Unintentional Childhood Injury Patterns, Odds, and Outcomes in Kampala City: an analysis of surveillance data from the National Pediatric Emergency Unit

Abstract

Abstract:Background:Unintentional Childhood Injuries pose a major public health challenge in Africa and Uganda. Previous estimates of the problem may have underestimated the childhood problem. We set to determine unintentional childhood injury pattern, odds, and outcomes at the National Paediatric Emergency unit in Kampala city using surveillance data.Methods:Incident proportions, odds and proportional rates were calculated and used to determine unintentional injury patterns across childhood (1-12 years).Results:A total of 556 cases recorded between January and May 2008 were analyzed: majority had been transported to hospital by mothers using mini-buses, private cars, and motorcycles. Median distance from injury location to hospital was 5 km. Homes, roads, and schools were leading injury locations. Males constituted 60% of the cases. Play and daily living activities were commonest injury time activities. Falls, burns and traffic accounted for 70.5% of unintentional childhood injuries. Burns, open wounds, fractures were commonest injury types. Motorcycles, buses and passenger-cars caused most crashes. Play grounds, furniture, stairs and trees were commonest source of falls. Most burn injuries were caused by liquids, fires and hot objects. 43.8% of cases were admitted. 30% were discharged without disability; 10%, were disabled; 1%, died. Injury odds and proportional incidence rates varied with age, place and cause. Poisoning and drowning were rare. Local pediatric injury priorities should include home, road and school safety.Conclusions:Unintentional injuries are common causes of hospital visit by children under 13 years especially boys. Homes, roads and educational facilities are commonest unintentional injury sites. Significant age and gender differences exist in intentional injury causation, characteristics and outcomes. In its current form, our surveillance system seems inefficient in capturing poisoning and drowning. The local prevention priorities could include home, road and school safety; especially dissemination and uptake of proven interventions. Burns should be focus of domestic injury prevention among under-fives. Commercial passenger motorcycles require better regulation and control.

The burden of trauma in four rural district hospitals in Malawi: A retrospective review of medical records

“…These proportions, which indicate a higher rate of injury among males than females, especially among adults, are similar to those reported from other studies in Malawi [12,13] as well as studies from Ethiopia [14], Kenya [15][16][17], Mozambique [18], Rwanda [19], South Africa [20], Tanzania [21], and Uganda [22,23].…”

“…Among children aged 0-16 years, the most common types of injury in a 2008-2010 study in Lilongwe were concussions (24.9%), fractures (21.7%), lacerations (16.5%), and burns (11.0%) [12]. No pattern for the distribution of injury types was clear from other reports from sub-Saharan Africa, perhaps because of differences in how mild and severe injuries (and inpatients versus outpatients) were tallied [15,23,27]. It is likely that soft tissue injuries account for most mild injuries but are not a major cause of severe injury.…”

Injury surveillance in a rural sub-Saharan setting: Results from a surveillance initiative in Nzega District, Tanzania

“…In these circumstances, the physician had to rely on their estimates. Also like Mutto et al (2011) we faced challenges capturing the occurrence of poisonings and drownings within the injury surveillance period. Mutto et al (2011) cited a triage issue for why poisonings are under-reported.…”

“…Also like Mutto et al (2011) we faced challenges capturing the occurrence of poisonings and drownings within the injury surveillance period. Mutto et al (2011) cited a triage issue for why poisonings are under-reported. Poisonings were likely to go directly to a medical department, and not a surgical ward where the injury surveillance was occurring.…”

Acidentes Domésticos Em Crianças: Concepções Práticas Dos Agentes Comunitários De Saúde

“…Quanto ao contexto internacional do problema, uma pesquisa realizada na cidade de Kampala na África, com crianças menores de 13 anos, que foram involuntariamente feridas, referiu que dos 556 pacientes registrados no hospital, 47% eram menores de cinco anos. Em relação aos ambientes domésticos, estes representaram 54,8% dos locais de maior ocorrência de lesões não intencionais na infância (4) . No Brasil, um estudo realizado com 7.123 crianças de idade inferior a 10 anos, evidenciou que 96,8% foram vítimas de acidentes, a maioria das ocorrências (66,6%) incidiu no domicílio, tendo o corte como lesão mais frequente (35,7%).…”