2 articles
Injuries represent a major public health issue, causing approximately 16,000 deaths globally each day (10% of all deaths), which is 32% more than the combined total caused by malaria, tuberculosis, and HIV/AIDS. Over the past 15 years, the WHO and regional initiatives have supported the piloting of trauma registries in low- and middle-income countries as essential tools for monitoring, planning, and prevention.
Objective
This article aims to assess the feasibility and utility of implementing a national trauma registry in the Republic of Moldova, in order to improve injury surveillance and emergency service planning.
In 2018, the pilot iCREATE trauma registry was tested for the first time in three countries: Moldova, Armenia, and Georgia. The data collection instrument was developed based on WHO recommendations, ICD-10, and IDB-JAMIE standards under the guidance of partners from the University of Iowa and Babeș-Bolyai University, Cluj-Napoca. All trauma cases from the Institute of Emergency Medicine and the Valentin Ignatenco Municipal Clinical Children’s Hospital in Chișinău were included in the registry.
The analyzed sample consists of 7,942 individuals, predominantly male (57.3%). The most represented age groups were 19-29 years (17.8%) and 30-39 years (17.6%), while individuals aged 70 and above accounted for 11% of the total. Most incidents occurred in urban areas (76.9%). Of the total patients, 52.4% were treated and discharged, while 37.5% required hospitalization. Injuries occurred primarily at home (55.4%) and on public roads (24.7%). The leading mechanism of injury was falls (68.2%), followed by other causes (12.2%) and cut/pierce injuries (10.0%). The most frequently affected body regions were the head/skull (12.5%) and knee (11.8%), followed by the hip (6.7%) and wrist (6.4%). Fractures were the most common injury type (34.5%), followed by contusions (23.0%) and open wounds (14.7%). Several gaps in data collection and reporting were identified and should be considered in future efforts to enhance trauma surveillance.
The data highlight the need to develop a national trauma registry as an essential tool for monitoring, prevention, and effective intervention, alongside health promotion campaigns targeting vulnerable groups and the involvement of relevant stakeholders.
Osteoporosis remains a major public health issue, particularly affecting the elderly, and is characterized by decreased bone mass and deterioration of bone structure, increasing the risk of severe fractures. The development of specific and precise tools that allow for the identification and estimation of the influence of modifiable factors on the development of osteoporosis is an important step in early intervention for at-risk individuals.
The initial version of the questionnaire was created to identify modifiable factors contributing to the development of osteoporosis, including the type and frequency of drinking water consumption, water quality, knowledge about its mineral composition, dietary preferences, alcohol and tobacco use, physical activities, and stressful situations. The questionnaire initially contained 65 questions, organized into three sections. Five experts reviewed the content validity, evaluating the clarity, cultural and linguistic relevance, structure, and coherence of the questions. The feedback led to adjustments, reducing the questionnaire to 52 questions. A pre-test was conducted with 30 adults from the Republic of Moldova, confirming the validity and internal consistency of the questionnaire, with a Cronbach’s Alpha coefficient of 0.768.
To ensure content validity, experts evaluated the questionnaire, and based on their comments and suggestions, semantic and syntactic reformulations and modifications were made. As a result, 13 questions were eliminated, reducing the second version of the questionnaire to 52 questions. During the pre-testing stage, the order and content of the questions were deemed appropriate by the respondents. The average time required to complete the questionnaire was 14.19 minutes (SD ± 1.567), with a minimum of 11.90 minutes and a maximum of 17.33 minutes. The sample used in the pre-testing stage included 30 respondents, the majority of whom (93.3%) were women. The respondents’ ages ranged from 25 to 72 years, with a mean age of 50.37 ± 2.6 years. The distribution of respondents was balanced between urban (53.3%) and rural (46.7%) areas. Regarding education level, 56.6% had higher education, 26.7% had secondary vocational education, and 16.7% had no higher education.
The study demonstrated that the new questionnaire is a valid and reliable instrument for assessing the impact of modifiable risk factors on morbidity due to osteoporosis. Ongoing research is necessary to refine and further validate the questionnaire within the broader population.