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Farhat T, Nahouli H, Hajjar M, Abdul-Sater Z, Kobeissi E, Menassa M, Chaya BF, Elamine A, El Sheikh WG, Tamim H, Hettiaratchy S, Abu-Sittah G. Characteristics of injuries during the 2006 Lebanon conflict: a three-center retrospective study of survivors, 16 years after the conflict. Front Public Health 2024; 12:1382514. [PMID: 38864014 PMCID: PMC11165059 DOI: 10.3389/fpubh.2024.1382514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/03/2024] [Indexed: 06/13/2024] Open
Abstract
Background Armed conflict injury is a growing public health concern, particularly in regions like the Middle East and North Africa (MENA). The protracted conflicts and political unrest in this region have led to a substantial number of injuries. Despite this, there is still limited understanding of the specific injury patterns stemming from conflicts, such as the 2006 Lebanon conflict. This study aimed to assess the characteristics and burdens of injuries resulting from this conflict, which occurred 16 years prior to this research. Methods This retrospective study analyzed data of individuals affected by the 2006 Lebanon conflict, across three tertiary care centers. Demographics, injuries, complications, injury management, and hospitalization expenses were extracted from medical records and analyzed using SPSS version 29.0. Categorical variables were presented as counts and proportions, and continuous variables as mean ± standard deviation (SD). Hospital comparisons utilized chi-square or Fisher's exact tests for categorical variables, and one-way ANOVAs for continuous variables. Analysis was conducted from September to November 2023. Results Across three hospitals, 341 patients were studied, comprising 73.6% males and 26.4% females. Among them, a notable proportion (57.3% males and 34.1% females) fell within the 18-39 age range. Children and adolescents under 18 years accounted for 15.9% of males and 25.9% of females. Blast-related injuries predominated, with 24.5% resulting from direct damage caused by explosive parts and 33.3% from blast wave forces. Extremity trauma occurred in 49.0% of patients, and head/neck trauma in 24.9%. Common injuries, including penetrating, musculoskeletal, and traumatic brain injuries affected 34.9%, 31.1, and 10.0% of patients, respectively. Wound repair, fracture treatment, and debridement were the most performed procedures on 15.5, 13.5 and 9.7% of the patients, respectively. The total cost of care was USD 692,711, largely covered by the Ministry of Public Health (95.9%). Conclusion Conflict-related injuries significantly contribute to the global burden of disease. Therefore, there is a pressing need to improve national guidelines to prioritize life-threatening cases and potential long-term disabilities. Furthermore, enhancing electronic registry systems to collect clinical data on injured patients is essential for conducting research and better understanding the needs of conflict casualties.
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Affiliation(s)
- Theresa Farhat
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Hasan Nahouli
- Division of Orthopedic Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Marwan Hajjar
- Division of Plastic Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Zahi Abdul-Sater
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Elsa Kobeissi
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Marilyne Menassa
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Bachar F. Chaya
- Division of Plastic Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ahmad Elamine
- Division of Plastic Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Walaa G. El Sheikh
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hani Tamim
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Shehan Hettiaratchy
- Centre for Blast Injury Studies, Imperial College London, London, United Kingdom
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- Imperial College Healthcare NHS Trust, London, United Kingdom
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Kobeissi E, Menassa M, Honein-AbouHaidar G, El Achi N, Abdul-Sater Z, Farhat T, Al Mohtar D, Hajjar M, Abdul-Khalek RA, Chaya BF, Elamine A, Hettiaratchy S, Abu-Sittah G. Long-term burden of war injuries among civilians in LMICs: case of the July 2006 war in Lebanon. Front Public Health 2023; 11:1305021. [PMID: 38145076 PMCID: PMC10748398 DOI: 10.3389/fpubh.2023.1305021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 11/21/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction Lebanon, a country located on the eastern shore of the Mediterranean Sea, is one of the world's smaller sovereign states. In the past few decades, Lebanon endured a perpetual political turmoil and several armed conflicts. July 12, 2006, marked the start of a one-month war in Lebanon, which resulted in thousands of casualties. Little is known about the long-term consequences of war injuries inflicted on civilians during the July 2006 war. Methods The objectives of this paper were to identify and evaluate: 1- civilians' access to healthcare and medicine under conditions of war; 2- the long-term socioeconomic burden on injured civilians; and 3- their quality of life more than a decade post-war. We adopted a mixed-method research design with an emphasis on the qualitative component. We conducted interviews with patients, collected clinical and financial data from hospital medical records, and administered a self-rated health questionnaire, the EQ-5D-5L. Simple descriptive statistics were calculated using Excel. NVivo 12® was used for data management and thematic analysis. Results We conducted 