Epidemiology Of Pediatric Injuries Research Articles

Pediatric injury during conflict and prolonged insecurity in Iraq from 2003–2014

Injury disproportionately affects low- and middle-income countries, and in Iraq, this risk has been compounded by conflict and insecurity since the Coalition invasion in 2003. Children in such settings are particularly vulnerable; yet, the epidemiology of pediatric injury during conflict has not been previously described. This study aimed to characterize the pattern and outcomes of pediatric injury in Baghdad, Iraq from 2003-2014. We conducted a cluster-randomized, cross-sectional, community-based survey in Baghdad in 2014 to determine the epidemiology and impact of injuries since 2003. This study details the injury patterns and outcomes among children (ie, <18years of age) as well as care sought and provided. A total of 900 households, which represented 5,148 persons, were surveyed. There were 152 pediatric injuries from 2003-2014 (28% of all injuries). The incidence of childhood injury during the study period was 6.5 per 1,000 life years. The most common cause of injury was fall (52 injuries; 34% of pediatric injuries) followed by road traffic crash (32; 22%). Fifteen percent of pediatric injuries were directly related to conflict (22 injuries). There were 10 reported deaths (7% of pediatric injuries). Although falls and road traffic crashes were the most common causes of childhood injury, conflict was directly responsible for 1 in 6 injuries. The number of pediatric injuries that resulted in death far exceeded that of low- and middle-income countries unaffected by conflict. These findings reflect the importance of pediatric injury prevention, protection of vulnerable populations, and essential trauma care during conflict.

Pediatric Orthopedic Injuries Following an Earthquake: Experience in an Acute-Phase Field Hospital.

Following the 2010 earthquake in Haiti, the Israel Defense Forces Medical Corps deployed a field hospital in Port au Prince. The purpose of this study was to characterize the injuries sustained by the pediatric population treated in the hospital and examine the implications for planning deployment in future similar disasters. Medical records of children treated in the hospital were reviewed and compared with medical records of the adult population. A total of 1,111 patients were treated in the hospital. Thirty-seven percent were aged 0 to 18 years. Earthquake-related injuries were the cause of admission in 47% of children and 66% of adults. Forty-seven percent of children with traumatic injuries sustained fractures. Seventy-two percent were in the lower limbs, 19% were in the upper limbs, and 9% were in the axial skeleton, with the femur being the most common long bone fractured compared with the tibia in adults. There were four functional operating theaters, and treatment guidelines were adjusted to the rapidly changing situation. Soft tissue injuries were treated by aggressive debridement. Fractures were stabilized by external fixation or casting. Amputation was performed only for nonviable limbs or life-threatening sepsis. Children were more likely than adults to undergo surgery (44% vs. 29% of trauma patients). To maximize hospital surge capacity, minor procedures were performed in the wards under sedation, and patients were discharged after an average of 1.4 days, with subsequent follow-up in the clinic. Children constitute a high percentage of patients in a developing country. The epidemiology of pediatric injuries following an earthquake differs significantly from that encountered in everyday practice and compared with that in adults. Children sustain a significantly higher percentage of femoral fractures and are more likely to require surgery. The shift to nontraumatic reasons for admission occurred earlier in the pediatric population than in adults. Organizations providing post-earthquake relief are usually geared toward adult populations and will require supplementation of both manpower and equipment specifically suited for treatment of pediatric patients. Early deployment teams should be adequately staffed with adult and pediatric orthopedists.

Pediatric orthopedic injuries following an earthquake

Following the 2010 earthquake in Haiti, the Israel Defense Forces Medical Corps deployed a field hospital in Port au Prince. The purpose of this study was to characterize the injuries sustained by the pediatric population treated in the hospital and examine the implications for planning deployment in future similar disasters. Medical records of children treated in the hospital were reviewed and compared with medical records of the adult population. A total of 1,111 patients were treated in the hospital. Thirty-seven percent were aged 0 to 18 years. Earthquake-related injuries were the cause of admission in 47% of children and 66% of adults. Forty-seven percent of children with traumatic injuries sustained fractures. Seventy-two percent were in the lower limbs, 19% were in the upper limbs, and 9% were in the axial skeleton, with the femur being the most common long bone fractured compared with the tibia in adults.There were four functional operating theaters, and treatment guidelines were adjusted to the rapidly changing situation. Soft tissue injuries were treated by aggressive debridement. Fractures were stabilized by external fixation or casting. Amputation was performed only for nonviable limbs or life-threatening sepsis. Children were more likely than adults to undergo surgery (44% vs. 29% of trauma patients). To maximize hospital surge capacity, minor procedures were performed in the wards under sedation, and patients were discharged after an average of 1.4 days, with subsequent follow-up in the clinic. Children constitute a high percentage of patients in a developing country. The epidemiology of pediatric injuries following an earthquake differs significantly from that encountered in everyday practice and compared with that in adults. Children sustain a significantly higher percentage of femoral fractures and are more likely to require surgery. The shift to nontraumatic reasons for admission occurred earlier in the pediatric population than in adults. Organizations providing post-earthquake relief are usually geared toward adult populations and will require supplementation of both manpower and equipment specifically suited for treatment of pediatric patients. Early deployment teams should be adequately staffed with adult and pediatric orthopedists. Epidemiologic study, level IV.

Epidemiology of paediatric injury in low income environment: Value of hospital based data prior to the institution of a formal registration system

Little attention is generally paid to paediatric injuries, especially in low income settings. The aim of this study is to provide an overview of the epidemiology of hospital-based paediatric injuries in a semi-urban area in Cameroon prior to the initiation of a formal registration system. A sixteen items data collection sheet derived from a newly instituted trauma registry is used to retrospectively gather hospital-based basic information about epidemiology of injuries in patients aged 15 years or below in a low income setting. Two hundred and seventy seven cases representing 16% of all injury cases could be analysed. The frequency of injuries significantly increased with age with a peak between 11 and 15 years (P < 0.001). Children in school playgrounds carried a significantly higher risk of sustaining an injury (P < 0.001). Falls and interpersonal violence were the most frequent mechanisms. The face and locomotor systems were the most commonly involved. More than 60% of patients were discharged back home. The data from the present registration system seem to indicate a higher injury rate in pre-adolescent children and in the school playground. The institution of a formal registration system is likely to improve the quality of data recording system.

Epidemiology of pediatric injury in Malawi: Burden of disease and implications for prevention

Epidemiology of pediatric injury in Malawi: Burden of disease and implications for prevention