Prevention of childhood unintentional injuries in low- and middle-income countries: A systematic review

Tupetz, Anna; Friedman, Kaitlyn; Duan, Zhao; Liao, Huipeng; Isenburg, Megan von; Keating, Elizabeth M.; Vissoci, João Ricardo Nickenig; Staton, Catherine A.

doi:10.1371/journal.pone.0243464

Cited by 39 publications

(29 citation statements)

References 77 publications

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“…'Levels Trends in Child Mortality 2020 ). Children from low and middle-income countries (LMICs) are disproportionately affected, accounting for over 90% of unintentional injury related deaths globally (Tupetz et al 2020 ; Peden MM, UNICEF, World 2008 ; World Health Organization 2021 ). While there have been efforts in reducing the burden of childhood mortality due to trauma in most high-income countries (HIC), in LMIC, efforts have largely focused on addressing mortality resulting from communicable illnesses, leaving a surge in mortality resulting from injuries among the same age population (Adeloye et al 2018 ; Sethi et al 2017 ; Ademuyiwa et al 2012 ).…”

Section: Introductionmentioning

confidence: 99%

Pediatric trauma burden in Tanzania: analysis of prospective registry data from thirteen health facilities

et al. 2022

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Background Trauma is among the leading causes of morbidity and mortality among pediatric and adolescent populations worldwide, with over ninety percent of childhood injuries occurring in low-income and middle-income countries. Lack of region-specific data on pediatric injuries is among the major challenges limiting the ability of health systems to implement interventions to prevent injuries and improve outcomes. We aim to characterize the burden of pediatric health injuries, initial healthcare interventions and outcomes seen in thirteen diverse healthcare facilities in Tanzania. Methods This was a prospective cohort study of children aged up to 18 years presenting to emergency units (EUs) of thirteen multi-level health facilities in Tanzania from 1st October 2019 to 30th September 2020. We describe injury patterns, mechanisms and early interventions performed at the emergency units of these health facilities. Results Among 18,553 trauma patients seen in all thirteen-health facilities, 4368 (23.5%) were children, of whom 2894 (66.7%) were male. The overall median age was 8 years (Interquartile range 4–12 years). Fall 1592 (36.5%) and road traffic crash (RTC) 840 (19.2%) were the top mechanisms of injury. Most patients 3748 (85.8%) arrived at EU directly from the injury site, using motorized (two or three) wheeled vehicles 2401 (55%). At EU, 651 (14.9%) were triaged as an emergency category. Multiple superficial injuries (14.4%), fracture of forearm (11.7%) and open wounds (11.1%) were the top EU diagnoses, while 223 (5.2%) had intracranial injuries. Children aged 0–4 years had the highest proportion (16.3%) of burn injuries. Being referred and being triaged as an emergency category were associated with high likelihood of serious injuries with adjusted odds ratio (AOR) 4.18 (95%CI 3.07–5.68) and 2.11 (95%CI 1.75–2.56), respectively. 1095 (25.1%) of patients were admitted to inpatient care, 14 (0.3%) taken to operation theatre, and 25 (0.6%) died in the EU. Conclusions In these multilevel health facilities in Tanzania, pediatric injuries accounted for nearly one-quarter of all injuries. Over half of injuries occurred at home. Fall from height was the leading mechanism of injury, followed by RTC. Most patients sustained fractures of extremities. Future studies of pediatric injuries should focus on evaluating various preventive strategies that can be instituted at home to reduce the incidence and associated impact of such injuries.

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Section: Introductionmentioning

confidence: 99%

Pediatric trauma burden in Tanzania: analysis of prospective registry data from thirteen health facilities

et al. 2022

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“…Child injuries are a public health concern for both high-income and low-income countries but more pronounced in countries undergoing extreme urbanization and industrialization [ 9 , 10 ]. However, the risk of injury-related deaths is higher among low- and middle-income than high-income countries [ 11 ]. Children of low- and middle-income countries are exposed to more hostile environments; open fires, unstable construction sites, unprotected stairways, absence of safe play space, and lack of safe storage of chemicals [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of childhood injuries in Saudi Arabia: a scoping review

Albedewi

Al-Saud

Kashkary³

et al. 2021

BMC Pediatr

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Background Injury is the leading cause of death among Saudi children. Despite that, much remains unknown on the epidemiology and the extent of burden. This scoping review aims to describe previous literature on injury burden, including types, causes, and outcomes. Methods We conducted a scoping literature search of English published articles on injuries among Saudi children between 0 to 18 years old using Scopus, MEDLINE, and Web of Science between January 2000 and December 2020. The primary outcome was the type and the cause of childhood injuries. Data extraction was based on specified data elements that included study characteristics and epidemiological parameters. The STROBE checklist was used to assess the quality of publications. Results The initial review identified 3,384 studies. Of which, 36 studies met the inclusion criteria. A total of 20,136 children were included; of them, 69% were males. Among studies that examined overall injuries, falls represented 31.9%, while 25.1% were due to Motor Vehicle Collision (MVC). The leading cause of fractures was falls (37.9%), followed by MVC (21.5%). The leading cause was flames (52.1%) followed by scald (36.4%) for burns. While for poisoning, medications were the leading cause of (39.9%), followed by toxic household products (25.7%). Weighted mortality rates were 5.2% for overall injuries, 8.3% for fractures of the skull and spine, and 17.4% for burns. Conclusions MVC and falls are associated with the highest share of injuries in the kingdom. These findings can guide prevention efforts to reduce injury burden and improve population health. Further population-based research is warranted to explore the determinants of childhood injuries across all regions of Saudi Arabia.

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“…They identified a small but significant literature base that justified much of the clinical practice in this field, including the effectiveness of outpatient therapy, ready-to-use supplementary and therapeutic foods, antibiotics, and low-dose vitamin A for managing these children.While acute malnutrition has remained a long-term scourge in child mortality, unintentional injuries have increased in prevalence as construction and road traffic has increased. Strategies to prevent these injuries were reviewed effectively byTupetz and colleagues,31…”

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confidence: 99%

Global emergency medicine: A scoping review of the literature from 2020

Balhara

Bandolin²,

Bannon‐Murphy³

et al. 2021

Academic Emergency Medicine

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Objective: The objective was to identify, screen, highlight, review, and summarize some of the most rigorously conducted and impactful original research (OR) and review articles (RE) in global emergency medicine (EM) published in 2020 in the peerreviewed and gray literature. Methods: A broad systematic search of peer-reviewed publications related to global EM indexed on PubMed and in the gray literature was conducted. The titles and abstracts of the articles on this list were screened by members of the Global Emergency Medicine Literature Review (GEMLR) Group to identify those that met our criteria of OR or RE in the domains of disaster and humanitarian response (DHR), emergency care in resource-limited settings (ECRLS), and EM development. Those articles that | 1329 TREHAN ET Al.

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Prevention of childhood unintentional injuries in low- and middle-income countries: A systematic review

Cited by 39 publications

References 77 publications

Pediatric trauma burden in Tanzania: analysis of prospective registry data from thirteen health facilities

Pediatric trauma burden in Tanzania: analysis of prospective registry data from thirteen health facilities

Epidemiology of childhood injuries in Saudi Arabia: a scoping review

Global emergency medicine: A scoping review of the literature from 2020

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