25 interviews. Injured civilians were mostly males, average age of 27. The most common mechanism of injury was blast injury. Most patients underwent multiple surgeries as well as revision surgeries. The thematic analysis revealed three themes: 1- recall of the time of the incident, the thousand miles journey, and patients' access to services; 2- post-trauma sequelae and services; and 3- long-term impact. Patients described the long-term burden including chronic pain, poor mobility, anxiety or depression, and limited activities of daily living. Discussion Civilians injured during the July 2006 war described the traumatising events they endured during the war and the limited access to medical care during and post-war. Up until this study was conducted, affected civilians were still experiencing physical, psychological, and financial sequelae. Acknowledging the limitations of this study, which include a small sample size and recall bias, the findings underscore the necessity for the expansion of services catering to civilians injured during wartime.
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Affiliation(s)
- Elsa Kobeissi
- Conflict Medicine Program, Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Marilyne Menassa
- Conflict Medicine Program, Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Gladys Honein-AbouHaidar
- Refugee Health Program, Global Health Institute, American University of Beirut, Beirut, Lebanon
- Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
| | - Nassim El Achi
- Conflict Medicine Program, Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Zahi Abdul-Sater
- Conflict Medicine Program, Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Theresa Farhat
- Conflict Medicine Program, Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Dalia Al Mohtar
- Conflict Medicine Program, Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Marwan Hajjar
- Department of Surgery, Division of Plastic and Reconstructive Surgery, American University of Beirut Medical Centre, Beirut, Lebanon
| | | | - Bachar F. Chaya
- Department of Surgery, Division of Plastic and Reconstructive Surgery, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Ahmad Elamine
- Department of Surgery, Division of Plastic and Reconstructive Surgery, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Shehan Hettiaratchy
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- St Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Ghassan Abu-Sittah
- Conflict Medicine Program, Global Health Institute, American University of Beirut, Beirut, Lebanon
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Al-Hajj S, El Haj R, Chaaya M, Sharara-Chami R, Mehmood A. Child injuries in Lebanon: assessing mothers' injury prevention knowledge attitude and practices. Inj Epidemiol 2023; 10:27. [PMID: 37340480 DOI: 10.1186/s40621-023-00434-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 04/27/2023] [Indexed: 06/22/2023] Open
Abstract
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.
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Affiliation(s)
- Samar Al-Hajj
- Epidemiology and Population Health Department, Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon.
| | - Rawan El Haj
- Epidemiology and Population Health Department, Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
| | - Monique Chaaya
- Epidemiology and Population Health Department, Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
| | | | - Amber Mehmood
- College of Public Health, University of South Florida, Tampa, FL, USA
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Noh JW, Lee LJ, Kim KB, Cha J, Kwon YD. Factors influencing injury or death due to traumatic events in Afghanistan's crisis-affected populations: a cross-sectional nationwide study. BMJ Open 2022; 12:e063329. [PMID: 36576193 PMCID: PMC9723898 DOI: 10.1136/bmjopen-2022-063329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Afghanistan, with one of the world's largest refugee populations, suffers an enormous burden of injury resulting in loss of life. This study aims to identify the epidemiology of injuries or death in the crisis-affected populations across Afghanistan and to investigate factors associated with injuries or deaths due to traumatic events. DESIGN Cross-sectional study. SETTING This study analysed Whole Afghanistan Assessment 2019 data. This survey geographically covered all 34 accessible provinces in Afghanistan. PARTICIPANTS 31 343 displaced and shock-affected households in Afghanistan. PRIMARY AND SECONDARY OUTCOME MEASURES Injury or death of household members due to traumatic events. RESULTS 2561 (8.2%) reported at least one household member had been injured or deceased because of a significant conflict or natural disaster in the past year. Households experienced significant events such as active conflict or violence (prevalence ratio, PR=5.575, p<0.001), earthquake (PR=3.118, p=0.004), flood (PR=1.534, p=0.008) and avalanche or heavy snowfall (PR=3.450, p<0.001) were significantly associated with injury or death. The likelihood of injury or death was significantly higher for long-distance households than for households living within a 5 km radius of the nearest healthcare facilities (6-10 km: PR=1.402, p=0.030; >10 km: PR=1.560, p=0.020). CONCLUSION The study provides an epidemiological profile of injuries or death in crisis-affected populations across Afghanistan. Results also suggest that certain factors place the crisis-affected populations in Afghanistan at high risk for injuries or death, which can inform the development of surveillance and prevention programmes, the monitoring of patterns over time and the formulation of healthcare policies.
