Incidence Of Unintentional Injuries Research Articles

Unintentional injury and its associated factors among left-behind children: a cross-sectional study

BackgroundUnintentional injuries among children and adolescents are a major public health problem worldwide. These injuries not only have negative effects on children’s physiology and psychology, but also bring huge economic losses and social burdens to families and society. Unintentional injuries are the leading cause of disability and death among Chinese adolescents, and left-behind children (LBC) are more prone to experience unintentional injury. The purpose of this study was to evaluate the type and incidence of unintentional injury among Chinese children and adolescents and explore the influences of personal and environmental factors by comparing the differences between LBC and not left-behind children (NLBC).MethodsThis cross-sectional study was conducted in January and February 2019. Additionally, 2786 children and adolescents from 10 to 19 years old in Liaoning Province in China were collected in the form of self-filled questionnaires, including Unintentional Injury Investigation, Unintentional Injury Perception Questionnaire, Multidimensional Subhealth Questionnaire of Adolescent (MSQA), Negative life events, “My Class” questionnaire and Bullying/victim Questionnaire. Multiple logistic regression analysis was used to explore the factors associated with unintentional injury among children and adolescents. Binary logistic regression analysis was used to explore the factors affecting unintentional injuries between LBC and NLBC.ResultsThe top three unintentional injuries were falling injuries (29.7%), sprains (27.2%) and burns and scalds (20.3%) in our study population. The incidence of unintentional injuries in LBC was higher than that in NLBC. Burn and scalds, cutting injury and animal bites in LBC were higher than those in NLBC. The results show that junior high school students (odds ratio (OR) = 1.296, CI = 1.066–1.574) were more likely to report multiple unintentional injuries than primary school students. Girls (OR = 1.252, CI = 1.042–1.504) had higher odds of reporting multiple unintentional injuries. The odds of multiple injuries in children and adolescents with low levels of unintentional injury perception were higher than those in children and adolescents with high levels of unintentional injury perception (OR = 1.321, C = 1.013–1.568). Children and adolescents with a higher levels of mental health symptoms (OR = 1.442, CI = 1.193–1.744) had higher odds of reporting multiple unintentional injuries. Compared with teenagers who had never experienced negative life events, teenagers who had experienced negative life events many times (OR = 2.724, CI = 2.121–3.499) were more likely to suffer unintentional injuries many times. Low-level discipline and order (OR = 1.277, CI = 1.036–1.574) had higher odds of reporting multiple unintentional injuries. In-school adolescents who were bullied were more likely to report being injured multiple times than their counterparts who were not bullied (OR = 2.340, CI = 1.925–2.845). Low levels of unintentional injury perception, experienced negative life events and bullying had greater impacts on LBC than on NLBC.ConclusionThe survey found that the incidence of at least one unintentional injury was 64.8%. School level, sex, unintentional injury perception, subhealth, negative life events, discipline and order and bullying were associated with incidents of unintentional injury. Compared with NLBC, LBC had a higher incidence of unintentional injury, and special attention should be given to this group.

Development and validation of risk behavior scale for in-home unintentional injury in urban children aged 0-6 years in China

Objective: To develop and evaluate the reliability and validity of risk behavior scale for in-home unintentional injury in urban children aged 0-6 years in China. Methods: Through literature review, expert consultation and pre-survey, the final scale was determined with 10 dimensions and 54 items. A total of 1 104 children aged 0-6 years were randomly selected by using multi-stage stratified cluster sampling in the urban area of Changsha and their guardians were invited to participate in this questionnaire survey. The information about the basic characteristics, incidence of unintentional injury and risk behaviors of the children were collected. Cronbach's α coefficient and split-half reliability were used to evaluate the reliability of the scale. Pearson correlation coefficient, Spearman correlation coefficient and factor analysis were used to evaluate the content validity and structural validity of the scale respectively. The children were divided into two groups according to the incidence of unintentional injury, and t-test was used to analyze the discriminant validity of the scale. Results: The children risk behavior scale had 54 items in 10 dimensions. A total of 1 094 valid questionnaires were returned and the effective response rate was 99.09%. The incidence of unintentional injury in the children was 18.65% (204/1 104). The Cronbach's α coefficient of the scale was 0.94, and the split-half reliability was 0.87. The Pearson correlation coefficients between each dimension and the total scale were 0.50-0.84 (all P<0.001). A total of 11 common factors were extracted from the total scale, and the cumulative variance contribution rate was 56.52%. The average factor load of 54 items was more than 0.30. The fitting indexes of the scale were 0.06 for root mean square error of approximation, 0.78 for comparative fit index, 0.79 for goodness-of-fit index, and 0.77 for adjusted goodness-of-fit index. The children with injuries had higher scores than those without injuries, the difference was significant (P<0.001). Conclusion: The scale developed has good reliability and validity on assessing the risk behaviors of unintentional injury in urban children in China.

