Epidemiology of Injury-Related Death in Children under 5 Years of Age in Hunan Province, China, 2009–2014

Abstract

BackgroundInjury is an important cause of childhood mortality in China. We described the epidemiology and trends of injury-related deaths of children <5 years of age in Hunan province, and discussed several policy implications.MethodsInjury-related deaths of children <5 years of age in 2009–2014 were identified from surveillance data. All specific injury mortality and mortality rates in urban and rural area were calculated from census data; Cochran-armitage trend test was used to assess the time trends.ResultsInjury was the leading cause of death in children <5 years of age. Overall injury mortality was 48.96 per 100,000 persons, gradually declined with the year (Z = -18.75, P<0.001), and accounted for 27.14% of all deaths. Injury mortality in rural areas was 64.66 per 100,000 persons, which was more than 3.73 times higher than the rate in urban areas. The three leading causes of injury-related death were drowning (43.63%), suffocation (27.57%), and traffic accidents (14.34%). Suffocation was the leading cause in children <1 year of age (79.49%). Suffocation has high incidence in the winter and spring, and drowning has high incidence in the summer season. Drowning was the leading cause in children 1–4 years of age (62.80%). Drowning and suffocation accounted for 67.74% and 65.11%, of injury-related deaths that occurred at home; while the traffic injury deaths (54.12%) occurred mainly in transit.ConclusionsInjury-related fatalities in children <5 years of age followed time trends that were different in rural and urban areas. Effective childhood injury prevention may require different prevention policies combination depending on epidemiological characteristics such as development of injury surveillance and public education on injury knowledge. There is a need for evidence-based surveillance of risk factors for development of effective injury prevention programs.

Under-five mortality from unintentional suffocation in China, 2006-2016

“…Under-five mortality rates from 2006-2016 were calculated as number of number of deaths divided by the corresponding population and then were age-adjusted using the age structure from the 2010 Chinese national census (<1 year and 1-4 years). In addition to reporting under-five mortality, we conducted analyses for the two age groups separately because developmental factors lead to great mortality gaps in suffocation rates between children under age 1 vs 1-4 years old [2,4,5,15] Following the ICD-10, we limited unintentional suffocation to ICD-10 codes “w75-w84”. We further divided unintentional suffocation into four groups according to the mechanism: (1) suffocation and strangulation in bed (w75); (2) inhalation-related suffocation (w78, w79, w80); (3) other specified suffocations (w76, w77, w81, w83); and (4) suffocations with unspecified cause (w84).…”

“…Mortality among young children in China (5.33 per 100 000 persons) is far higher than other nations, including the US (3.31 per 100 000 persons), Canada (1.2 per 100 000 persons), and Australia (0.8 per 100 000 persons), and suffocation deaths among young children in China account for an estimated 28% of unintentional suffocation deaths to children in that age group globally [1]. Previous studies in China suggest unintentional suffocation was the leading cause of injury deaths for infants (<1 year old) in multiple areas of the country, including Hunan province [2], Henan province [3,] Beijing city [4], and Guangzhou city [5] of China, and that children in rural areas had higher unintentional suffocation incidence and mortality rates than those in urban areas [2,4-8].…”

“…The only published national study examining under-five unintentional suffocation mortality used data from the Chinese Maternal and Child Mortality Surveillance (MCMS) system; it reported a substantial mortality decrease between 2000 and 2010, plus higher unintentional suffocation mortality in rural areas in both 2000 and 2010 compared to urban areas [6]. Several other published studies investigated the epidemiology of under-five unintentional suffocation mortality for Hunan province [2], Beijing city [4,9], Guangzhou city [5] and Sichuan province [7], revealing a declining trend in mortality over time and higher mortality rates in boys and rural children than in girls and urban children.…”

Forearm fractures in children from Zadar region

“…Poznato je kako se prijelomi kostiju u djece mogu prevenirati, no potrebno je poznavati regionalne specifičnosti pretežitih aktivnosti djece, načine i mjesta na kojima ona najčešće zadobiju ozljedu (13)(14)(15). U nas je ovakvih istraživanja malo i sva dosad objavljena provedena su u zagrebačke djece (16)(17)(18)(19)(20).…”

Ulykker er vanligste dødsårsak for barn i Kina

“…I en registerbasert studie fra Kina ble skaderelaterte dødsfall hos barn under fem år i Hunanprovinsen, med over 71 millioner innbyggere, kartlagt (1). Skader var den vanligste dødsårsaken hos barn under fem år.…”