Casey et al. International Journal of Emergency Medicine 2012, 5:28 http://www.intjem.com/content/5/1/28 thus often receives referrals or transfer patients from dispensaries, clinics, and hospitals throughout the re- gion. This may contribute to a selection bias and limits the generalizability of these hospital-based epidemiology results to the overall population or other healthcare sites. This affect would tend to skew the data towards more severely injured patients, which is supported by the low number of lacerations, bites, and other minor injuries. Conversely, limited access to pre-hospital care services or limited transportation from more remote sites potentially negatively impacts delivery of patients to health care centers with severe or morbid injuries. As such, many injury-related deaths may be unaccounted for in hospital records resulting in an underestimation of the true morbidity and mortality related to injury. Conclusions Our study demonstrates that a substantial minority of patients presenting to a Tanzanian referral hospital’s emer- gency department have sustained injury. These data give a detailed and more robust picture of the patient demo- graphics, mechanisms of injury, types of injury, and patient outcomes from similar resource limited settings. Addition- ally they demonstrate the need for prospective data collec- tion, injury prevention, and development of emergency medical care strategies in low-income countries. Additional file Additional file 1: Data Collection Form. Abbreviation DALY: Disability Associated Life Years; KCMC: Kilimanjaro Christian Medical Centre; RTI: Road Traffic Injury; TBI: Traumatic Brain Injury; WHO: World Health Organization. Competing interests The authors declare that there are no competing interests. Acknowledgements We thank Katherine Magee for her work with the initial statistical analysis. Author details 1Division of Emergency Medicine, Duke University School of Medicine, Durham, NC, USA. 2Hubert Yeargan Center for Global Health, Duke University, Durham, NC, USA. 3Duke Global Health Institute, Duke University, Durham, NC, USA. 4Kilimanjaro Christian Medical Centre, Kilimanjaro Christian Medical College, Moshi Tanzania, East Africa. Authors’ contributions EJC, NMT and CJG conceived and drafted the initial study design. ERC, CJG, NMT < FM, EWO and MBH revised the study design. ERC, FM and EM, supervised the conduct of the study and data collection. ERC and NMT analyzed the data. ERC drafted the manuscript and all authors contributed substantively to its revision. ERC takes responsibility for the manuscript as a whole. All authors read and approved the final manuscript. Funding Duke Global Health Institute funding of $7,450 for the Duke Global Health Residency Fellowship Pathway research project. 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International Journal of Emergency Medicine 2012 5:28.