More than 7,000 persons died of injuries in Guinea in 2007. Males were 30% more likely to experience a fatal injury than females. The overall injury risk increased as people got older. Transportation, fire/burn, falls, homicide, and drowning were the five leading causes of injuries for all ages combined, accounting for 87% of all fatal injuries. An exception was the poisoning as the fourth leading cause of death for children less than five years old.
Compared to the estimates from
the Global Burden of Disease: 2004 Update for Guinea (86.9 per 100,000 population)
[
4], the rate based on Guinea’s official statistics (72.8 per 100,000 population) is lower. More importantly, the death cause patterns of injuries obviously differ between two data sources (Figure
). For example, the percentages of fire/burn, falls, homicide, and suicide were 7.9%, 3.2%, 19.9%, 5.8%, respectively, based on the estimates of GBD 2004 update;
[
4] while according to Guinea’s official statistics, they were 21.5%, 11.7%, 9.6%, and 0.2%. The observed discrepancy indicates large variations in the injury death patterns across countries in Africa, stressing that the policy-making for injury control should be based on own data for each country.
As well as in most countries, transportation was the most important cause of injury-induced deaths in Guinea. The large transportation-related deaths may be due to increasing motorization, inadequate adoption and enforcement of traffic laws, high traffic law violation, poor traffic control, and lack of adult supervision of children
[
7-
9]. Six recommendations proposed by the
World Report on Road Traffic Injury Prevention[
10], have the potential to be used to improve the transportation safety in Guinea, including 1) identify a lead agency in government to guide the national road traffic safety effort; 2) assess the problem, policies and institutional settings relating to road traffic injury and the capacity for road traffic injury prevention; 3) prepare a national road safety strategy and plan of action; 4) allocate financial and human resources to address the problem; 5) implement specific actions to prevent road traffic crashes, minimize injuries and their consequences and evaluate the impact of these actions; and 6) support the development of national capacity and international cooperation.
Fire/burn constituted more than 20% of total injury-induced deaths in Guinea, which differed from in other African countries
[
4]. The high prevalence of fire/burn-induced deaths could be ascribed to unsafe power sources for cooking, lighting, and heating, crowding and flammable house
[
11-
14]. In Guinea, a typical house is a one-room with two doors but without windows
[
15]. The room is made of mud walls and a roof of bamboo and leaves
[
15]. One hut is usually crammed with four or more persons to sleep
[
15]. These factors make house fire a significant contributor to fire-related deaths in Guinea. Improvement in the housing system and introduction of safe cooking, lighting and heating, may have the potential to decrease unnecessary fire-induced fatalities.
It is not unique for Guinea that males and old adults are high-risk population for fatal falls. However, there is a lack of scientific data in support of development of fall prevention programs because little is known about the mechanism of falls for Guineans, like personal behaviors, environmental factors, engineering factors. Clearly, further studies are needed in Guinea to identify protective and risk factors of falls, to develop and evaluate fall prevention programs. In general, a multidisciplinary approach is needed but environmental modifications should be emphasized
[
16]. In the last several decades, many prevention programs have been developed to decrease fall-induced injuries in older population in the developed countries
[
17]. Guinea could benefit from successful interventions from other countries but needs to consider necessary modifications when introducing them because of huge cultural differences between Guinea and these countries.
Violence, particularly homicides, has become a major public concern for Guinean society. The result may be due to primarily social instability from frequently alternated government and lack of enforcement of laws
[
18-
20]. Although the awareness campaigns against violence have been launched by the government, international organizations and other partners recently
[
21], more actions are needed. Especially, strictly-designed studies should be conducted to develop cost-effective interventions to prevent violence.
The extremely low suicide rate may be partially due to the impact of religious belief of Muslim. According to the official statistics, approximately 85% of Guineans (7.8 million) are Muslim
[
22]. The doctrines of Muslim regard suicide as one of the greatest sins and utterly detrimental to one's spiritual journey. A verse in the Quran instructs, ‘
And do not kill yourselves, surely God is most merciful to you.’
[
23] On the other hand, however, the low suicide rate may also be caused by potential under-reporting in terms of poor data quality of many developing countries
[
24] and social stigma associated with suicide
[
25].
Poisoning caused a significant proportion of child fatal injuries in Guinea. As the
World Report on Child Injury Prevention summarizes, the greatest obstacle for world child poisoning control is the lack of reliable data
[
26]. Currently, there are few poisoning data collection systems but almost all of them are located in the developed countries
[
26]. Although measures like poison control centers, hotline, child-resistant packaging, and education (including training of parents and caregivers) combined with home visitations, have been found somewhat effective, few measures have been tested in the developing countries
[
25]. It is important for Guinea to develop a separate data collection system for poisoning control, or to include poisoning data needed in the existing data system. Furthermore, rigorous studies are needed to test the effectiveness of successful prevention interventions from developed countries in the local communities.
This study is primarily limited by the data quality of Guinea’s official statistics. The real injury mortality may be underestimated to some degree because some deaths that occurred out of hospital and the corpses were not sent to the mortuary might have not been counted by the official statistics. Additionally, injuries might have been misclassified as other diseases or conditions in the remote areas considering poor condition of medical care centers, lack of experienced health care providers
[
27,
28].
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