Prevention of childhood unintentional injuries in low- and middle-income countries: A systematic review.

Anna Tupetz,Joao Ricardo Nickenig Vissoci,Catherine A Staton,Kaitlyn Friedman,Huipeng Liao,Duan Zhao,Elizabeth M Keating,Megan Von Isenburg,Abraham Salinas-Miranda

doi:10.1371/journal.pone.0243464

Abstract

Injuries are a leading cause of death and disability among children. Numerous injury prevention strategies have been successful in high-income countries, but the majority of unintentional injuries happen to children living in low- and middle-income countries (LMICs). This project aims to delineate the childhood injury prevention initiatives in LMICs. For inclusion, peer-reviewed articles needed to address unintentional injury, include children <18, assess a prevention-related intervention, contain a control group, and be published after 1988. Two pairs of reviewers evaluated articles independently to determine study eligibility. 74 articles were included. 30 studies addressed road traffic injuries, 11 drowning, 8 burns, 3 falls, 8 poisonings, and 21 an unspecified injury type. The findings show positive effects on injury outcome measures following educational interventions, the need for longer follow-up periods after the intervention, the need for effectiveness trials for behavior change, and the need for an increase in injury prevention services in LMICs. This is the first systematic review to summarize the prevention initiatives for all types of childhood unintentional injuries in LMICs. Increased attention and funding are required to go beyond educational initiatives with self-reported measures and little follow-up time to robust interventions that will reduce the global burden of unintentional injuries among children.

Highlights

Five million deaths are attributed to injury globally every year, and 12% of these are among children [1]
We only included studies conducted in low and middle-income countries (LMICs), the geographic regions of first authors included Argentina, Bangladesh, Brazil, China, Colombia, Cuba, Denmark, Germany, Indonesia, Iran, Kenya, Mexico, The Netherlands, Pakistan, Peru, Saudi Arabia, South Africa, Sweden, Uganda, the United Kingdom, the United Republic of Tanzania, the United States, and the West Indies
26% (n = 5) of the RCTs addressed road traffic injuries (RTI), 37% (n = 7) non-specific or all injury categories, 21% (n = 4) addressed drowning, and 16% (n = 4) examined burns, falls, or poisonings (Fig 4B). This is the first systematic review evaluating all types of childhood unintentional injury prevention initiatives in LMICs published within the past 30 years, building on the 2008 World Health Organization (WHO) report on Child Injury Prevention

Summary

Introduction

Five million deaths are attributed to injury globally every year, and 12% of these are among children [1]. Injuries are a leading cause of death and disability among children [2]. Over 900,000 children under the age of 18 die every year due to unintentional injuries [2]. We identified the current state of childhood injury prevention programs in low and middle-income countries (LMICs), including seemingly effective intervention methods as well as challenges and gaps in current research efforts.

Objectives

Methods

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Discussion

Conclusion