A Mixed-Method Study on Recurrent Unintentional Injuries in Children and Adolescents in a Rural Area of Delhi

Introduction: Unintentional injuries are largely preventable causes of death and disability in children. Understanding the extent of the problem and its contributing factors will help us in addressing them and thus prevent their occurrence to a great extent. Methodology: It is a mixed-method study, which is a part of a funded research project on unintentional childhood injuries, conducted in two villages of Delhi, on 397 children and adolescents. Quantitative data for occurrence of injuries was collected over 16 months during the period 1st September 2017-31st December 2018. Outcome variables included incidence of unintentional childhood injuries, knowledge of subjects regarding injuries and their prevention, family practices for injury prevention and treatment seeking behavior as reported by subjects, safety score regarding domestic and peridomestic environment, and danger signs within the house. Subjects with three or more incidents of unintentional injuries during the entire period of data collection were considered to have recurrent injuries and were classified as belonging to high-risk group. The qualitative part of the study included in-depth interview of subjects who suffered from recurrent injuries and their guardians in their families. Total 13 children were identified as high-risk group, of which three were below 10 years of age and hence were not interviewed. Purpose of interview was to assess the perception of each adolescent subject and his/her guardian in the family, regarding possible reasons for occurrence of recurrent injuries and the ways in which injuries can be prevented in these subjects. Results: Recurrent injuries occurred in 3.28% of total population, significantly more in male subjects. Mean age of the recurrently injured subjects and mean age of their guardians were lower than the corresponding uninjured group. Rate ratio and rate difference indicated greater vulnerability of the high-risk group of subjects. KAP scores of mothers and practice of families were significantly lower in the high-risk group than the other group. The main reasons for injury occurrence mentioned by both subjects and their guardians were that children are careless, naughty, fight with other children, and since parents do not stay at home there is no one to monitor them. Work-related injuries were also stated. Other than preventing the reasons for recurrent injuries stated by both the groups, some more measures were suggested. These were to keep the community clean as one major injury had occurred due to unclean surroundings, take help from close neighbors, particularly by working mothers of nuclear families, and elder siblings to take care of their younger siblings. Conclusion: Deeper understanding of the factors associated with unintentional injuries in specific cases provides a scope for targeted interventions. Educational programs and training of the people in the community and counseling members of the concerned families, will significantly help in prevention of injuries.

Day care as a strategy for drowning prevention in children under 6 years of age in low- and middle-income countries.

