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Interpersonal Violence-Related Trauma Among South African Children
Arushi Biswas1, Daniel S Rhee1, Adam D Laytin2
1Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Insights
Pediatric interpersonal violence (IPV) injuries are a significant concern in South Africa, with distinct patient demographics and injury patterns observed in trauma centers. Further research is crucial to address the needs of this vulnerable pediatric population.
Area of Science:
- Trauma Surgery
- Pediatric Emergency Medicine
- Public Health
Background:
- Injuries significantly contribute to childhood disability-adjusted life years globally, with a disproportionate impact on low- and middle-income countries.
- While motor vehicle collisions and self-harm injuries in children are well-documented in South Africa, injuries from interpersonal violence (IPV) remain less understood.
- This study addresses the knowledge gap regarding pediatric IPV-related injuries in a South African trauma setting.
Purpose of the Study:
- To characterize the injury patterns, management strategies, and outcomes of pediatric patients presenting with IPV-related injuries.
- To compare the characteristics and outcomes of pediatric IPV trauma patients with those of non-IPV trauma patients.
- To highlight the unique clinical needs of children experiencing IPV.
Main Methods:
- A retrospective review of trauma patients aged 18 years or younger was conducted.
- Data were collected from the Pietermaritzburg Metropolitan Trauma Service between 2012 and 2022.
- Patients with IPV-related injuries were compared to those with non-IPV injuries, with descriptive analysis of patient and injury characteristics and outcomes.
Main Results:
- Out of 2155 trauma admissions, 500 (23.2%) were attributed to IPV.
- The majority of IPV patients were male (81.4%) with a median age of 16.0 years, experiencing predominantly blunt (54.2%) or penetrating (44.2%) trauma.
- Commonly used weapons included knives (21.6%), stones (11.2%), and firearms (11.0%), with the head (56.4%), abdomen (20.8%), and thorax (19.2%) being the most frequently injured regions.
Conclusions:
- Pediatric patients with IPV-related injuries represent a distinct subgroup within trauma populations.
- These patients exhibit different demographic profiles, injury patterns, and require specific clinical management.
- Further investigation is essential to comprehensively understand and address the needs of this under-recognized group of pediatric trauma patients.
Introduction:
Injuries account for a major portion of disability-adjusted life years in children globally, and low-and middle-income countries are disproportionally affected. While injuries due to motor vehicle collisions and self-harm have been well-characterized in pediatric populations in South Africa, injuries related to interpersonal violence (IPV) are less understood. Our study aims to characterize patterns of injury, management, and outcomes for pediatric patients presenting with IPV-related injuries in a South African trauma center.
Methods:
We performed a retrospective review of trauma patients ≤18 y of age presenting to the Pietermaritzburg Metropolitan Trauma Service in Gray's Hospital in South Africa from 2012 to 2022, comparing those with injuries resulting from IPV to those with non-IPV injuries. Patients' and injury pattern characteristics and outcomes were descriptively analyzed.
Results:
Out of 2155 trauma admissions, 500 (23.2%) had IPV-related injuries. Among patients with IPV-related injuries, the median age was 16.0 y. 407 (81.4%) patients were male. 271 (54.2%) patients experienced blunt trauma, 221 (44.2%) had penetrating trauma, and 3 (0.6%) suffered both. The most common weapons were knives (21.6%), stones (11.2%), and firearms (11.0%). The most commonly injured regions were the head (56.4%), abdomen (20.8%), and thorax (19.2%). 19.6% underwent surgical intervention, and 14.4% were referred out for subspecialty care. 1.4% patients died, and 1.2% returned to Pietermaritzburg Metropolitan Trauma Service within 30 d of discharge.
Conclusions:
IPV patients are a distinctive subgroup of pediatric trauma patients with different demographics, patterns of injury, and clinical needs. Further research is needed to better understand the unique needs of this neglected population.
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