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Risk factors of Non-fatal Unintentional Home Injuries among Children under 5 Years Old; a Population-Based Study
Sedigheh Nouhjah1, Sharareh R Niakan Kalhori2, Azadeh Saki3
1Social Determinants of Health Research Center, school of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.; Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Insights
Unintentional home injuries affect 30.7% of children under five, with burns and falls being common. Key risk factors include older age, living in Ahvaz city, and maternal illiteracy.
Area of Science:
- Pediatrics
- Public Health
- Injury Prevention
Background:
- Unintentional home injuries pose significant risks to children, leading to mortality, disability, and requiring extensive medical care.
- Millions of children worldwide experience temporary or permanent disability due to home-related incidents annually.
Purpose of the Study:
- To investigate the characteristics and identify risk factors associated with unintentional home injuries in children under five years of age.
- To develop a risk stratification model for predicting home injuries in young children.
Main Methods:
- A cross-sectional, population-based survey was conducted in Khuzestan province, Iran, involving 2693 children under five.
- Demographic and epidemiologic data on home injuries were collected, followed by multivariate logistic regression analysis to determine independent risk factors.
Main Results:
- 30.7% of children experienced at least one home injury, with burns (38.4%), falls (28.3%), and poisoning (8.7%) being the most frequent mechanisms.
- Independent risk factors identified include age ≥ 24 months, residing in Ahvaz city, maternal illiteracy, ethnicity, private housing, birth weight, and being the first child.
- The developed risk stratification model demonstrated a sensitivity of 53.5% and specificity of 84.8% with an Area Under the ROC Curve of 0.75.
Conclusions:
- Maternal illiteracy, older child age (≥ 24 months), being the first child, residing in Ahvaz city, and living in private housing are significant risk factors for home injuries in children.
- The study highlights the prevalence of specific injury mechanisms like burns and falls, emphasizing the need for targeted prevention strategies.
- The findings provide a foundation for developing effective risk stratification models and public health interventions to reduce childhood home injuries.
Introduction:
In addition to the annual mortality rate, unintentional home injury may result in temporary or permanent disability and requires medical attention and continuous care in millions of children. This study aimed to explore features and risk factors of these injuries.
Methods:
In this cross-sectional study, demographic variables and epidemiologic pattern of home injuries among children under 5 years of age were collected via a population-based survey in seven main cities of Khuzestan province, southwest Iran, during September 2011 to December 2012. Developing a risk stratification model, independent risk factors of unintentional home injury were determined and put to multivariate logistic regression analysis.
Result:
2693 children with the mean age of 27.36 ± 15.55 months (1 to 60) were evaluated (50.9% boy). 827 (30.7%) cases had a history of at least one home injury occurrence since birth to study time. The most common injury mechanisms were burning with 291 (38.4%) cases, falling with 214 (28.3%) and poisoning with 66 (8.7%) cases, respectively. The independent risk factors of unintentional home injury were age ≥ 24 month (p<0.001), residency in Ahvaz city (p<0.001), mother's illiteracy (p<0.014), ethnicity (p<0.001), private housing (p=0.01), birth weight (p<0.001), and being the first child (p=0. 01). Sensitivity, specificity, and area under the ROC curve of the model designed by multivariate analysis were 53.5%, 84.8%, and 0.75 (95% CI: 0.73- 0.77; P < 0.001, figure 1), respectively.
Conclusion:
According to the findings of this study, 30.7% of the studied children were injured at least once since birth. Burning, falling, poisoning, swallowing objects, choking, and biting were the main home injury mechanisms. Age ≥ 24 months, being the first child, living in a private house, being a resident of Ahvaz city, and having an illiterate mother were found to be risk factors of home injury.
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