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Ben Abderrahim S, Belhaj A, Bellali M, Hmandi O, Gharbaoui M, Harzallah H, Naceur Y, Ben Khelil M, Allouche M. Patterns of Unnatural Deaths Among Children and Adolescents: Autopsy Study (2011-2018). Pediatr Dev Pathol 2022; 25:635-644. [PMID: 36503303 DOI: 10.1177/10935266221132884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS The problem of unnatural death in children is still relevant because of their vulnerability. This work aimed to describe the epidemiological profile and patterns of these medicolegal deaths in children and adolescents in northern Tunisia. METHODS We conducted a retrospective study from January 2011 to December 2018, within the Forensic Department of Charles Nicolle Hospital in Tunis. All children who died of unnatural causes were included (767 cases). RESULTS An overall male predominance was observed (sex ratio = 2.4). Accidental deaths represent the most common manner of death (81.4%) involving most frequently domestic accidents occurring in children aged between 1 and 4 years. In cases of suicide, the highest risk profile was a female child aged between 15 and 18 years. The suicide occurred most often in the victim's home with hanging representing the common means of suicide. For the criminal form, the most common means in those cases were stabbing and blunt injuries. CONCLUSION Our study delivered a broad picture of unnatural deaths among children in Tunisia. These deaths, largely absent from child survival initiatives presently on the global agenda, can be prevented if they are addressed strategically, as their injury prevention strategies differ from adults.
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Affiliation(s)
- Sarra Ben Abderrahim
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia
| | - Azza Belhaj
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia.,University of Tunis El Manar, Tunis Faculty of Medicine, Tunis, Tunisia
| | - Mohamed Bellali
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia.,University of Tunis El Manar, Tunis Faculty of Medicine, Tunis, Tunisia
| | - Ons Hmandi
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia.,University of Tunis El Manar, Tunis Faculty of Medicine, Tunis, Tunisia
| | - Meriem Gharbaoui
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia.,University of Tunis El Manar, Tunis Faculty of Medicine, Tunis, Tunisia
| | - Hana Harzallah
- University of Tunis El Manar, Tunis Faculty of Medicine, Tunis, Tunisia.,Department of Forensic Medicine, Habib Bougatfa University Hospital, Bizerte, Tunisia
| | - Yomn Naceur
- University of Tunis El Manar, Tunis Faculty of Medicine, Tunis, Tunisia.,Regional Hospital Béja, Béja, Tunisia
| | - Mehdi Ben Khelil
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia.,University of Tunis El Manar, Tunis Faculty of Medicine, Tunis, Tunisia
| | - Mohamed Allouche
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia.,University of Tunis El Manar, Tunis Faculty of Medicine, Tunis, Tunisia
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Karunarathne A, Bhalla A, Sethi A, Perera U, Eddleston M. Importance of pesticides for lethal poisoning in India during 1999 to 2018: a systematic review. BMC Public Health 2021; 21:1441. [PMID: 34294076 PMCID: PMC8296580 DOI: 10.1186/s12889-021-11156-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 05/27/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Poisoning is a major problem in India. However, there is little systematic information on the key poisons responsible for most deaths by geographical area and over time. We aimed to review the literature to identify the poison classes causing the greatest number of deaths in India over the last 20 years. METHODS We performed a systematic literature review in Medline, Embase and Google Scholar (1999-2018), and Indian online medical journals, to find papers that reported deaths from all forms of poisoning in India, with last search 20 April 2020. We included epidemiological studies, observational studies, randomised trials, interventional studies, and case series published from 1999 to 2018 that showed the number of deaths and autopsy studies indicating the specific poisons or poison classes. Studies providing the case fatality for specific poisons or classes, which enabled calculation of the number of deaths, were also included. We excluded deaths due to animal bites and stings, ethanol or methanol poisoning, and gas inhalation as well as papers reporting a single death (case study of single patient). We grouped the papers into 5-year intervals and identified the two most common poison classes in each paper. We used descriptive statistics to summarise the findings over time based on the causative poison and the location of the study. RESULTS We identified 186 papers reporting 16,659 poisoning deaths between 1999 and 2018. The number of publications per 5-year interval showed no clear trend over the period (48, 38, 67, and 36 for consecutive periods). Half of the deaths (n = 8338, 50.0%) were reported during the first 5 years of the study (1999-2003), the number of deaths declining thereafter (to n = 1714 in 2014-2018). Deaths