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Affiliation(s)
- Jin-Won Noh
- Division of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Gangwon-do, Korea (the Republic of)
| | - Lena J Lee
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health Clinical Center, Bethesda, Maryland, USA
| | - Kyoung-Beom Kim
- Industry-Academic Cooperation Foundation, Yonsei University, Wonju, Gangwon-do, Korea (the Republic of)
| | - Jiho Cha
- Moonsoul Graduate School of Future Strategy, Korea Advanced Institute of Science and Technology, Daejeon, Korea (the Republic of)
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, The Catholic University of Korea, Seoul, Korea (the Republic of)
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Al-Hajj S, Ariss AB, Bachir R, Helou M, Zaghrini E, Fatouh F, Rahme R, El Sayed MJ. Paediatric injury in Beirut: a multicentre retrospective chart review study. BMJ Open 2022; 12:e055639. [PMID: 35338061 PMCID: PMC8961129 DOI: 10.1136/bmjopen-2021-055639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE This study aims to assess the epidemiology of paediatric injury in Beirut, giving insights into their characteristics, contributing risk factors and outcomes. DESIGN AND SETTING A retrospective study was conducted to review medical charts for children aged 0-15 years presented to five hospital emergency departments (ED) located in Beirut over a 1-year period (June 2017-May 2018). PARTICIPANTS A total of 1142 trauma-related visits for children under 15 years of age were included. A descriptive analysis and a bivariate analysis were performed to investigate admitted and treated/discharged patients. PRIMARY OUTCOME A logistic regression was conducted to identify factors associated with hospital admission among injured children. RESULTS A total of 1142 cases of paediatric injury ED cases were sampled, mean age was 7.7±4.35 years. Children aged 0-5 years accounted for more than one-third of the total cases, 40.0% (206/516) of the fall injuries and 60.1% (220/366) of home injuries. The leading cause of paediatric injury was fall (45.2%), nearly 4.1% of the cases were admitted to hospitals. Factors associated with admission included injury to abdomen (OR=8.25 (CI 1.11 to 61.24)), to upper extremity (OR=5.79 (CI 2.04 to 16.49)), to lower extremity (OR=5.55 (95% CI 2.02 to 15.20) and other insurance type (OR=8.33 (CI 2.19 to 31.67)). The three types of injuries mostly associated with hospital admission were fracture (OR=13.55 (CI 4.77 to 38.44)), concussion (OR=13.60 (CI 2.83 to 65.41)) and organ system injury (OR=31.63 (CI 3.45 to 290.11)). CONCLUSIONS Injury remains a major health problem among the paediatric population in Lebanon. Parental child safety educational programmes and age-targeted injury prevention strategies should be initiated and implemented to mitigate the burden of child injuries and improve child safety and well-being.