Drowning is responsible for an estimated 320,000 deaths a year, and over 90% of drowning mortality occurs in low- to middle-income countries (LMICs), with peak drowning rates among children aged 1 to 4 years. In this age group, mortality due to drowning is particularly common in rural settings and about 75% of drowning accidents happen in natural bodies of water close to the home. Providing adequate child supervision can protectchildren from drowning, and organized formal day care programs could offer a way to achieve this. Primary objective • To assess the effects of day care programs for children under 6 years of age on drowning-related mortality or morbidity, or on total drowning accidents (fatal and non-fatal), in LMICs, compared to no day care programs or other drowning prevention interventions Secondary objectives • To assess the effects of day care programs in LMICs for children under 6 years of age on unsafe water exposure • To assess safety within these programs (e.g. transmission of infection within day care, physical or sexual abuse of children within day care) • To assess the incidence of unintentional injury within these programs • To describe the cost-effectiveness of such programs, in relation to averted drowning-related mortality or morbidity SEARCH METHODS: On November 23, 2019, and for an update on August 18, 2020, we searched MEDLINE (PubMed), Embase, CENTRAL, ERIC, and CINAHL, as well as two trial registries. On December 16, 2019, and for an update on February 9, 2021, we searched 12 other resources, including websites of organizations that develop programs targeted to children. We included randomized, quasi-randomized, and non-randomized controlled studies (with explicitly listed specific study design features) that implemented formal day care programs as a single program or combined with additional out-of-day care components (such as educational activities aimed at preventing injury or drowning or early childhood development activities) for children of preschool age (below 6 years of age) in LMICs for comparison with no such programs or with other drowning prevention interventions. Studies had to report at least one outcome related to drowning or injury prevention for the children enrolled. Two review authors independently performed study selection and data extraction, as well as risk of bias and GRADE assessment. Two non-randomized observational studies, conducted in rural Bangladesh, involving a total of 252,631 participants, met the inclusion criteria for this review. One of these studies compared a formal day care program combined with parent education, playpens provided to parents, and community-based activities as additional out-of-day care components versus no such program. Overall we assessed this study to be at moderate risk of bias (moderate risk of bias due to confounding, low risk of bias for other domains). This study showed that implementation of a formal day care program combined with parent education, provision of playpens to parents, and community-based activities, in a rural area with a high drowning incidence, likely reduces the risk of death from drowning over the study period of 4 years and 8 months compared to no day care program (hazard ratio 0.18, 95% confidence interval [CI] 0.06 to 0.58; 1 study, 136,577 participants; moderate-certainty evidence). Drowning morbidity (non-fatal drowning resulting in complications), total drowning (fatal and non-fatal), unsafe water exposure, and program safety (e.g. transmission of infection within day care, physical or sexual abuse of children within day care) were not reported, nor was the incidence of other unintentional injuries. Cost-effectiveness was reported as 812 USD (95% CI 589 to 1777) per disability-adjusted life-year averted as a consequence of drowning (moderate-certainty evidence). The second study compared day care programs with or without playpens provided to parents as an additional component versus only playpens provided to parents as an alternative drowning prevention intervention. Overall we assessed the study to be at critical risk of bias because we judged bias due to confounding to be at critical risk. As the certainty of evidence was very low, we are uncertain about the effects on drowning mortality rate of implementing a day care program compared to providing playpens (rate ratio 0.25, 95% CI 0.15 to 0.41; 1 study; 76,575 participants; very low-certainty evidence). Likewise, we are uncertain about the effects of a day care program with playpens provided as an additional component versus playpens provided alone (rate ratio 0.06, 95% CI 0.02 to 0.12; 1 study, 45,460 participants; very low-certainty evidence). The other outcomes of interest - drowning morbidity, total drowning, unsafe water exposure, program safety, incidence of other unintentional injuries, and cost-effectiveness - were not reported. This review provides evidence suggesting that a day care program with additional out-of-day care components such as community-based education, parent education, and playpens provided to parents likely reduces the drowning mortality risk in regions with a high burden of drowning compared to no intervention.

Effectiveness of School-Based Interventions in Reducing Unintentional Childhood Injuries: A Cluster Randomized Trial

ObjectiveTo evaluate the effectiveness of school-based interventions in promoting child safety and reducing unintentional childhood injuries.MethodsThis cluster randomized trial with 1:1 allocation of clusters to intervention and control arm was conducted in the public and private schools of Dakshina Kannada district, Karnataka, over a period of 10 months. Study participants included children from standard 5–7 in schools selected for the study. 10 schools that could accommodate 1100 students each, were randomly allocated to the interventional and control arm. A comprehensive child safety and injury prevention module was developed based on the opinions of school teachers through focus group discussions. This module was periodically taught to the students of intervention arm by the teachers. The children in control arm did not receive any intervention. Outcome was assessed by determining the incidence of unintentional injuries and type of injuries from the questionnaire used at the baseline, and at the end of three, six, and ten months.ResultsUnintentional injuries declined progressively from baseline until the end of the study in both the interventional arm (from 52.9% to 2.5%) and control arm (from 44.7% to 32%) [AOR (95% CI) 0.458 (0.405–0.518); P value <0.001]. The decline in incidence of injuries in the interventional arm was higher than that in the control arm (50.4% vs 12.7%; P <0.001).ConclusionSchool based educational intervention using child safety and injury prevention modules is effective in reducing unintentional injuries among school children over a 10-month period.

