Incidence, case-fatality rate and clinical pattern of firearm injuries in two cities where arm owning is forbidden.

OBJECTIVE

To review firearm injuries in five hospitals of Douala and Yaounde, both towns of Cameroon, a Sub-Saharan African country where ownership of firearm is forbidden.

METHODS

This was a retrospective investigation carried out within the period January 1998 to December 2002. Records of the mortuaries, the emergency departments, the intensive care units, the operating rooms and the surgical units were all analysed to identify any injury caused by firearm. Our gold standard was any individual with a clear diagnosis of firearm injury, as determined by a medical doctor.

RESULTS

286 firearm injuries were found; 1.14 cases per 100,000 per year. 66% of cases were due to civilian assaults, 20% to armed forces, 8% to hunting accidents and 6% to accidental handling. There was no case of suicide or of shooting from a relative. The type of weapon was unknown in 31% of cases, it was a hand gun in 36%, a hunting type in 21% and an assault rifle in 12%. The mean age of victims was 33 years and the male:female ratio 5.5:1. The site of injury was unknown in 2%; the head in 6%, the chest in 12%, the abdomen in 31%, the extremities in 46%, the spine in 1% and multiple in 2%. The case fatality rate was 12.58%, and the victims were mainly criminals killed by armed forces assaults; the same ratio of survivors developed late complications.

CONCLUSION

The incidence of firearm injuries in the two largest cities of Cameroon is five to fifty times lower than in many other towns, especially in Western countries. This may be due at least partially, to the current legislation on the ownership of firearm which is very restrictive in this country. Some efforts are however needed to reduce illegal access to weapons and to educate hunters on the safe handling of their gun.