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Published on: February 2, 2017
A Prospective Epidemiological Survey of Paediatric Trauma in Africa: A Cross-Sectional Study
Abdelbasit Elsayed Ali1, Adesoji O Ademuyiwa2, Kokila Lakhoo3
1Department of Paediatric Surgery, King Saud Medical City, Riyadh, Saudi Arabia.
Insights
Falls and motor vehicle crashes are the leading causes of pediatric trauma in the Pan African Paediatric Surgical Association (PAPSA) zone. Improving access to healthcare and specialized services is crucial to reduce child mortality and disability.
Area of Science:
- Pediatric Surgery
- Trauma Care
- Public Health
Background:
- Pediatric trauma is a significant global cause of child morbidity and mortality.
- Low- and middle-income countries face challenges in providing adequate pediatric trauma services due to insufficient information and funding.
Purpose of the Study:
- To assess the scale of pediatric trauma in the Pan African Paediatric Surgical Association (PAPSA) zone.
- To identify common causes of pediatric trauma and limiting factors for service provision.
- To define strategies for reducing potential mortality and disability from pediatric trauma.
Main Methods:
- Prospective data collection via an electronic form on the PAPSA platform.
- Analysis of pediatric major trauma cases admitted between April 2019 and June 2020.
- Inclusion of data on injury type, mechanism, severity, management, transport, and outcomes.
Main Results:
- Falls (36.53%) and motor vehicle crashes (MVCs) (33.15%) were the leading causes of injury in 531 pediatric trauma cases.
- Limb fractures (34.1%) and traumatic brain injury (20.9%) were the most common injuries.
- Significant challenges included long distances to healthcare facilities (up to 157 km), limited ambulance use (10.1%), and lack of primary care (70.2%).
Conclusions:
- Pediatric trauma is predominantly seen in children under 5 years old, with falls and MVCs as primary causes.
- Inadequate ambulance services and a shortage of subspecialty care (neurosurgery, orthopedics, rehabilitation) hinder effective trauma management.
- Implementing targeted recommendations is essential to alleviate the burden of pediatric trauma in the region.
Background:
Trauma is a leading cause of morbidity and mortality in children worldwide. There is a need for development and provision of efficient paediatric trauma services based on adequate information and funding which are lacking in low- and middle-income countries.
Aims:
This study was carried out to assess the scale of the problem, identify the most common causes of trauma in Pan African Paediatric Surgical Association (PAPSA) zone and to define the limiting factors for provision of the necessary services required to reduce the potential mortality and disability.
Materials And Methods:
Data were collected through an electronic form sent out in PAPSA platform. Members were requested to provide prospective data on all paediatric major trauma admitted to or seen at their health facilities between the beginning of April 2019 and the end of June 2020. Hospital location, child's age, gender, type of injury, mechanism of injury, severity, initial management, method of transport, time to arrive to hospital, availability of surgical specialities, length of hospital stay and injury outcome were analysed.
Results:
There were 531 entries. The mean age was 3.53 years and median age 1.34 years. Male-to-female ratio was 2:1. The leading causes for injuries were falls 194 (36.53%) and motor vehicle crashes (MVCs) 176 (33.15%) followed by obstetrical 42 (7.9%), thermal 27 (5.1%) and domestic injuries 22 (4.1%). The most common injuries were limb fractures 181 (34.1%) and traumatic brain injury 111 (20.9%). Public and private transport were used in 313 (58.9%), while ambulance service was used in only 54 (10.1%). Distances to a health facility varied between 1 and 157 km. 70.2% of cases did not receive any primary care, while definitive care was received in 95.5% of the cases. Outcome was full recovery in 90.6% of patients, morbidity in 8.1% and a mortality rate of 1.3%.
Conclusions:
Most of the injuries were in the under 5-year age group. The two main causes of trauma in children in this study were the falls from height and MVCs. Long distance travels to reach health-care facilities were noticeable in this study, together with substantial lack of adequate ambulance facilities and shortage in necessary subspecialty services such as neurosurgical, orthopaedics and rehabilitation. Implementing proposed recommendations can reduce the burden.