Cervical traction suture technique during large loop excision of the transformation zone increases complete lesion excision

PurposeA surgical technique was developed in the past by our group to reduce the rate of inadvertent complications. It was then seemed that it also increased the rate of complete lesion excision. The objective of the study was to evaluate the effectiveness of a cervical traction suture technique in increasing the prevalence of complete lesion excisions and reducing the incidence of unintended injuries to adjacent tissues during large loop excision of the transformation zone (LLETZ). Basic proceduresA retrospective cohort study, including all consecutive patients who underwent LLETZ between January 2016 and June 2018, at the outpatient Colposcopy clinic of a general hospital in Galilee Medical Center. We divided patients into two groups based on whether their LLETZ utilized the cervical traction suture technique. We compared these two groups using an independent-samples t test, and we compared the study-specific proportions to those reported in the literature using the proportion test. Main findingsA total of 66 patients were included in the analysis; 33 had undergone LLETZ with a traction suture, and 33 had undergone LLETZ without a traction suture. The prevalence of complete lesion excision was 93.3 % among patients undergoing LLETZ with a traction suture and 72.7 % among those without a traction suture (p = 0.04). The incidence of unintentional injuries to adjacent organs was 12.1 % in women with a traction suture and 18.2 % in women without a traction suture (p = 0.73). Principal conclusionsUsing a cervical traction suture along with LLETZ can increase the rate of complete lesion excision and may reduce the prevalence of unintended injuries.

A study on Unintentional injury and its impact among Children in Thirumazhisai, Chennai, India

Injury-related death accounts for 9% of mortality, worldwide. Unintentional injury accounts for a major part of injury-related disability-adjusted life years. Unintentional injury in children is of importance because it contributes a major part to child mortality and can also potentially have long-term effects. A cross-sectional study was conducted to find the incidence of unintentional injury in children of age 1 year to 18 years, in a sub-urban area, Thirumazhisai, in Chennai, India. The study was conducted from January 21, 2019, to March 21, 2019. The study was conducted on 144 participants, which included the primary caretaker of the child with unintentional injury, which occurred within the last 3 months, using pre-designed semi-structured questionnaire. The data was collected and analysed using Microsoft Excel and SPSS software. The study results showed that among the 144 participants, 75 were males and 69 were females. The cause of injury was recorded and classified as those due to playing outdoors (38.9%), domestic accidents (25%), sports-related injury (8.3%) and other injuries (30.6%). The commonest injury was abrasions (45.1%) followed by cuts &amp;lacerations (30.6). Commonest body parts affected were hands (47.9%) and legs (46.5%). Around 30% had to take leave from school for up to 2 days, 26% had to take leave for more than 2 days and 25% had local pain. The injury was treated at healthcare centre in only 52.8% of the study group.Unintentional injuries sustained while playing outside were more common among caretakers who had only up to school education and those who were unemployed/housewives. Health education and awareness creation can be done for primary caretakers on the prevention of unintentional injuries as it can affect their schooling and create financial problem for the family.

Development and performance test of the environment scale of unintentional injury in the home for children aged 0-6 years old in urban area of China

Objective: To develop the environment scale of unintentional injury in the home for children aged 0-6 years living in urban area of China, and test its validity and reliability. Methods: The content of the environment scale was established through the literature review, expert consultation and pilot study. A total of 1 104 children aged 0-6 years in urban area of Changsha were enrolled in this study by using a multi-stage stratified cluster random sampling method. The questionnaire was used to collect the basic information of children, the incidence of unintentional injury and the status of home environment. The reliability of the scale was tested by using Cronbach's α coefficient and split-half reliability coefficient. The content validity and construct validity were tested by using Pearson correlation analysis and factor analysis. All children were divided into two groups according to the incidence of unintentional injury in the home and the discrimination validity of the scale was tested by using t-test. Results: The scale had 54 items in 6 dimensions. The number of eligible questionnaires was 1 074, including 554 (51.6%) from boys and 519 (48.3%) from children under 3 years old. The incidence rate of unintentional injury and in-home injury was 18.34% (197 children) and 10.71% (115 children). The internal consistency reliability (Cronbach's α) coefficient for the scale was 0.87 and the split-efficacy reliability coefficient was 0.82, both meeting the standard of reliability above 0.70. The Pearson correlation coefficient between each dimension and the whole scale ranged from 0.53 to 0.84 (all P values <0.001). The common factor cumulative variance contribution rate of the scale was 58.34%. There were 54 items with factor loadings greater than 0.30. The root mean square error of approximation, comparative fit index and goodness-of-fit index were 0.07, 0.61 and 0.71, respectively. The score of scale in children with injury was significantly higher than that in children without injury (P=0.022). Conclusion: The validity and reliability of the environment scale for unintentional injury in the home for children aged 0-6 years old in the urban area of China are good.

An App-Based Intervention for Caregivers to Prevent Unintentional Injury Among Preschoolers: Cluster Randomized Controlled Trial.

