Epidemiology of Childhood Injury

Abstract

A review of childhood injuries at the Wesley Guild Hospital, a component of Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria, showed that 1,471 patients seen in the children's emergency room during a period of 4 years (1992-1995) were there as a result of trauma, representing 9% of all patients seen. The case notes and accident and emergency cards of 1,224 were available for review. Ages ranged from 2 months to 15 years, with a mean of 6.9 years, and 40% of the patients were between 5 and 10 years of age. More males were affected than females, with a ratio of 1.5:1. Road traffic crashes were the most common causal factor, responsible for 324 injuries (26.5%). About 90% of these were pedestrians knocked down by automobiles and motorcycles. Passengers accounted for about 10% of the cases. Falls occurred in 305 patients (25%); 229 patients fell while on level ground either playing or running, accounting for 75%. There were 122 patients (10%) with misplaced foreign bodies; about 60% of these were recovered from the ears, and 26.3% from the nostrils. Edible seeds were the most common foreign bodies, followed by beads. Injuries from bites occurred in 108 patients, with dog and snake bites taking the lead. Burns, mainly from scalding, occurred in 89 patients. Other rare injuries were knife wounds, gunshot wounds, and injuries resulting from assaults. The home was the most common site of injury (570 patients, 46.7%) followed by streets or roadways (363 patients, 29.7%); 19.5% of injuries occurred at school. The most common anatomic region affected was the head and neck, followed by the limbs. One hundred ninety-seven patients (16%) had bony fractures, femurs being the most affected bone. Head injury was seen in 104 patients, representing 8.5%, although only 17 of these injuries were severe. There were 10 cases of abdominal injury and 9 cases of chest injury, representing 0.8 and 0.7%, respectively. Wound infection occurred in 6.4% of the patients. Death occurred in 19 patients, accounting for 1.6%; 10 of these patients had severe head injuries. Road traffic injuries and burns accounted for the greatest number of complications. The findings of this study suggest that trauma is an important factor in childhood morbidity and mortality in our environment, with road traffic injuries taking the lead. Preschool pedestrian children were most commonly affected, the majority of them on errands for their parents. We believe that the majority of these injuries are preventable.

Clinical Spectrum of Trauma at a University Hospital in Nigeria

“…Other published reports had mentioned violent traumas from gunshot and assaults, rather than RTA, as most common cause of trauma encountered [20]. Assaults from secret cult activities among Nigerian students are another form of trauma which previous reports from Nigeria had not documented [1,6,9,21]. This takes the form of machete cuts and/or gunshot injuries.…”

Fatal Head Injuries in Children Under the Age of 5 Years in Pretoria

“…1 On the other hand, Adesunkanmi et al in 1998 reported a study from Nigeria (for the period 1992-1995), stating that most deaths in infants were due to infectious disease processes, but with trauma deaths (especially due to road traffic accidents as the external cause/circumstance of death) being the second most common cause of death. 2 This difference between developed and developing countries has however been changing, with the WHO World Report On Child Injury Prevention (2004 data) indicating that also in developing countries, an increasing number of children are now dying from injury and that head injuries are the single most common type of fatal injury sustained by children. 3 Danseco et al reported (from Maryland, USA) that injury rates increase with age and recorded higher nonfatal injuries amongst the 5-9 year old children, yet the rate for fatal injuries was higher amongst children aged from 0-4 years.…”

“…5 Tabish et al reported that in India (2003) the most common cause of head injury was due to falls (68.2%), followed by transportation accidents (28%), assault (2%) and injuries due to flying objects (2%). 6 Head injury as a result of falls was stated to be the third leading cause of death in children aged [1][2][3][4] years, according to a study from Chicago (Hall et al, 1989). 7 There appears to be minimal recent published literature on the fatal head injuries in the pediatric population.…”

Retrospective study of impact of social factor in pediatric trauma at teaching hospital of Vindhya region of India

“…[16][17][18][19][20][21][22][23][24][25][26][27] In our study too, boys were more commonly (63.21%) hospitalized than girls (36.79%), Male children are given more freedom, opportunities, and facilities than females in all aspects in our society. Likewise, they are more exposed to potential risk factors and potential environment suitable for trauma such as playing on roads, rooftop, on trees, or near construction sites.…”