Demographic, occupational and societal risk exposures to physical injuries in a rural community in Western Kenya: a 12-week longitudinal study

OBJECTIVE: We studied factors associated with the weekly occurrence of physical injuries in a rural setting to determine injury-related burden and risk exposures. DESIGN: Prospective cohort study. SETTING: Suna-West subcounty, Migori County, Western Kenya. PARTICIPANTS: 390 study participants (subjects) cluster sampled from 92 households, recruited and followed up for 12 weeks, between August and October 2019. METHODS: We collected data weekly on occurrence of injuries, individual-level and household-level independent variables using a standard interviewer-administered questionnaire adapted from the WHO survey tool for injuries. Analyses related occurrence of injuries and independent variables using a multilevel Poisson regression model, adjusting for age and sex. OUTCOME MEASURES: Quantifying injury-related burden and patterns by demographic, occupational and societal risk exposures. RESULTS: We documented 44 injuries, coming from 38 subjects dwelling in 30 of the 92 study households. On average, each study subject and household experienced 1.2 and 1.5 episodes of injuries across the 12 study weeks. Open wounds and bruises were the most frequent injuries commonly reported among middle-aged (18–54 years) and young (5–17 years) subjects at 32.2 and 7.6 episodes per 1000-person week, respectively. The common cause of injuries among young, middle-aged and old subjects (>54 years) were falls, road accidents and person-related assault or being hit by an object, each at 15.2, 18.9, and 11.4 episodes per 1000-person week, respectively. Subjects not domesticating animals (incidence rate ratio (IRR)=7.6, 95% CI 1.4 to 41.7) and those making a visit outside the local subcounty of residence (IRR=2.2, 95% CI 1.5 to 3.1) were at higher risk of reporting injuries. CONCLUSION: We provide evidence of a higher burden of physical injuries associated with demographic, occupational and societal risk exposures with the most injuries resulting from falls. Further studies could better define granular characteristics constituting these factors.