BackgroundApp-based interventions have the potential to reduce child injury in countries with limited prevention resources, but their effectiveness has not been rigorously examined.ObjectiveThis study aimed to assess the effectiveness of an app-based intervention for caregivers of preschoolers to prevent unintentional injury among Chinese preschoolers.MethodsA 6-month cluster randomized controlled trial was conducted from December 2017 to June 2018. Recruitment was conducted through preschools, which were randomly allocated to either the control group (ie, app-based parenting education excluding unintentional injury prevention) or the intervention group (ie, app-based parenting education including unintentional injury prevention). A total of 2920 caregivers of preschoolers aged 3-6 years from 20 preschools in Changsha, China, were recruited offline through the schools. The primary outcome was unintentional injury incidences among preschoolers in the past 3 months; this measure was assessed through an online caregiver-report at the baseline visit and at 3-month and 6-month follow-up visits. Secondary outcome measures included caregivers’ self-reported attitudes and behaviors concerning child supervision during the last week. Generalized estimating equations (GEEs) were used to assess the effectiveness of the app-based intervention on responses at 3 and 6 months after adjusting for sociodemographic variables, baseline level of the outcome variable, and engagement with interventions in the assigned group. All analyses were intention-to-treat. A per-protocol sensitivity analysis was also conducted.ResultsIn total, 1980 of the 2920 caregivers completed the study. The mean age of participants was 32.0 years (SD 5.5) and 68.99% (1366/1980) of them were female. During the 6-month follow-up visit, unintentional injury incidence did not change significantly in either group: incidence in the intervention group went from 8.76% (94/1073) to 8.11% (87/1073), P=.59; incidence in the control group went from 9.4% (85/907) to 7.5% (69/907), P=.15. The changes did not differ between the groups (odds ratio [OR] 1.14, 95% CI 0.80-1.62). Changes in the average score in attitude concerning unintentional injury prevention were also similar between the groups (B .05, 95% CI -0.03 to 0.13). Changes in unintentional injury prevention behaviors were greater in the intervention group than in the control group after the intervention (B .87, 95% CI 0.33-1.42). Analyses of individual injury prevention behaviors showed that the intervention reduced three risky behaviors: unsafe feeding of children (OR 0.73, 95% CI 0.60-0.89); incorrectly placing children in cars (OR 0.73, 95% CI 0.57-0.93); and allowing children to ride bicycles, electric bicycles, or motorcycles unsupervised (OR 0.80, 95% CI 0.64-0.99). The intervention also improved scores on three safety-focused behaviors: testing water temperature before giving children a bath (OR 1.26, 95% CI 1.05-1.52); properly storing sharp objects (OR 1.24, 95% CI 1.01-1.52); and safely storing medicines, detergents, and pesticides (OR 1.24, 95% CI 1.02-1.51).ConclusionsThe app-based intervention did not reduce unintentional injury incidence among preschoolers but significantly improved caregivers’ safety behaviors. This app-based intervention approach to improve caregiver behaviors surrounding child injury risk offers promise to be modified and ultimately disseminated broadly.Trial RegistrationChinese Clinical Trial Registry ChiCTR-IOR-17010438; http://www.chictr.org.cn/showproj.aspx?proj=17376 (Archived by WebCite at http://www.webcitation.org/75jt17X84)International Registered Report Identifier (IRRID)RR2-10.1186/s12889-018-5790-1

Unintentional injury and role of different predictors among 1–5 years children: a community based cross sectional study in a rural population of a developing country

Injury has been increasing exponentially, especially in children, and it has become a public health concern. The present study was conducted with the objective of determining the prevalence and profile of unintentional injury among children of 1–5-year age group in a rural community of India and also to find out the predictors. Primary caregiver was interviewed by using a structured interview schedule. Parent supervisory behaviour was assessed using Parent Supervision Attributes Profile Questionnaire (PSAPQ), and child injury risk-taking behaviour was assessed by using injury behaviour checklist (IBC). Children encountered any unintentional injury event during last three-month period were 261 (62.7%). PSAPQ score was significantly higher in those parents where children had no episode of injury compared to others. Among four components of the PSAPQ, protectiveness (p = 0.049) and risk tolerance (p = 0.001) score had significant positive association with the incidence of unintentional injury. Binary multivariable logistic regression technique had found that age of the child, gender, primary care giver, birth order of the baby, the number of siblings, social class and IBC score has significant association with history of unintentional injury. There is utmost need for the development of effective programmes and training strategies to prevent unintentional injury among under-five children in future.