due to pesticide poisoning (94.5%) were dominant across the study period compared to other classes of poison [hair dye paraphenylenediamine poisoning (2.6%), medicine overdose (1.4%) or plant poisoning (1.0%)]. Among the pesticides, aluminium phosphide was the most important lethal poison during the first 10 years before declining markedly; organophosphorus insecticides were important throughout the period, becoming dominant in the last decade as aluminium phosphide cases declined. Unfortunately, few papers identified the specific organophosphorus insecticide responsible for deaths. CONCLUSION Use of the published literature to better understand the epidemiology of lethal poisoning in India has clear limitations, including secular variation in publishing practices and interest in poisoning. Unfortunately, there are no long-term detailed, combination hospital and community studies from India to provide this information. In their absence, our review indicates that pesticides are the most important poison in India, with organophosphorus insecticides replacing aluminium phosphide as the key lethal poison after government regulatory changes in 2001 reduced the latter's lethality. Plant and hair dye poisoning and medicines overdose caused few deaths. Aluminium phosphide deaths mostly occurred in northern Indian states, whereas deaths from organophosphorus insecticide poisoning occurred throughout India. Paraquat poisoning has become a clinical problem in the last 10 years. Lethal pesticide poisoning remains alarmingly common, emphasising the need for additional regulatory interventions to curtail the burden of pesticide poisoning deaths in India. More detailed reporting about the specific pesticide involved in lethal poisoning will be helpful to guide regulatory decisions.
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Affiliation(s)
- Ayanthi Karunarathne
- Centre for Pesticide Suicide Prevention, and Pharmacology, Toxicology & Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Ashish Bhalla
- Department of Internal Medicine, Nehru Hospital, Institute of Medical Education and Research, Chandigarh, India
| | - Aastha Sethi
- Centre for Pesticide Suicide Prevention, and Pharmacology, Toxicology & Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Government of Maharashtra, Mumbai, Maharashtra, India
| | - Uditha Perera
- Usher Institute for Population Health Sciences & Informatics, University of Edinburgh, Edinburgh, UK
| | - Michael Eddleston
- Centre for Pesticide Suicide Prevention, and Pharmacology, Toxicology & Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
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Holmes BD, Haglund K, Beyer KMM, Cassidy LD. Qualitative methods of road traffic crash research in low- and middle-income countries: a review. Int J Inj Contr Saf Promot 2018; 26:194-199. [PMID: 30569824 DOI: 10.1080/17457300.2018.1535512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Benjamin D Holmes
- a Institute for Health & Equity, Medical College of Wisconsin , Milwaukee , WI , USA
| | - Kristin Haglund
- b College of Nursing , Marquette University , Milwaukee , WI , USA
| | - Kristin M M Beyer
- a Institute for Health & Equity, Medical College of Wisconsin , Milwaukee , WI , USA
| | - Laura D Cassidy
- a Institute for Health & Equity, Medical College of Wisconsin , Milwaukee , WI , USA
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Terranova C, Zen M, Maguolo N, Cirillo T, Montisci M. Underage victims and perpetrators of murder in Italy: 2007-2015. J Forensic Leg Med 2018; 59:39-44. [PMID: 30130701 DOI: 10.1016/j.jflm.2018.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 05/07/2018] [Accepted: 08/13/2018] [Indexed: 02/04/2023]
Abstract
From the epidemiological and criminological points of view, murders committed by minors, including both victims and perpetrators, differ from those observed in adults. Analysis of trends and characteristics of murders at national level could provide useful information to assess the phenomenon and address political and social choices aiming at preventing violence involving children and adolescents. This study focuses on the trends of murders in Italy during the period 2007-2015 and compares the data with those for other age groups. Data on murders regarding trends, gender, age and ethnic group from the Italian Institute of Statistics were analysed by chi-square with odds ratio and linear regression. Results show that, after standardization, murders involving minors as victims and perpetrators were less frequent with respect to data observed in all age groups. Trend analysis showed that murders involving minors remained stable in the period considered, but the stability of the rate of murders of minors was in contrast with reduced rates in other age groups. Among minors, males aged 14-17 are at higher risk of being the perpetrators and victims of homicide. The rate of perpetrators and victims among foreign-born minors was higher than that among the native-born. Further studies are needed to determine risk factors associated with these results and to propose preventive strategies through appropriate policies and interventions.
