Global childhood unintentional injury surveillance in four cities in developing countries: a pilot study
Adnan A Hyder1, David E Sugerman, Prasanthi Puvanachandra
1Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. ahyder@jhsph.edu
Insights
Childhood injuries are common in low-income countries, with falls and road traffic incidents being leading causes. This study highlights the need for systematic surveillance to understand injury patterns and risk factors.
Area of Science:
- Global Health
- Pediatric Injury Epidemiology
- Public Health Surveillance
Background:
- Childhood injuries pose a significant public health challenge in low-income countries.
- Emergency departments (EDs) are critical points for data collection on unintentional injuries.
- Existing data on the frequency and nature of childhood injuries in these settings are limited.
Purpose of the Study:
- To determine the frequency and nature of childhood injuries in low-income countries.
- To explore risk factors associated with childhood injuries.
- To utilize emergency department (ED) surveillance data for injury research.
Main Methods:
- Pilot phase of the multi-country Global Childhood Unintentional Injury Surveillance (GCUIS) project.
- Sequential sampling of children under 11 years presenting to EDs in Bangladesh, Colombia, Egypt, and Pakistan in 2007.
- Data collected over a 3-4 month period at each site.
Main Results:
- 1559 injured children were analyzed; 65% were male, 60% were aged 5 years or older.
- Injuries were most frequent in the morning (34%), occurring at home (56%) or during play (63%).
- Falls (56%), road traffic injuries (22%), and burns (13%) were the most common injury types. Drowning and road traffic injuries had the highest severity scores.
Conclusions:
- Hospitals in low-income countries face a substantial burden from childhood injuries.
- Systematic surveillance is essential for identifying injury epidemiology and risk factors.
- Standardized surveillance methods enable international comparisons and identification of common injury issues.
Objective:
To determine the frequency and nature of childhood injuries and to explore the risk factors for such injuries in low-income countries by using emergency department (ED) surveillance data.
Methods:
This pilot study represents the initial phase of a multi-country global childhood unintentional injury surveillance (GCUIS) project and was based on a sequential sample of children < 11 years of age of either gender who presented to selected EDs in Bangladesh, Colombia, Egypt and Pakistan over a 3-4 month period, which varied for each site, in 2007.
Findings:
Of 1559 injured children across all sites, 1010 (65%) were male; 941 (60%) were aged >or= 5 years, 32 (2%) were < 1 year old. Injuries were especially frequent (34%) during the morning hours. They occurred in and around the home in 56% of the cases, outside while children played in 63% and during trips in 11%. Of all the injuries observed, 913 (56%) involved falls; 350 (22%), road traffic injuries; 210 (13%), burns; 66 (4%), poisoning; and 20 (1%), near drowning or drowning. Falls occurred most often from stairs or ladders; road traffic injuries most often involved pedestrians; the majority of burns were from hot liquids; poisonings typically involved medicines, and most drowning occurred in the home. The mean injury severity score was highest for near drowning or drowning (11), followed closely by road traffic injuries (10). There were 6 deaths, of which 2 resulted from drowning, 2 from falls and 2 from road traffic injuries.
Conclusion:
Hospitals in low-income countries bear a substantial burden of childhood injuries, and systematic surveillance is required to identify the epidemiological distribution of such injuries and understand their risk factors. Methodological standardization for surveillance across countries makes it possible to draw international comparisons and identify common issues.
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