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Affiliation(s)
| | - Abdel-Badih Ariss
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rana Bachir
- American University of Beirut, Beirut, Lebanon
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mariana Helou
- Department of Emergency Medicine, Rizk Hospital, Beirut, Lebanon
| | - Elie Zaghrini
- Department of Emergency Medicine, Lebanese Hospital Geitawi, Beirut, Lebanon
| | - Fathalla Fatouh
- Department of Emergency Medicine, Harriri University Hospital, Beirut, Lebanon
| | - Rachid Rahme
- Sacre-Coeur Hospital, Baabda, Mont-Liban, Lebanon
| | - Mazen J El Sayed
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Abstract
This paper uses a unique dataset from Lebanon, a developing country with unstable political conditions, to explore the drivers of research outcomes. We use the Negative Binomial model to empirically examine the determinants of the total number of publications and single and co-authored articles. The results indicate that males are more likely to publish co-authored papers than females. Moreover, our findings show a quadratic relationship between age and the number of published papers with a peak at the age of 40. After this turning point, the publication rate starts to decrease at an increasing rate. When we run the model by gender, we find that females in large departments tend to publish more co-authored papers. We also find that full professors tend to publish more papers in Q1 and Q2 journals, while associate professors have more papers in Q2 and Q3 journals.
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Ghoubaira J, Diab M, Nassereldine H, Tamim H, Saadeh S, Price R, Moustafa M, Al‐Hajj S. Road traffic injury in Lebanon: A prospective study to assess injury characteristics and risk factors. Health Sci Rep 2021; 4:e396. [PMID: 34849405 PMCID: PMC8611407 DOI: 10.1002/hsr2.396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 08/21/2021] [Accepted: 08/24/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Road traffic injury (RTI) is a significant yet poorly characterized cause of morbidity and mortality in the Middle East. This hospital-based-study examined RTI in Lebanon and provided an understanding of their characteristics. METHODS We collected prospective RTI data from three participating hospitals over 3 months using a designed tool based on Canadian CHIRPP and WHO tools. We performed logistic regression analysis to examine the relationship between contributing risk factors (age, sex) and injury types as well as the association of safety measures used (seatbelts or helmets) and body parts injured. RESULTS A total of 153 patients were collected. Male preponderance with 72%, with mean age 32.6 (SD = 14.9) years. RTI was highest among passengers aged 15 to 29 (48%). Motorcyclists comprised the greatest injury proportion (38%), followed by vehicle-occupants (35%), and pedestrians (25%) (P = .04). Hip injuries represented the most affected body part (48.7%), followed by head/neck (38.2%). Only 31% (n = 47) of victims applied safety measures (seatbelts or helmets). Six drivers (7%) reported cell phone use at collision. The use of safety measures was associated with a substantial reduction in head/neck injuries (P = .03), spine injuries (P = .049), and lower risk of traumatic brain injury (TBI) (P = .02). CONCLUSIONS RTI is a major health problem in Lebanon. Safety measures, though poorly adhered to, were associated with less severe injuries, and should be further promoted via awareness campaigns and enforcement. Trauma registries are needed to assess the RTI burden and inform safety interventions and quality-of-care improvement programs.
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Affiliation(s)
| | - Marwa Diab
- Faculty of MedicineAmerican University of BeirutBeirutLebanon
| | | | - Hani Tamim
- Department of Internal MedicineAmerican University of Beirut Medical CenterBeirutLebanon
| | - Samer Saadeh
- Emergency Department ZHUMC Medical CenterLebanese UniversityBeirutLebanon
| | - Raymond Price
- Center for Global Surgery, University of UtahSalt LakeUtahUSA
| | | | - Samar Al‐Hajj
- Faculty of MedicineAmerican University of BeirutBeirutLebanon
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Farran N. Mental health in Lebanon: Tomorrow's silent epidemic. MENTAL HEALTH & PREVENTION 2021; 24:200218. [PMID: 34660191 PMCID: PMC8503814 DOI: 10.1016/j.mhp.2021.200218] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 09/05/2021] [Indexed: 12/14/2022]
Abstract
Lebanon is a middle-income country that has been recently crippled by several tragedies including the economic collapse, COVID-19, and the fourth of August Beirut port explosion, the world's most powerful non-nuclear explosion of the twenty-first century. Recent data on mental health from Lebanon is summarised, and other topics such as the psychological impact of cumulative adversities and the role of international support in Lebanon are examined. Data from Lebanon shows severe levels of distress among the people, in a country with minimal resources. Given current adversities in Lebanon, recent data in the country, and the literature on adversity and mental health outcomes of man-made disasters, Lebanon is most likely going to face an epidemic in poor mental health. A call is made for the wider scientific community and international organizations to support the mental health field in the country and help prevent further negative mental health outcomes. Understanding how to better navigate mental health in places with extreme adversity and emergencies can be beneficial to other communities which might face similar challenges.
