Introduction: Traumatic injury is a growing public health concern globally, and is a major cause of death
and disability worldwide. The purpose of this study was to quantify the socioeconomic impact of lower
extremity fractures in Uganda.
Methods: All adult patients presenting acutely to Uganda’s national referral hospital with a single long
bone lower extremity fracture in October 2013 were recruited. Consenting patients were surveyed at
admission and again at six-months and 12-months post-injury. The primary outcome was the
cumulative 12-month post-injury loss in income. Secondary outcome measures included the change in
health-related quality of life (HRQoL) and the injury’s effect on school attendance for the patients’
dependents.
Results: Seventy-four patients were recruited during the study period. Sixty-four (86%) of the patients
were available for 12-months of follow-up. Compared to pre-injury earnings, patients lost 88.4% ($1822
USD) of their annual income in the 12-months following their injury. To offset this loss in income,
patients borrowed an average of 28% of their pre-injury annual income. Using the EuroQol-5D
instrument, the mean HRQoL decreased from 0.91 prior to the injury to 0.39 (p < 0.0001) at 12-months
post-injury. Ninety-three percent of school-aged dependents missed at least one month of school during
their guardian’s recovery and only 61% had returned to school by 12-months post-injury.
Conclusion: This study demonstrates that lower extremity fractures in Uganda had a profound impact on
the socioeconomic status of the individuals in our sample population, as well as the socioeconomic
health of the family unit.