Factors affecting social integration after road traffic orthopaedic injuries in Rwanda

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Abstract Background Road traffic injuries (RTIs) leading to long-term disability present a significant public health challenge, causing immense personal and societal consequences. However, in many developing countries, information on the social integration of patients post-RTI remains limited. Purpose This study aimed to identify factors contributing to social integration following road traffic-related orthopedic injuries in Rwanda. Methodology The research encompassed a multicenter, cross-sectional study involving 369 adult RTI victims from five Rwandan referral hospitals, all of whom experienced accidents in 2019. Participants completed the IMPACT-S Questionnaire, which evaluated the level of social integration in terms of activities and participation. Statistical analysis using logistic regression, with a significance level set at p<0.05, helped estimate odds ratios (OR) and 95% confidence intervals (CI). We obtained ethical approval to conduct the study from the University of Rwanda, College of Medicine and Health Sciences Institutional Review Board. All participants signed a written consent before enrollment into the study, and all data were kept confidential and only used for the purpose of this study. Results The study’s findings indicated that the mean age of RTI victims was 37.5±11.26 years, with a notable male predominance over females. Of the participants, 5.69% were unable to resume normal life activities. The overall mean score on the IMPACT-S scale was moderate, at 77±17. Specifically, participants achieved an average score of 76±16 for “activities” and a higher average of 84±16 for “participation.” Certain factors were associated with poor social integration compared to others, including belonging to the age group above 65 years (OR=8.25, p=0.02), female sex (OR=3.26, p=0.02), lack of rehabilitation (OR=3.82, p=0.01), and length of hospital stay > 15 days (OR=4.44, p=0.02). Conclusion The majority of RTI victims in Rwanda achieved successful reintegration into society; nevertheless, their mobility and community engagement were more significantly impacted compared to other aspects assessed by the IMPACT-S scale. The study emphasized the importance of early management, effective rehabilitation, and prompt patient discharge from the hospital in facilitating a successful return to everyday life after road traffic-related orthopedic injuries.

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