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Affiliation(s)
- Natali Farran
- Institute of Psychiatry, Psychology, and Neuroscience. King's College London, 16 De Crespigny Park, Camberwell, London SE5 8AB, UK
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Al-Hajj S, Chahrour MA, Nasrallah AA, Hamed L, Pike I. Physical trauma and injury: A multi-center study comparing local residents and refugees in Lebanon. J Glob Health 2021; 11:17001. [PMID: 34737871 PMCID: PMC8542374 DOI: 10.7189/jogh.11.17001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Refugees are susceptible to various types of injury mechanisms associated with their dire living conditions and settlements. This study aims to compare and characterize the emergency department admissions due to physical trauma and injuries among local residents and refugees in greater Beirut. Methods This epidemiological study analyzes injury incidence and characteristics of patients presenting to Emergency Departments of 5 sentinel hospitals between 2017 and 2019. Using the WHO Injury Surveillance Guidelines and Pan-Asia Trauma Outcomes Study form, an injury data surveillance form was designed and used in hospital settings to collect data on injuries. Chi-square test analysis was performed to compare differences in injury characteristics between local residents and refugees. Regression models were constructed to assess the effect of being a refugee on the characteristics of injuries and outcomes of interest. Results A total of 4847 injuries (3933 local residents and 914 refugees) were reported. 87.4% of the total injuries among refugees were sustained by the younger age groups 0-45 years compared to 68.8% among local residents. The most prevalent injury mechanism was fall (39.4%) for locals and road traffic injury (31.5%) for refugees. The most injured body part was extremities for both populations (78.2% and 80.1%). Injuries mostly occurred at home or its vicinity (garden or inside the camp) for both populations (29.3% and 23.1%). Refugees sustained a higher proportion of injuries at work (6%) compared to locals (1.3%). On multivariate analysis, refugee status was associated with higher odds of having an injury due to a stab/gunshot (odds ratio (OR) = 3.392, 95% confidence interval (CI) = 2.605-4.416), having a concussion injury (OR = 1.718, 95% CI = 1.151-2.565), and being injured at work (OR = 4.147, 95% CI = 2.74-6.278). Refugee status was associated with increased odds of leaving the hospital with injury-related disability (OR = 2.271, 95% CI = 1.891-2.728)] Conclusions Injury remains a major public health problem among resident and refugee communities in Beirut, Lebanon. Refugees face several injury-related vulnerabilities, which adversely affect their treatment outcomes and long-term disabilities. The high prevalence of occupational and violence-related injuries among refugees necessitates the introduction of targeted occupational safety and financial security interventions, aiming at reducing injuries while enhancing social justice among residents.
