Africa as part of a larger effort to estimate the global burden of sports injuries among adolescents.
Methods:
Data from the World Health Organization (WHO) Global School-Based Student Health (GSHS) cross-national surveys was used to estimate the number of adolescents sustaining sports injuries in Africa. WHO-GSHS surveys have been conducted in 16 African countries since 2003. These surveys measured the number of adolescents sustaining serious injuries (defined as injuries that necessitated treatment or caused the child to miss a day of normal activities) within the past year. Nine surveys contained supplemental data on serious injuries attributable to sports. Gender-stratified sports injury rates were calculated based on weighted averages reflecting the relative sample size of each national survey. These rates were subsequently applied to every African country’s adolescent population to estimate country-specific injury rates and continent-wide totals.
Results:
The 9 countries with supplemental data on serious injuries attributable to sports injuries included: Botswana, Ghana, Kenya, Mauritius, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe. These surveys represented a total of 15,822 males and 18,495 females. In these countries, sports injury rates ranged from 19.7% to 30.4% for males and 6.9% to 20.2% for females. Weighted average sports injury rates for males and females were 23.8% and 13.5%, respectively. When these rates were applied to the adolescent populations of every African country, an estimated 31,303,816 males and 17,295,093 females sustained sports injuries. In total, an estimated 48,598,909 adolescents sustained sports injuries in Africa over a one-year period.
Conclusion:
By calculating gender-stratified sports injury rates, we estimated that nearly 50 million African adolescents sustained sports injuries over one year. Injuries represent a major burden of disease worldwide and disproportionately affect LMICs, yet there is a paucity of data characterizing injury rates among adolescents in LMICs. The fraction of injuries attributable to sports and the proportion of these injuries necessitating surgical care are poorly understood. Further work will help to more precisely define the burden of sports injuries in LMICs and the role that surgery can play in mitigating this burden.