Probing the Psychosocial Correlates of Unintentional Injuries Among Grade-School Children: A Comparison of Urban and Migrant Students in China

ObjectiveTo assess the prevalence and characteristics of unintentional injuries among 5 to 9 grades students for both urban and migrant children groups, and probe the major socio-demographic and psychosocial risk factors.MethodsA cross-sectional survey was conducted from May to June in 2013 with 2266 urban and 1770 migrant children among 5 to 9 grades from 13 schools in Yinzhou, Southeast China. Unintentional injuries and psychosocial factors were measured via self-administered questionnaires. Descriptive statistics and binary logistic regression were employed in data analysis.ResultsThe annual prevalence of unintentional injury in the past year was 38%. Compared with urban children, migrant children reported lower prevalence of sprains/fractures (15.5 vs. 18.7%), but higher in animal bites (15.7 vs. 9.6%), burns (20.7 vs. 16%), nonfatal drowning (6 vs. 2.7%), and unintentional injury (40.9 vs. 35.7%). Binary logistic regression analysis revealed that male, young age, attending migrant children school, scoring high in emotional symptoms, conduct problems or hyperactivity, with suicide ideation, and experiencing verbal maltreatment were associated with unintentional injury incidence in the past 12 months.ConclusionsThe annual prevalence of unintentional injury among 5 to 9 grades schoolchildren in Yinzhou was high. Child unintentional injuries were associated with multi-level psychosocial factors. Although the direct correlation between migrant status and unintentional injuries was unobserved, migration could have an indirect relationship with injury. The findings could inform some implications for prevention strategies in urban area.

Effectiveness of an app-based intervention for unintentional injury among caregivers of preschoolers: protocol for a cluster randomized controlled trial

BackgroundEach year, over 15,000 preschoolers die from unintentional injuries in China. Many interventions proven to work in other nations have not been implemented nationwide in China. The rapid popularity of smartphones offers an opportunity to overcome this limitation and disseminate evidence-based interventions to the large population of China. This study aims to assess the effectiveness of an app-based intervention for caregivers of preschoolers to prevent unintentional injury among young Chinese children.MethodA single-blinded, 6-month, parallel-group cluster randomized controlled trial with 1:1 allocation ratio will be conducted in Changsha, China. In total, 2626 caregivers of preschoolers ages 3–6 years old who own a smartphone will be recruited from 20 preschools. Clusters will be randomized at the preschool level and allocated to either the control group (routine education plus app-based parenting education excluding unintentional injury prevention) or the intervention group (routine education plus app-based parenting education including unintentional injury prevention). The app-based injury prevention program was developed based on the Theory of Planned Behavior, the Haddon Matrix, the Mobile Learning framework, and a needs assessment. Data collection will be conducted at baseline, 3-month, and 6-month follow-up via app-based survey plus printed questionnaire survey. The primary outcome measure is unintentional injury incidence among preschoolers in the past 3 months. Secondary outcome measures include economic losses due to unintentional injury in the past 3 months, the Incremental Cost-Effectiveness Ratios (ICERs), and parent’s attitudes and behaviors concerning supervision to prevent preschooler unintentional injury in the past week. An intention-to-treat approach will be used to evaluate outcome measures. Chi-square tests will examine differences for outcome measures between groups at each time point and generalized estimation equations (GEE) will test the overall effectiveness of the app-based intervention. Missing outcome data will be imputed using the Expectation Maximization algorithm (EM).DiscussionThis trial will examine evidence concerning the effectiveness of an innovative app-based intervention for caregivers of Chinese preschoolers. If effective, the app-based intervention could offer an effective population-based intervention option to cost-effectively promote unintentional injury prevention in countries and regions where injury control is under-supported.Trial registrationChiCTR-IOR-17010438. Registered 15 January 2017.