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Affiliation(s)
- Samar Al-Hajj
- Health Management and Policy Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Mohamad A Chahrour
- Health Management and Policy Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Ali A Nasrallah
- Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Lara Hamed
- Health Management and Policy Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Ian Pike
- Department of Pediatrics, Faculty of Medicine, University of British Columbia. BC Injury Research and Prevention Unit, BC Children's Hospital Research Institute, Vancouver, BC, Canada
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Al-Hajj S, Arjinian S, Hamadeh Z, Al-Zaghrini E, El Asmar K. Child transport injuries and deaths in Lebanon: a multicentre retrospective study. BMJ Open 2020; 10:e037973. [PMID: 33109652 PMCID: PMC7592305 DOI: 10.1136/bmjopen-2020-037973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 08/24/2020] [Accepted: 09/13/2020] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Road traffic injury (RTI) constitutes the leading cause of deaths and disabilities for individuals aged 5-29 years globally. Lebanon suffers from a high toll of transport mortality and morbidity, though accurate and reliable RTI data are limited. The aim of this study is to assess the prevalence and the characteristics of child transport injuries and deaths in Lebanon and to determine their outcomes and associated risk factors. METHODS We conducted a multicentre retrospective study to analyse data on transport injuries and deaths for children aged 0-17 years over a 3-year period (2015-2017). Data were captured from multiple sources, including police reports and the emergency departments of 30 hospitals across the country . We performed logistic regression models to examine the effects and test the association of multiple simultaneous factors on the child injury outcome and severity. RESULTS A total of 3,033 cases of child transport injuries and 237 fatalities were collected. The majority of the cases were males (73%) (mean (SD) age=11 (±5) years). Transport victims were Lebanese (66.5%) and Syrian refugees (27.9%). The most commonly reported factor contributing to child's RTI was a child riding in high-speed vehicles (25%) and the most affected body regions were upper and lower extremities (29.9%), followed by head injuries (26.1%). Pedestrians had higher odds of sustaining fatal injuries compared to four-wheel vehicle occupants (OR=1.6; 95% CI: 1.17 to 2.27). Older age groups of 6-14 years (OR=0.51; 95% CI: 0.79 to 0.69) and 15-17 years (OR=0.41; 95% CI: 0.30 to 0.61) had lower odds of dying from transport injuries compared to the younger age group of 0-5 years. CONCLUSION Child transport injury is a major public health problem in Lebanon. Findings from this study urge policy-makers and health professionals to implement evidence-based child transport safety policies and behaviour change programs to reduce child transport injuries and deaths.
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Affiliation(s)
- Samar Al-Hajj
- Health Management and Policy Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | | | | | - Elie Al-Zaghrini
- Emergency Medicine Department, Faculty of Medicine, Lebanese American University, Beirut, Lebanon
| | - Khalil El Asmar
- Epidemiology and Population Health Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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Al-Hajj S, Nehme R, Hatoum F, Zheng A, Pike I. Child school injury in Lebanon: A study to assess injury incidence, severity and risk factors. PLoS One 2020; 15:e0233465. [PMID: 32530949 PMCID: PMC7292362 DOI: 10.1371/journal.pone.0233465] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 05/05/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND School-based injuries represent a sizeable portion of child injuries. This study investigated the rates of school-based injuries in Lebanon, examining injury mechanisms, outcomes and associated risk factors. METHODS Data were prospectively collected by intern school nurses at 11 private schools for the 2018-2019 academic year. Descriptive and inferential analyses were performed. Chi-square comparisons were conducted to determine the significance of any differences in injury rates between boys and girls for each category of school. RESULTS 4,619 injury cases were collected. The yearly rate for school injuries was 419.1 per 1,000 children for the year 2018-2019. Boys demonstrated a significantly higher injury rate for all mechanisms of injuries, with the exception of being injured while walking, injured in the gym/sports areas, and other areas outside the playground and classroom. Elementary school children had the highest rate of injuries, nearly 2.4 times higher than kindergarten, 2.8 times higher than middle school, and 14.5 times higher than high school. Injuries to the face, upper extremities, and lower extremities were nearly 3 times more common than injuries to other areas of the body. Bumps/hits and bruises were most common-almost 3 times more likely than all other injury types. Injuries were mainly minor or moderate in severity-severe injuries were about 10 times less likely. Most injuries were unintentional, with rates nearly 5 times higher than those with unclear intent and 12 times higher than intentional injuries. CONCLUSIONS School injuries represent a relatively common problem. Compliance with playground safety standards coupled with the implementation of injury prevention strategies and active supervision at schools can curtail child injuries and ensure a safe and injury-free school environment.
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Affiliation(s)
- Samar Al-Hajj
- Health Management and Policy Department, American University of Beirut, Riad El-Solh, Beirut, Lebanon
| | - Ricardo Nehme
- Department of Biology, American University of Beirut, Beirut, Lebanon
| | - Firas Hatoum
- Department of Biology, American University of Beirut, Beirut, Lebanon
| | - Alex Zheng
- BC Injury Research and Prevention Unit, BC Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Ian Pike
- BC Injury Research and Prevention Unit, BC Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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