Epidemiology of childhood injuries in rural Puducherry, South India

The global, regional, and national burden of burns: An analysis of injury by fire, heat, and hot substances in the global burden of disease study 2019

BACKGROUND

Burn caused by exposure to hot substances is a common occurrence but there is little data on prevalence trends and disease burden. This research report the burden of burn injuries globally, regionally, and nationally from 1990 to 2019, identify hotspots, and analyze factors affecting disease burden with data from Global Burden of Disease 2019 survey.

METHODS

The Global Burden of Disease 2019 estimated the incidence, death rate, and disease-adjusted life years (DALY) for injuries due to exposure to fire, heat, and hot substances from 1990 to 2019. For comparison, all rates were age standardized. And the estimated annual percentage change (EAPC) was used to reflect the degree of change of the annual rate.

RESULTS

Globally, there were an estimated 8,378,122 (95 % uncertainty interval [UI]: 6,531,887-10,363,109) burn injuries in 2019, with age-standardized incidence, death, and DALY rates of 118 (95 % UI: 89-147), 1.44 (95 % UI: 1.14-1.72), and 96.6 (95 % UI: 75.03-123.05) per 100,000 people, which were 22 %, 43 %, and 43 % lower than those in 1990, respectively. Regionally, age-standardized incidence rate showed a positive association with Socio-demographic Index (SDI) from 1990 to 2019, whereas age-standardized death and DALY rates were negatively associated with SDI. The variation in the age-standardized incidence rate was intrinsic, and the variation in the age-standardized death rate was related to the human development index in the country. The global burn incidence population was skewed, with peaks mainly in the 5 to 19 years age group, but age-specific death rates and disease burden were higher in the under-5 and older age groups.

CONCLUSIONS

The results of this study indicate the need to consider regional differences in burns when allocating health resources. Despite the reduced global burden of burns, incidence and deaths remain high. Moreover, there are significant differences between regions which are associated with the SDI and the human development index. Additionally, differences exist in the age and sex of the affected populations. Although the exact causes require further study, there is no doubt that the prevention of burns requires serious attention.

Prevalence of unintentional injuries and its risk factors among under-five children residing in urban poor resettlements in Rishikesh

Background

A community-based study on childhood injuries would provide valuable information on the epidemiology of injuries to undertake appropriate preventive measures. Therefore, the current study was conducted in urban poor resettlements of Rishikesh to estimate the prevalence of unintentional injuries and to document the sociodemographic risk factors associated with unintentional injuries among under-five children.

Aims and Objectives

Estimation of the prevalence of unintentional injuries and their risk factors among under-five children of urban poor resettlements in Rishikesh.

Materials and Methods

A community-based cross-sectional study was conducted in urban poor resettlement areas of Rishikesh for a period of 1 year. It included 300 children selected using a simple random sampling technique to collect data on injury status.

Results

The prevalence of unintentional injury among study participants was 16%. Falls were (64.6%) the major cause of injury, followed by dog bites (12.5%). The major sites of the injury were the head (25%), face (22.9%), upper limb (27.1%), and lower limb (18.8%).75% of the injuries happened at home. 66% of injuries happened when the child was playing alone or playing with peers. About 20.8% of injuries were bruises or superficial injuries. 39.6% of children had cut/bite/open wound injuries. Fractures happened in 14.6% of injured children. More than half (54.2%) of children did not develop any physical disability due to injury. Among children who developed a disability, more than 90% are able to recover completely. The majority of study participants were taken to nearby hospitals (66.6%) or health centers (10.4%). Only one of them went to a traditional bone setter, rest all visited either a general practitioner or pharmacy. The median expenditure for the treatment of the injured child was INR 425 (175-2750). The age of the child and unintentional injury showed a statistically significant association.

Conclusion

The prevalence of the injury was 16% (12-20.7%) similar to a number of similar studies. Although the majority of the injuries were mild in severity, injuries have also contributed to temporary disability among children and have led to loss of school days.

A Community-Based Cross-Sectional Study on the Epidemiology of Injuries in Raipur City, Chhattisgarh

BACKGROUND

Globally, injuries are a major public health concern. An injury is a physical damage that results when the human body is suddenly or briefly subjected to intolerable levels of energy.

