Bystander intervention is associated with reduced early mortality among injury victims in Cameroon.
PLOS Global Public Health · 2024-01-01 · Observational study
Abstract
Despite high injury mortality rates, Cameroon currently lacks a formal prehospital care system. In other sub-Saharan African low and middle-income countries, Lay First Responder (LFR) programs have trained non-medical professionals with high work-related exposure to injury in principles of basic trauma care. To develop a context-appropriate LFR program in Cameroon, we used trauma registry data to understand current layperson bystander involvement in prehospital care and explore associations between current non-formally trained bystander-provided prehospital care and clinical outcomes. The Cameroon Trauma Registry (CTR) is a longitudinal, prospective, multisite trauma registry cohort capturing data on injured patients presenting to four hospitals in Cameroon. We assessed prevalence and patterns of prehospital scene care among all patients enrolled the CTR in 2020. Associations between scene care, clinical status at presentation, and outcomes were tested using univariate and multivariate logistic regression. Injury severity was measured using the abbreviated injury score. Data were analyzed using Stata17. Of 2212 injured patients, 455 (21%) received prehospital care (PC) and 1699 (77%) did not receive care (NPC). Over 90% (424) of prehospital care was provided by persons without formal medical training. PC patients were more severely injured (p<0.001), had markers of increased socioeconomic status (p = 0.01), and longer transport distances (p<0.001) compared to NPC patients. Despite increased severity of injury, patients who received PC were more likely to present with a palpable pulse (OR = 6.2, p = 0.02). Multivariate logistic regression adjusted for injury severity, socioeconomic status and travel distance found PC to be associated with reduced emergency department mortality (OR = 0.14, p<0.0001). Although prehospital injury care in Cameroon is rarely performed and is provided almost entirely by persons without formal medical training, prehospital intervention is associated with increased early survival after injury. Implementation of LFR training to strengthen the frequency and quality of prehospital care has considerable potential to improve trauma survival.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Bystanders · Low- and middle-income settings · Mortality & survival
Related articles
- Emergency Care Interventions for Victims of Explosive Ordnance Reduce Mortality: A Modeling Study. (Prehosp Disaster Med, 2025)
- Prehospital trauma care reduces mortality. Ten-year results from a time-cohort and trauma audit study in Iraq. (Scand J Trauma Resusc Emerg Med, 2012)
- Prehospital trauma system reduces mortality in severe trauma: a controlled study of road traffic casualties in Iraq. (Prehosp Disaster Med, 2012)
- Trained lay first responders reduce trauma mortality: a controlled study of rural trauma in Iraq. (Prehosp Disaster Med, 2010)
- Effect of the rural rescue system on reducing the mortality rate of landmine victims: a prospective study in Ilam Province, Iran. (Prehosp Disaster Med, 2009)
- Bystander interventions and their impact on road injury outcomes: a scoping review. (Scand J Trauma Resusc Emerg Med, 2025)