Pediatric casualties in contemporary armed conflict: A systematic review to inform standardized reporting

Strengthening the emergency health response to children wounded by explosive weapons in conflict

“…The proportion of conflict-related injury caused by blast mechanisms is higher among children than adults 24. A recent systematic review of child victims of 21st century armed conflicts demonstrated that nearly 60% of conflict-related injuries in children were attributable to blast mechanisms, compared with approximately 25% in adults, a finding consistent with prior reports from Afghanistan and Iraq 24.…”

“…The proportion of conflict-related injury caused by blast mechanisms is higher among children than adults 24. A recent systematic review of child victims of 21st century armed conflicts demonstrated that nearly 60% of conflict-related injuries in children were attributable to blast mechanisms, compared with approximately 25% in adults, a finding consistent with prior reports from Afghanistan and Iraq 24. In certain settings this proportion may be even higher, such as in Syria where approximately 80% of child victims of war between 2011 and 2017 were caused by blast injury, predominantly from barrel bombs and airstrikes 5…”

“…While some reports describe a higher incidence of lower extremity injury due to children’s shorter stature, others describe a higher rate of upper extremity injury due to children’s predisposition to handle and play with explosives—an activity that leads to higher rate of craniofacial and ocular injuries, with bilateral blindness in up to 20% of wounded children 31. The above-cited systematic review demonstrated overall similar wounding patterns with no statistically significant differences observed in the incidence of head or extremity injuries; however, non-uniform reporting of injury precluded stratification by age group for pooled analyses 24. The pliability of children’s bones permits greater distribution of energy into soft tissue and viscera, which often causes severe injury to internal organs 38.…”

“…In the present viewpoint article, we synthesize what is known regarding injury epidemiology and considerations specific to the clinical care of pediatric populations, focusing primarily on gaps and opportunities for strengthening the care of child victims of explosive weapons (table 1). No formal scoping or systematic review of this topic was undertaken because two recent systematic reviews have been conducted and because this was not our primary objective 23 24. Instead, we have synthesized the evidence base around children injured by explosive weapons using the findings of these reviews, which we have supplemented with focused literature queries as well as our perspectives as clinicians and researchers with experience in injury prevention, pediatric trauma care in austere settings, and humanitarian response.…”

Please stop the Russian-Ukrainian war – children will be more than grateful

“…In the short term, children of attacked countries bear disproportionate consequences of war. They undergo higher-energy tissue injuries than adults and massive burns, leading to higher mortality [ 1 , 2 ]. Health care disruption leads to a lack of medicines and halts routine preventive care, including childhood vaccinations.…”