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Epidemiology of head injury in Malaysian children: a hospital-based study
J Rohana1, L C Ong, A Abu Hassan
1Department of Paediatrics, Universiti Kebangsaan Malaysia.
Insights
Accidental head injuries in children, primarily from falls and road traffic accidents, highlight the need for better safety measures. Lack of adult supervision and protective devices contributed to severe outcomes, including fatalities.
Area of Science:
- Pediatrics
- Trauma Surgery
- Public Health
Background:
- Accidental head injuries are a significant cause of morbidity and mortality in children.
- Understanding the specific circumstances and causes of these injuries is crucial for developing effective prevention strategies.
Purpose of the Study:
- To determine the proportion of accidental head injuries among children presenting to an emergency department.
- To identify the leading causes and circumstances of these injuries in pediatric patients.
Main Methods:
- A prospective observational study was conducted at the Emergency Department, Hospital Kuala Lumpur.
- Data were collected from November 1993 to January 1994 on children under 14 years presenting with accidental head injuries.
Main Results:
- Accidental head injuries constituted 4.75% of all emergency department cases.
- Falls (63%) were the leading cause, followed by road traffic accidents (RTA) (30.7%).
- Over half of RTA injuries involved pedestrians, particularly in the 5-14 age group, often without adult supervision. No protective devices were used in vehicle-related injuries, and all fatalities occurred in this group.
Conclusions:
- There is a need for stricter enforcement of laws regarding protective devices in vehicles.
- Interventions to reduce child pedestrian injuries and address lack of adult supervision are essential.
- Public health initiatives should focus on preventing falls and improving safety during RTA.
Abstract:
A prospective observational study was carried out at the Emergency Department, Hospital Kuala Lumpur to determine the proportion of accidental head injury among children and the circumstances of injury. The study was carried out from November 1993 to January 1994 on all children below 14 years who presented to the Emergency Department with accidental head injury. Accidental head injury made up (4.75%) of all cases seen at the Casualty Department. The ratio of boys to girls was 2:1. The mean age of head injured children was 5.2 (S.D. 3.63) years. The leading cause of head injury was fall (63%) followed by road traffic accidents (RTA) in (30.7%) while the rest were due to 'impact' (injury caused by flying object or missiles) injuries. More than half (54.4%) of those injured in RTA were pedestrians. Pedestrian injury was particularly important in the 5-< 14 years age group, where adult supervision was lacking in two thirds of the children. None of the patients who were involved in vehicle-related injuries had used a suitable protective or restraining device. All three patients who died were from this group. This study emphasises the need for stricter enforcement of laws related to the use of protective devices and measures to decrease child pedestrian injury. The issues of lack of adult supervision, both in and outside the home need to be addressed.