OBJECTIVES

The objectives of this study are to describe the nature and mechanism of injuries and their association with age and gender and to assess the health-seeking behavior and cost incurred due to mortality and morbidity related to injuries.

METHODS AND MATERIALS

A cross-sectional study focused on the community was conducted in 10 chosen wards of Raipur City. The sample size was 310 injured individuals. The recall period was for a full year. Information was gathered by using a questionnaire that had been pretested. The results were given as percentages, and the association was determined using the chi-square test and Fischer's exact test.

RESULTS

The majority (30.1%) of the study subjects suffered from cut/bite/open wound injuries, followed by fractures (17.3%). The leading type of injury was caused by falls (38.8%) and road traffic injuries (34.9%), followed by burns (7.1%) and dog bites (5.4%). Ninety percent of the study subjects had taken medical care. Half of them (51.3%) visited a private hospital, and 23.1% did not visit any hospital for treatment. Fifty percent of the study subjects or their family had expenses less than Indian National Rupee (INR) 500. A significant association was found between age and fracture and the sprain type of injury. The burn type of injury was more among females, which is significantly associated. A significant association was found between age and injury caused by a dog bite, fall, and traffic. The association between gender and injury caused by traffic, burn, and fall was significant.

CONCLUSIONS

Focusing on reducing injury-related morbidity may be crucial in injury prevention techniques including behavioral changes, health education, and the urgent need for the proper implementation and oversight of a road safety act.

Child injuries in Lebanon: assessing mothers' injury prevention knowledge attitude and practices

BACKGROUND

Childhood injury is a neglected public health problem with a sizeable burden on children's well-being and their families. This study aims to describe the pattern and types of childhood injuries and to determine the level of mothers' Knowledge, Attitude, and Practices (KAP) towards childhood injury prevention in Lebanon. The study further examines the association between childhood injury occurrence and mothers' supervision.

METHODS

This cross-sectional study recruited mothers of children aged up to 10 years from multiple sites (i.e., a medical center, a private clinic, a healthcare facility, and a refugee camp clinic). Data were collected on mothers' KAP toward childhood injuries using self-administrated questionnaires. A summation score for KAP correct answers was calculated and descriptive and statistical analyses were performed to measure the association between the outcomes.

RESULTS

A total of 264 mothers were surveyed and injury data were collected on their 464 children. The prevalence of childhood injury was 20% in the past 12 months, mostly sustained by males (53.8%) and children aged 5-10 years (38.7%). The most common type of injury was fall (48.4%), followed by burns (%7.5), and sports injuries (7.5%). Hospitalized children were more likely to be males and older than 5 years (p < 0.001). More than one-third of the mothers demonstrated poor knowledge, while the majority showed poor practice (54.4%), and fair attitude (45.6%) towards child injury prevention. Children of working mothers have three times higher odds of sustaining injuries (OR: 2.95, 95% CI: 1.60;5.47) compared to those of non-working mothers, accounting for possible confounders (p = 0.001).

CONCLUSION

Childhood injuries represent a major health problem in Lebanon. Findings from this study showed that mothers are less knowledgeable and unprepared to prevent their children from getting injured. Educational programs are much needed to address the gap in the mothers' KAP toward child injury prevention. Further studies are recommended to understand the cultural context and examine its key determinants to identify effective strategies and develop tailored interventions for preventing childhood injuries.

Mortality from fall: A descriptive analysis of a multicenter Indian trauma registry

INTRODUCTION

Fall is the second most common mechanism of trauma worldwide after road traffic injuries. Data on fall predominantly comes from the high-income countries (HICs) and mostly includes injuries in children and elderly. There are very few studies from low- and middle-income countries(LMICs) that describe fall related injuries other than fragility fractures in elderly. This study describes the profile of poly-trauma patients admitted with a history of 'fall' and assesses the variables associated with mortality.

METHOD

We analyzed data from the 'Towards Improved Trauma Care Outcome' (TITCO) database which prospectively collected data of poly-trauma patients admitted to four major tertiary care hospitals of India between 2013 to 2015. Patients across all age groups admitted to hospital with the history of 'fall'; were included in our study. Single bone fractures were excluded.  The Kaplan Meier survival analysis was used to estimate the survival probability in different age groups.