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Affiliation(s)
- Claudio Terranova
- Legal Medicine and Toxicology, Department of Legal and Work Medicine, Toxicology and Public Health, University Hospital of Padova, Via G. Falloppio n.50, Padova, 35121, Italy.
| | - Margherita Zen
- Division of Rheumatology, Department of Medicine, University of Padova, Via Giustiniani n.2, Padova, 35128, Italy
| | - Nicola Maguolo
- Legal Medicine and Toxicology, Department of Legal and Work Medicine, Toxicology and Public Health, University Hospital of Padova, Via G. Falloppio n.50, Padova, 35121, Italy
| | - Tommaso Cirillo
- Legal Medicine and Toxicology, Department of Legal and Work Medicine, Toxicology and Public Health, University Hospital of Padova, Via G. Falloppio n.50, Padova, 35121, Italy
| | - Massimo Montisci
- Legal Medicine and Toxicology, Department of Legal and Work Medicine, Toxicology and Public Health, University Hospital of Padova, Via G. Falloppio n.50, Padova, 35121, Italy
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Lukaszyk C, Ivers RQ, Jagnoor J. Systematic review of drowning in India: assessment of burden and risk. Inj Prev 2018; 24:451-458. [PMID: 29330198 DOI: 10.1136/injuryprev-2017-042622] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 12/05/2017] [Accepted: 12/15/2017] [Indexed: 11/03/2022]
Abstract
AIM To examine the burden and risk factors for fatal and non-fatal drowning in India. METHODS Relevant literature was identified through a systematic search of 19 electronic databases and 19 national and global, institutional, organisational and government sources of injury data. Search terms used pertained to drowning, injury, trauma, morbidity and mortality in India. RESULTS A total of 16 research articles and five data sources were included in the review. Three national data sources provided counts of drowning deaths, reporting a range of 1348-62 569 drowning deaths per year. A further three national data sources provided information on drowning-related morbidity; however, each source presented different outcome measures making comparison difficult. Ten research studies investigated risk factors associated with drowning in India. Key risk factors reported were male gender, young age (0-5 years) and individuals residing in the North-Eastern part of the country who have high exposure to water sources within community settings. CONCLUSION Drowning-related morbidity and mortality have a significant impact on India, with risk factors identified for this setting similar to those within other low-income and middle-income countries. Regional data which look beyond routinely collected data are required to accurately investigate the burden and impact of drowning, to inform targeted, context-specific approaches for drowning reduction initiatives.
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Affiliation(s)
- Caroline Lukaszyk
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Rebecca Q Ivers
- The George Institute for Global Health, University of New South Wales, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia.,Southgate Institute, Flinders University, Adelaide, Australia
| | - Jagnoor Jagnoor
- The George Institute for Global Health, University of New South Wales, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
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Alsaif DM, Almadani OM, Ali Almoghannam S, Hamdi D, Al-Farayedhi MA, Kharosha MA. Child Fatalities in Dammam: A Call for Child Fatality Reviews in Arab Countries. J Forensic Sci 2017; 63:1171-1175. [PMID: 29098711 DOI: 10.1111/1556-4029.13685] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 10/15/2017] [Accepted: 10/16/2017] [Indexed: 11/29/2022]
Abstract
Identifying children's risk exposure is the first step toward mortality prevention. This retrospective study determined the causes of child fatalities in Dammam, Saudi Arabia. Death reports of children and adolescents from 1999 to 2015 (N = 157) were analyzed. Boys represented most cases (69%) and there were two age peaks (1-5 years and 16-18 years). Accidents (typically immersion) defined the main death circumstance (51%) followed by homicide (25%). Only 33% of cases underwent autopsy, and the most common cause of death was head injury (27%) followed by firearm injury. Only one immersion death underwent autopsy. This study revealed important data about the risk exposure of children in Dammam and emphasizes deficient investigative procedures. Child fatality reviews comprise systematic data collection by multidisciplinary teams to determine the true risks toward children in a community. Such teams do not exist in Arab countries; therefore, strategies should be implemented to initiate them.
