Abstract
BackgroundChild survival initiatives historically prioritized efforts to reduce child morbidity and mortality from infectious diseases and maternal conditions. Little attention has been devoted to paediatric injuries in resource‐limited settings. This study aimed to evaluate the demographics and outcomes of paediatric injury in a sub‐Saharan African country in an effort to improve prevention and treatment.MethodsA prospective trauma registry was established at the two university teaching campuses of the University of Rwanda to record systematically patient demographics, prehospital care, initial physiology and patient outcomes from May 2011 to July 2015. Univariable analysis was performed for demographic characteristics, injury mechanisms, geographical location and outcomes. Multivariable analysis was performed for mortality estimates.ResultsOf 11 036 patients in the registry, 3010 (27·3 per cent) were under 18 years of age. Paediatric patients were predominantly boys (69·9 per cent) and the median age was 8 years. The mortality rate was 4·8 per cent. Falls were the most common injury (45·3 per cent), followed by road traffic accidents (30·9 per cent), burns (10·7 per cent) and blunt force/assault (7·5 per cent). Patients treated in the capital city, Kigali, had a higher incidence of head injury (7·6 per cent versus 2·0 per cent in a rural town, P < 0·001; odds ratio (OR) 4·08, 95 per cent c.i. 2·61 to 6·38) and a higher overall injury‐related mortality rate (adjusted OR 3·00, 1·50 to 6·01; P = 0·019). Pedestrians had higher overall injury‐related mortality compared with other road users (adjusted OR 3·26, 1·37 to 7·73; P = 0·007).ConclusionPaediatric injury is a significant contributor to morbidity and mortality. Delineating trauma demographics is important when planning resource utilization and capacity‐building efforts to address paediatric injury in low‐resource settings and identify vulnerable populations.
Highlights
Global health initiatives have historically prioritized infectious diseases and maternal conditions in efforts to reduce child morbidity and mortality
Overall trends in global childhood mortality have decreased in the past 20 years, yet profound inequity persists among low- and middle-income countries (LMICs)[1]
This study has demonstrated that the Rwanda Injury Registry was successful in documenting the injury epidemiology and outcome of children with injuries presenting at the two main referral hospitals in the country
Summary
Global health initiatives have historically prioritized infectious diseases and maternal conditions in efforts to reduce child morbidity and mortality. The Global Burden of Disease Study 20132 revealed that less than 20 per cent of developing countries had achieved Millennium Development Goal 4, which aimed to reduce the under-five mortality rate by two-thirds between 1990 and 2015. Child survival initiatives historically prioritized efforts to reduce child morbidity and mortality from infectious diseases and maternal conditions. This study aimed to evaluate the demographics and outcomes of paediatric injury in a sub-Saharan African country in an effort to improve prevention and treatment. Paediatric patients were predominantly boys (69⋅9 per cent) and the median age was 8 years. Delineating trauma demographics is important when planning resource utilization and capacity-building efforts to address paediatric injury in low-resource settings and identify vulnerable populations
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