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Paediatric trauma in the rural developing world: low cost measures to improve outcome
C N Mock1, D Denno, E S Adzotor
1Holy Family Hospital, Berekum, Ghana.
Insights
Paediatric trauma in rural Africa, particularly burns, leads to significant mortality and disability. Early intervention and targeted prevention strategies are crucial for improving outcomes in injured children.
Area of Science:
- Pediatric Trauma Care
- Injury Epidemiology
- Global Health
Background:
- Injuries pose a significant threat to child survival and well-being in rural developing settings.
- Understanding the specific patterns and outcomes of pediatric trauma is essential for targeted interventions.
Purpose of the Study:
- To identify factors influencing survival and functional outcomes in children admitted with injuries to a rural African hospital.
- To inform prevention and management strategies for pediatric trauma in resource-limited environments.
Main Methods:
- Retrospective review of 181 injured children admitted between 1987 and 1990.
- Analysis of injury types, presentation times, previous treatments, Injury Severity Score (ISS), and outcomes (mortality and disability).
Main Results:
- Burns were the most frequent injury (39%), predominantly domestic scalds in young children.
- A majority of patients (65%) presented late (>24h post-injury) and untreated (81%).
- Major disability affected 14% of survivors, linked to ISS, extremity injury, and delayed presentation; mortality correlated with ISS.
Conclusions:
- Domestic burn prevention in young children is critical.
- Enhanced care for extremity injuries and burns, alongside utilizing non-medical health workers in remote areas, can reduce pediatric trauma mortality and disability.
Abstract:
We reviewed 181 injured children admitted to a rural African hospital from 1987 to 1990 to ascertain factors influencing survival and functional outcome. Burns were the most common (39 per cent), occurred in the youngest patients, and were due to domestic scalding in 54 per cent of cases. Of the patients, 65 per cent presented more than 24 h after injury and 81 per cent presented without any previous treatment. Major disability occurred in 14 per cent of survivors and was associated with Injury Severity Score (ISS), extremity injury, and delayed presentation. Mortality was associated with the ISS. The mean ISS was 6.3. An ISS of 20-25 was associated with 75 per cent mortality. Trauma caused 8 per cent of hospital deaths in the 5-19 years age group. To reduce the mortality and disability from paediatric trauma in the rural developing world, we recommend: (i) prevention strategies targeting domestic burns in younger children, (ii) increased attention to care of extremity injuries and burns, and (iii) increased use of non-medical health care providers in more remote areas.