Lower incidence of unintentional injury with older age in children in China? A meta-analysis

Objective: The aim of this study was to identify the relationship between children's age and the incidence of unintentional injuries, and giving some basic data on the guidance for the prevention of unintentional injuries in children aged 0 to 18 years in China.Methods: The literatures on the incidence of unintentional injury in children included in China from 2008 to 2018 were analyzed by meta-analysis method. The data were retrieved according to the guidance of Cochrane Systematic review. A meta-analysis was carried out on homogeneous studies, and then subgroup analysis was conducted according to age group. Publication bias was also evaluated. Stata software (version 15.0) and SPSS software (version 18.0) were used to analyze the gathered information. Results: A total of 3，303 related pieces of literature were reviewed. Of the 37 that met the inclusion criteria. The meta-analysis showed that total sample sizes were 77，023, and the pooled incidence of unintentional injury is 20%, 95%CI (17%-23%), (P&lt; 0.001). Subgroup analysis showed the following results: the incidence are 15%, 23%, 20% and 20% for aged in “0-2”, “3-5”, “6-11”, “12-18” subgroups, respectively. However, the trend of decreased incidence of unintentional injury with older age in children was not significant.Conclusions: The pooled incidence of unintentional injuries in children is high. Based on accessible literature, the incidence between different age subgroup were not statistically significant. We should pay attention to the incidence of unintentional injuries in children of all age subgroups.

Injury pyramid of unintentional injuries according to sex and age in South Korea.

ObjectiveThe injury-related disease burden in South Korea is relatively high compared to that in other nations. This study was conducted to identify the scale and causes of injury by severity, using an injury pyramid and analyzing the sex and age-dependent differences and the basic demographic characteristics.MethodsUnintentional injury was estimated for each group after classifying injury-related deaths, hospitalizations, and outpatient department (OPD) visits based on their severity. The injury pyramid was calculated by classifying the injury outcomes into deaths, hospitalizations, and outpatient visits.ResultsThe incidence of unintentional injury included 31.74 deaths, 1,715.27 hospitalizations, and 7,317.55 OPD visits per 100,000 persons. The incidence of injury was higher among males than that among females. There were more hospitalizations and OPD visits than deaths among females. The mortality and hospitalization rates due to injury per 100,000 persons were the highest among those ≥75 years old, and the OPD visit rate was the highest among preschool children aged 0 to 6 years. The injury mechanisms that caused most deaths and hospitalizations in South Korea were injuries related to traffic, falls, poisoning, and burns/fires.ConclusionThe scale of unintentional injury varies based on sex, age, and injury mechanism; additionally there are differences in the incidence of injuries between males and females depending on their age and injury mechanism. The high incidence of injury in elderly people could be a factor that increases the burden of injury in South Korea; hence, it is necessary to develop an injury prevention program that targets the elderly.

Incidence and characteristics of unintentional injuries among children in a resource limited setting in Kampala, Uganda

ABSTRACTGiven that little is known about the epidemiology of unintentional injuries in children in low-income countries, this study sought to determine the incidence and characteristics of unintentional injuries among children aged ≤18 years in a slum community in Uganda. From a household survey, the incidence and odds ratios for factors associated with unintentional injury characteristics were calculated. Of 1583 children, 706 had suffered 787 unintentional injuries yielding an annual incidence rate of 497 injuries per 1000 children. Commonest injuries were cuts, bites or open wounds (30.6%) and bruises or superficial injuries (28.6%) with majority (75.5%) occurring at home. Boys were more likely to be injured at school (AOR 4.34; 95% CI 1.22–15.54) and to be injured from falls (AOR 1.41; 95% CI 1.01–1.96). Older children (12–18 years) were more likely to suffer from fractures (AOR 2.37; 95% CI 1.26–4.43), concussions and organ system injuries (AOR 3.58; 95% CI 1.03–12.39) and cuts, bites or open wounds (AOR 2.05; 95% CI 1.21–3.48). Older children were less likely to suffer burns or scalds as compared to the young children (AOR: 0.23; 95% CI 0.11–0.50). Unintentional injury incidence rate was high among children with most occurring in the homes.

Meta-analysis of the Unintentional Death of Children Aged 0 to 5 Years in China Between 1995 and 2015.

ObjectivesThe aim of this study was to identify the primary cause of and a means by which to prevent the unintentional injury and death of children aged 0 to 5 years in China.MethodsA systematic review of literature published in this area between 1995 and 2015, accessible via Chongqing VIP, Wanfang, CNKI, and PubMed databases, in addition to other electronic databases and related magazines and professional information, was conducted. The data were retrieved using Cochrane Systematic review methods. All information was judged using the Jadad method. A meta-analysis was carried out on homogeneous studies. RevMan 5.3 software was used to analyze the gathered information.ResultsA total of 125 related pieces of literature were retrieved. Of the 14 that met the inclusion criteria, 6 were of moderate quality and 8 of general quality. The meta-analysis showed that in a comparison of unintentional injury and death of male and female children, the odds ratio was [1.73 to 1.95] for a 95% confidence interval (P < 0.00001). In a comparison of urban and rural areas, the odds ratio was [0.02, 0.02] for a 95% confidence interval (P < 0.00001).ConclusionsBased on accessible literature, the incidence of unintentional injury and death of boys is higher than that in girls and is also higher in rural areas than in urban areas of China. Considering the significant difference in the latter comparison, developing and implementing methods to reduce the unintentional injury and death of children in rural areas should receive greater attention.