RESULTS

A total of 3686 patients were included in our study. The median age of the patients was 28 years (IQR: 9, 47) with the majority being males (73.6%). Almost one-third of the patients were within the age group of 0-14 (30.4%). Most of the patients (79.9%) had a diagnosis of traumatic brain injury (TBI). The overall in-hospital mortality was 18% (664), but higher at 39.0% among patients over 65 years of age. Probability of survival decreased with increase of age.

CONCLUSION

Falling from height is a common injury mechanism in India, occurring more in young males and usually associated with TBI. Isolated TBI and TBI associated with other injuries are the main contributors of mortality in fall injuries. Mortality from these injuries increased with age and ISS.

Epidemiology of non-fatal burn injuries in children: evidence from Bangladesh Health and Injury Survey 2016

BACKGROUND

Burn is a major cause of childhood injury-related morbidity and mortality. Global estimates suggest that 90% of all cases occur in low-income and middle-income countries and over half of the disability-adjusted life-years are lost from fire-related burns in children. In Bangladesh, there is a scarcity of data on childhood burn injuries. The goal of the study was to describe the epidemiology of non-fatal burns in Bangladeshi children, including incidence estimates and identify high-risk groups.

METHODS

Bangladesh Health and Injury Survey 2016 was a large scale cross-sectional survey. The survey was conducted among 299 216 population utilising a multistage cluster sampling method. Among the 100 842 children, there were 437 non-fatal burn cases.

RESULTS

Among different injury mechanisms in children, burn was ranked fifth (7.4%). The overall yearly incidence rate (IR) of burns was 866.7 per 100 000 children (95% CI 785.6 to 947.8) in Bangladesh. The incidence was highest among 1-4 years old children (IR 2028.3, 95% CI 1761.1 to 2334.7) and had a 3.5 times higher risk of burns compared with the 15-17 years age group. Females had a much higher IR of non-fatal burns than males between the ages of 10-15 years (1655.2 vs 482.2). About 70% of burns occurred in rural areas. Hot liquid (44.7%), flames (32.5%) and hot objects (20.7%) were identified as the main causes of burns. The kitchen (60.9%), yards (20.8%) and bedroom and living room (10.5%) were the three most common places for burns. According to the study, 34.8% of burn incidences occurred between the hours of 7:00 and 10:00.

CONCLUSION

Children in Bangladesh suffer from a high rate of non-fatal burns. The high-risk category was identified as preschool-aged boys and adolescent girls. The majority of the incidents occurred in the morning and inside the kitchen. These findings will help raise awareness and create intervention measures to reduce the high incidence of non-fatal childhood burns in Bangladesh.

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

OBJECTIVE

To evaluate the effectiveness of school-based interventions in promoting child safety and reducing unintentional childhood injuries.

METHODS

This 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.

RESULTS

Unintentional 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).

CONCLUSIONS

School based educational intervention using child safety and injury prevention modules is effective in reducing unintentional injuries among school children over a 10-month period.

Injury and its associated factors among residents of an urban slum during the festival month in South India: A community-based survey

Introduction

Injury morbidity and mortality have been steadily increasing in both developed and developing countries including India. The current study tried to assess the incidence of injury and identify the risk factors associated with injuries during the festival month in a selected urban area in Puducherry.

Methods

It is a community-based cross-sectional survey conducted among the residents in the urban field practice area of a medical college in Puducherry. Participants were interviewed using a pretested questionnaire. Information on the incidence of injury and its associated factors were collected. Data were entered in EpiData and analyzed using Stata. Generalized linear models with Poisson distribution were used to identify the risk factors associated with the injuries.

Results

Overall, 1380 participants from two selected clusters were interviewed. The incidence rate of injuries was 5.2% (95% CI: 4.0-6.4). In adjusted analysis male (RR 1.96, 95% CI: 1.15-3.37) and student (RR 2.91, 95% CI: 1.13-7.54) were independently associated with having an injury. Most of the injuries were unintentional and accidental.

