A silent epidemic: Exploring the clinico-epidemiological impact of explosion and gunshot injuries in the emergency department of a tertiary hospital in Somalia.

Background: Mass casualty incidents, such as explosions and gunshot wounds (GSWs), pose significant public health challenges. This study analyzes the clinico-epidemiological profile and outcomes of patients with explosive injuries and GSWs in Somalia. Method: A retrospective analysis was conducted on 225 patients admitted to the Emergency Department of a tertiary hospital in Somalia between January and December 2021. Data collected included injury type, anatomical distribution, demographics, hospital admissions, and outcomes. Results: Of the 225 explosion and GSW injuries, explosive injuries accounted for 58 %, while GSWs made up 42 %. The majority of patients were male (85.3 %), with 89.5 % in the GSW group and 82.3 % in the explosion group. More than half(58.7 %) of the patients were aged 18 to 30 years, with 59.2 % in the explosion group and 57.9 % in the GSW group. Anatomical analysis revealed that head injuries were most common(21 %), particularly in explosion cases, as well as higher rates of head (26.2 %), maxillofacial(7.7 %), and lower-limb injuries (12.3 %) compared to GSW patients. Some 21.7 % of patients were discharged from ED, 19 % admitted to ICU and an inpatient death rate of 12.9 %, including three patients (1.3 %) who died in the Emergency Department, all from the explosion injury group. Conclusion: The rising incidence of traumatic injuries necessitates a multifaceted approach, including enhanced emergency response systems and public health initiatives. This data serves as a call to action for healthcare providers and policymakers to prioritize the management and prevention of explosion and gunshot-related injuries in Somalia.