Change in child mortality patterns after injuries in Sweden: a nationwide 14-year study.

Sweden has one of the world's lowest child injury mortality rates, but injuries are still the leading cause of death among children. Child injury mortality in the country has been declining, but this decline seems to decrease recently. Our objective was therefore to further examine changes in the mortality of children's death from injury over time and to assess the contribution of various effects on mortality. The underlying hypothesis for this investigation is that the incidence of lethal injuries in children, still is decreasing and that this may be sex specific. We studied all deaths from injury in Sweden under-18-year-olds during the 14years 1999-2012. We identified those aged under 18 whose underlying cause of death was recorded as International Classification of Diseases, 10th Revision (ICD-10) diagnosis from V01 to X39 in the Swedish cause of death, where all dead citizens are registered. From the 1 January 1999 to 31 December 2012, 1213 children under the age of 18 died of injuries in Sweden. The incidence declined during this period (r=-0.606, p=0.02) to 3.3 deaths/100,000 children-years (95% CI 2.6-4.2). Death from unintentional injury was more common than that after intentional injury (p<0.0001). There was a reduction in the incidence of unintentional injuries during the study period (r=-0.757, p=0.03). The most common causes of death were injury to the brain (n=337, 41%), followed by drowning (n=109, 13%). The number of deaths after intentional injury increased (r=0.585, p=0.03) and at the end of the period was 1.5 deaths/100,000 children-years. The most common causes of death after intentional injuries were asphyxia (n=177, 45%), followed by injury to the brain (n=76, 19%). Mortality patterns in injured children in Sweden have changed from being dominated by unintentional injuries to a more equal distribution between unintentional and intentional injuries as well as between sexes and the overall rate has declined further. These findings are important as they might contribute to the preventive work that is being done to further reduce mortality in injured children.

Community-Based Study on Family-Related Contributory Factors for Childhood Unintentional Injuries in an Urban Setting of Sri Lanka.

A community-based descriptive cross-sectional study was carried out among children aged 1 to 4 years residing in an urban setting of Sri Lanka to assess the incidence and associated family-related factors of unintentional injuries. A total of 458 children were recruited using simple random sampling technique, giving a response rate of 91.6%. The incidence of unintentional injuries that needed medical attention during the study period of 3 months was 28.1 per 100 children (95% CI = 19.46-36.74). The factors that were significantly associated with the occurrence of unintentional injuries among children are low monthly income of the family (P = .045), low social support to the mother of index child (P = .022), nonauthoritative type of parenting of the mother of index child (P = .039), cared by person other than mother during day time (P = .002), frequent arguments between parents (P = .004), and frequent alcohol consumption of father (P = .001).

Epidemiologic features of child unintentional injury in rural PuCheng, China

:Background:Epidemiologic features of unintentional injuries among children in rural China are unknown.Methods:Using a stratified sampling method, we conducted a retrospective study of injury reports over a year-long period. Structured oral questionnaires were administered to parents of 2551 children ages 0 to 14. Results:The annual incidence of unintentional injuries was 15.6%, with boys (16.7%) having a slightly higher rate than girls (14.5%; p greater than .05). The four leading causes of injury for both genders were falls (5.1% annual incidence), burns (2.9%), animal-related injuries (1.7%), and traffic injuries (1.6%). Conclusions:Unintentional injuries have substantial negative effects on children and their families. In rural PuCheng, China, the incidence of unintentional injury among children is extremely high compared to other regions of the world. The types of injuries incurred are somewhat different from those reported in other geographic areas. Injury prevention programs targeting the issues specific to this region, and similar rural regions of China, are needed.

Disparities in fatal and non-fatal injuries between Irish travellers and the Irish general population are similar to those of other indigenous minorities: a cross-sectional population-based comparative study

ObjectivesTo assess recent disparities in fatal and non-fatal injury between travellers and the general population in Ireland.DesignA cross-sectional population-based comparative study.SettingRepublic of Ireland.ParticipantsPopulation census and retrospective mortality data were collected...