Conclusion

The reported incidence of at least one injury was 52 per 1000 population per month and the majority were accidental in nature. It was higher during the festival week. Public health strategies at the primary healthcare level targeting adult males and school children will be effective in the reduction and prevention of injury.

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

Objective

To evaluate the effectiveness of school-based interventions in promoting child safety and reducing unintentional childhood injuries.

Methods

This 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.

Results

Unintentional 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).

Conclusion

School based educational intervention using child safety and injury prevention modules is effective in reducing unintentional injuries among school children over a 10-month period.

Economic benefit in treatment of unintentional childhood injuries by implementation of child-to-child approach

Background:

Childhood injury has been recognized as a major threat to child survival and health, as well as economic burden, which includes the cost to government and out-of-pocket expenses (OOPE) to families. Child-To-Child Approach is an innovative technique to reduce childhood injuries and expenses on their treatment.

Objectives:

To assess economic benefit in the treatment of unintentional childhood injuries, including OOPE by families, by the implementation of the child-To-Child approach.

Materials and Methods:

The present study is part of a quasi-experimental before-and-after intervention study conducted in the rural area of Delhi for the prevention of childhood injuries through intervention by the child-To-Child approach. Cost of injury treatment, including travel and accommodation expenses, and wage loss were noted. The projected gain in the total cost and out-of-pocket expenditure on injury treatment throughout 20 years of childhood and adolescence were calculated.

Results:

Both incidences of injuries and total expenditure for treatment of injuries had decreased during the postintervention period in the intervention group, against a rise in the control group. The proportion of OOPE for availing private health care facilities for treatment of injuries, which was more than one-fourth of total expenses, also had decreased in the intervention group during the postintervention period. On economic analysis, it is projected that there will be enormous gain in cost by the implementation of child-To-Child approach in the study area in 20 years, along with saving of OOPE of the families.

Conclusion:

Child-To-Child approach is effective in preventing childhood injuries and reducing the cost of treatment of injuries.

Effects of a Safety-Awareness-Promoting Program Targeting Mothers of Children Aged 0-6 Years to Prevent Pediatric Injuries in the Home Environment: Implications for Nurses

Pediatric injuries pose a significant problem, both in Turkey and worldwide, because they lead to death or disability in a number of children each year. This quasi-experimental study aimed to identify the effects of the training provided to mothers with children aged 0-6 years about the hazards that lead to pediatric injuries. The population of the research comprised mothers with children aged 0-6 years, living in the city center. Considering the educational and socioeconomic levels of the individuals registered in the family health centers (FHC), the FHCs were divided into 3 groups of high, moderate, and low socioeconomic level. Subsequently, 1 FHC was selected from each level using simple random sampling. The study was conducted with 300 volunteer mothers registered in these FHCs. The tools used for data collection included the "0-6-year-old Children's Mothers' Identification Scale of Safety Precautions for the Prevention of Pediatric Injuries," the "Risk Assessment Form for Pediatric Injuries" (RAF), and a 33-item questionnaire. After the training on the prevention of pediatric injuries, the mothers' scores on the identification of safety precautions for pediatric injuries increased significantly (p = 000). In addition, there was a significant difference between the pre- and posttest scores of the mothers (p < .05) on all dimensions of the RAF (choking, burns, poisoning, sharp object injuries, and falling; all p values <.05). Thus, the training provided to mothers to prevent pediatric injuries was effective in improving the awareness of the mothers.

Effect of community-based intervention on knowledge, attitude, and self-efficacy toward home injuries among Egyptian rural mothers having preschool children

BACKGROUND

Parent's level of knowledge, state of their attitude, and their self-efficacy are the most incriminated reasons for the faulty application of the first aid measures, particularly in children's home injuries.

OBJECTIVES

To assess the effect of a health education intervention on improving knowledge, attitude and self- efficacy of mothers having preschool children about home injuries and the basic first aid measures.

METHODS

A pre-posttest evaluation of the effect of a health education intervention on changing knowledge, attitude, and self-efficacy about home injuries and the basic first aid measures of 244 rural Egyptian mothers having preschool children.