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Affiliation(s)
- Dalia Mohammed Alsaif
- Center of Forensic and Legal Medicine, Ministry of health, Dammam, Eastern Province, P.O.Box 6668, Saudi Arabia 31176
| | - Osama M Almadani
- Center of Forensic and Legal Medicine, Ministry of health, Dammam, Eastern Province, P.O.Box 6668, Saudi Arabia 31176
| | - Salah Ali Almoghannam
- Center of Forensic and Legal Medicine, Ministry of health, Dammam, Eastern Province, P.O.Box 6668, Saudi Arabia 31176
| | - Dina Hamdi
- Center of Forensic and Legal Medicine, Ministry of health, Dammam, Eastern Province, P.O.Box 6668, Saudi Arabia 31176
| | - Maram A Al-Farayedhi
- Center of Forensic and Legal Medicine, Ministry of health, Dammam, Eastern Province, P.O.Box 6668, Saudi Arabia 31176
| | - Magdy A Kharosha
- Center of Forensic and Legal Medicine, Ministry of health, Dammam, Eastern Province, P.O.Box 6668, Saudi Arabia 31176
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Wang Y, Du M, Hao Z, Zhang H, Zhang Q, Hao W, Xi L, Sun J. Causes of Death in Children Aged < 15 Years in the Inner Mongolia Region of China, 2008-2012. Glob J Health Sci 2016; 8:56176. [PMID: 27157187 PMCID: PMC5064087 DOI: 10.5539/gjhs.v8n9p76] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 01/04/2016] [Indexed: 11/12/2022] Open
Abstract
The objective of our study was to identify the causes of death in children <15 years of age in Inner Mongolia and to examine the age-specific causes of death. Study data from 2008-2012 were obtained from the Death Registry System that is maintained by the Inner Mongolia Centers for Disease Control and Prevention. The mortality rate (per 100,000) for children <15 years of age was calculated and stratified by age in different years. We computed the proportion of age-specific causes of death for children <15 years that occurred between 2008 and 2012 across eight monitoring points in Inner Mongolia. We used a log-linear model to analyze the year and age effects on childhood mortality. From 2008-2012, the standardized mortality of children <15 years of age was 42.78/100,000. The mortality rate was not significantly different from 2008 to 2012 (p>0.05); the mortality rate was the highest in the <1-year age group (p<0.05); and the mortality rate of the <1-year age group was higher in 2012 compared to that in 2009 (p<0.05), 2010 (p<0.05), and 2011 (p<0.05). In children aged 1-14 years, the leading cause of death was injuries, among which transport accident injuries were the most prevalent. To reduce the childhood mortality rate in Inner Mongolia, China, we should focus on the prevention of perinatal deaths in infants <1 year of age and on the prevention of transport accident injuries among older children (1-14 years).
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Yagmur F, Celik S, Yener Z, Koral F, Yaman T, Sezer Y, Kandemir E. Head Trauma–Related Deaths Among Preschool Children in Istanbul, Turkey. Am J Forensic Med Pathol 2016; 37:35-9. [DOI: 10.1097/paf.0000000000000213] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mukherjee B, Farooqui JM, Farooqui AAJ. Retrospective study of fatal electrocution in a rural region of western Maharashtra, India. J Forensic Leg Med 2015; 32:1-3. [DOI: 10.1016/j.jflm.2015.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 01/30/2015] [Accepted: 02/02/2015] [Indexed: 11/26/2022]
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