RESULTS

About 35% of the male children had home injuries 8 weeks earlier to the study. Mean score of total knowledge increased from 10.21±3.1 in pretest to 18.90 ± 2.6 in posttest, total attitude from 6.19±1.8 to 10.26±2.3 and self-efficacy from 20.75±6.1 to 34.43 ± 10.1 with (p < 0.001) for all changes. Age, education level and previous home injuries were the significant predicting factors for total knowledge, attitude and self- efficacy of the mothers.

CONCLUSION

Health education improves knowledge, attitude, and self-efficacy of the mothers which were obvious regarding home injuries than first aid measures. There is a need for including knowledge about home injuries in the educational curriculum of high schools and universities and to perform training courses to mothers about first aid measures.

Incidence and Impact of Unintentional Childhood Injuries: A Community Based Study in Rural South India

OBJECTIVE

To estimate the incidence of unintentional childhood injuries and to assess the impact of injury during childhood.

METHODS

This is a cross sectional study, conducted in 13 clusters of a rural block in Vellore. Children were screened by two-stage cluster sampling method by two weeks and three months recall method. The primary caregivers of injured children were administered a questionnaire to assess the impact of the injury.

RESULTS

Childhood injury related morbidity was 292.5 per 1000 y. Children between 10 and 14 y (4.6%) and boys (4.5%) had a higher rate of injury. Fall (43.1 %) was the most common cause of injury followed by RTIs (Road Traffic Incidents- 27.6%). Work absenteeism for primary caregivers ranged from 1 to 60 (IQR 2-7) days. Sickness absenteeism ranged from 1 to 45 d with a mean of 7.64 (IQR 2-7) days. Half of the children missed school after an injury. The days spent with temporary disability ranged from 1 to 60 d with a mean of 11.79 (IQR 2-7) d and 7.73% had permanent disability.

CONCLUSIONS

Unintentional childhood injury is a neglected public health problem which leads to sickness absenteeism and disability. Boys and older children are the most common victims of injury. There is a need for establishing state or nationwide injury registries to help understand accurate estimates of disability-adjusted life year (DALY) and loss of productivity.

Epidemiology of non-fatal injuries among Egyptian children: a community-based cross-sectional survey

BACKGROUND

Injuries are a major cause of childhood morbidity and mortality worldwide. We aimed to determine the magnitude and characteristics of child injuries in Egypt and to identify the associated risk factors.

METHODS

A community-based, cross-sectional survey was conducted over 27 Egyptian governorates from June to October, 2011. The target population was 1977 households with children aged 0-18 years who had experienced accidental injuries.

RESULTS

In the 6-month period before the investigation, 1576 injuries were reported in 1472 children from a sample population of 1399 households (response rate 70.8 %). Falls (25 %) and burn injuries (20.3 %) were the most common accidental injuries. The incidence of these injuries was significantly higher among boys (57.2 %) than girls and in children aged 2-6 years (70 %) compared with older and younger children. The five main causes of injuries were wounds (30.6 %), fractures (28.7 %), burns (20.3 %), swallowing a foreign body (8.4 %) and accidentally ingesting a poison (7.8 %). Injuries from drowning (n = 27), animal bites (n = 22) and sunstroke (n = 20) mostly occurred in rural children, accounting for 65 %, 54.4 % and 52 %, respectively, of all injuries in rural children. Home and its immediate surroundings (64.4 %) was the most common setting for injuries. Maternal age, education and working status were also associated with childhood injuries (p < 0.05). Children of second and third birth order were at higher risk for injuries (p < 0.0001).

CONCLUSIONS

Childhood injuries account for a substantial healthcare burden in Egypt. Our findings emphasise the importance of developing national preventive programs designed to reduce the incidence of childhood injuries.

Pattern of fall injuries in Pakistan: the Pakistan National Emergency Department Surveillance (Pak-NEDS) study

Background

We aimed to analyse the frequency and patterns of fall-related injuries presenting to the emergency departments (EDs) across Pakistan.

Methods

Pakistan National Emergency Departments surveillance system collected data from November 2010 to March 2011 on a 24/7 basis using a standardized tool in seven major EDs (five public and two private hospitals) in six major cities of Pakistan. For all patients presenting with fall-related injuries, we analysed data by intent with focus on unintentional falls. Simple frequencies were run for basic patient demographics, mechanism of falls, outcomes of fall injuries, mode of arrival to ED, investigations, and procedures with outcomes.

Results

There were 3335 fall-related injuries. In cases where intent was available, two-thirds (n = 1186, 65.3%) of fall injuries were unintentional. Among unintentional fall patients presenting to EDs, the majority (76.9%) were males and between 15-44 years of age (69%). The majority of the unintentional falls (n = 671, 56.6%) were due to slipping, followed by fall from height (n = 338, 28.5%). About two-thirds (n = 675, 66.6%) of fall injuries involved extremities, followed by head/neck (n = 257, 25.4%) and face (n = 99, 9.8%). Most of the patients were discharged from the hospital (n = 1059, 89.3%). There were 17 (1.3%) deaths among unintentional fall cases.

Conclusion

Falls are an important cause of injury-related visits to EDs in Pakistan. Most of the fall injury patients were men and in a productive age group. Fall injuries pose a burden on the healthcare system, especially emergency services, and future studies should therefore focus on safety measures at home and in workplaces to reduce this burden.

Disseminating childhood home injury risk reduction information in Pakistan: results from a community-based pilot study

Background: Most childhood unintentional injuries occur in the home; however, very little home injury prevention information is tailored to developing countries. Utilizing our previously developed information dissemination tools and a hazard assessment checklist tailored to a low-income neighborhood in Pakistan, we pilot tested and compared the effectiveness of two dissemination tools. Methods: Two low-income neighborhoods were mapped, identifying families with a child aged between 12 and 59 months. In June and July 2010, all enrolled households underwent a home hazard assessment at the same time hazard reduction education was being given using an in-home tutorial or a pamphlet. A follow up assessment was conducted 4–5 months later. Results: 503 households were enrolled; 256 received a tutorial and 247 a pamphlet. The two groups differed significantly (p < 0.01) in level of maternal education and relationship of the child to the primary caregiver. However, when controlling for these variables, those receiving an in-home tutorial had a higher odds of hazard reduction than the pamphlet group for uncovered vats of water (OR 2.14, 95% CI: 1.28, 3.58), an open fire within reach of the child (OR 3.55, 95% CI: 1.80, 7.00), and inappropriately labeled cooking fuel containers (OR 1.86, 95% CI: 1.07, 3.25). Conclusions: This pilot project demonstrates the potential utility of using home-visit tutorials to decrease home hazards in a low-income neighborhood in Pakistan. A longer-term randomized study is needed to assess actual effectiveness of the use of allied health workers for home-based injury education and whether this results in decreased home injuries.

Injury prevention and care: an important public health agenda for health, survival and safety of children

Injuries affect the lives of thousands of young people and their families each year in India. With the gradual decline of communicable and nutritional diseases, injuries will be a leading cause of mortality, morbidity and disabilities and the success achieved so far in child health and survival is in jeopardy. Available data indicate that among children less than 18 y, 10-15 % of deaths, 20-30 % of hospital registrations and 20 % of disabilities are due to injuries. Based on available data, it is estimated that injuries result in death of nearly 1, 00,000 children every year in India and hospitalisations among 2 million children. Road Traffic Injuries (RTI's), drowning, falls, burns and poisoning are leading injury causes in India. Drowning and burns are major causes of mortality in less than 5 y, while RTIs, falls and poisoning are leading causes in 5-18 y. A shift in the occurrence of suicides to younger age groups of 15-20 y is a matter of serious concern in recent years. More number of males, those in rural areas, and majority of poor income households are affected due to injuries.Child injuries are predictable and preventable. Children have limitations of size, development, vision, hearing and risk perceptions as compared to adults and hence are more susceptible and vulnerable to injuries. Thus, it is important to make products and home - road and school environments safer along with greater supervision by parents and care givers. The key approaches include vehicle and product safety, environmental modification, legislation and enforcement, education and skills development along with availability of quality trauma care. Child injury prevention and care requires good quality data, building human and financial resources, strengthening policies and programmes based on evidence and integrated implementation of countermeasures along with monitoring and evaluation. Child injury prevention and control is crucial and should be an integral part of child health and survival.