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Naeem R, Ali A, Buksh AR, Quddusi A, Khan UR. Tip-over injuries among children: Data from an urban emergency department of Karachi, Pakistan. Injury 2023; 54 Suppl 4:110526. [PMID: 36481052 DOI: 10.1016/j.injury.2022.11.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/18/2022] [Accepted: 11/26/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Most unintentional injuries among children occur in the home environment. Tip-overs, defined as incidents where heavy objects fall on children due to some type of interaction, are one of the reasons for injuries inside the home. This study aims to determine injury patterns and outcomes for child injuries resulting from tip-overs in the home environment as reported in the emergency department. METHODS We performed a retrospective chart review of pediatric (under 18 years) tip-overs injuries occurred in years 2010 to 2015 at the Aga Khan University Hospital. Furthermore, parents of injured children participated in phone interviews to provide information about the injury scene. File review and telephonic interviews were conducted in the year 2015 and 2016. RESULTS A total of 75 children visited the emergency department with tip-over injuries, out of which 55 (73%) were boys. The majority of incidents (75.5%) happened inside the home, and the most common places were the living room and bedroom (32% and 21% respectively). More than half (53%) of the children were not under adult supervision at the time of the incident and less than half (47%) of the household took safety measures after the incident. Tip-over injuries were common among 3-year-old children with decreasing frequency as children grew older. The most common causes of tip-overs were TV/TV trolley (32%), followed by furniture (28%), and wall and roof (23%). The most common sites of injuries were head (n = 33, 44%) and extremities (n = 33, 44%). A majority of the cases (n = 66, 88%) were admitted to the hospital from the emergency department, under care of both general (n = 51, 68%) and critical care units (n = 15, 20%). More than a quarter (n = 27, 36%) required at least one surgical procedure during their hospital stay. The median length of hospital stay was one days (interquartile range, IQR 1-5 days). There were two cases of mortality (3%). CONCLUSION Most tip-over injuries among children were caused by TV, furniture, and TV trolleys. These injuries can be prevented with public education around home safety measures, such as mounting them on the wall.
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Affiliation(s)
- Rubaba Naeem
- Department of Emergency Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Asrar Ali
- Department of Emergency Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Ahmed Raheem Buksh
- Department of Emergency Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | | | - Uzma Rahim Khan
- Department of Emergency Medicine, Aga Khan University Hospital, Karachi, Pakistan.
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Perveen F, Ahmed N, Masud S, Ihsan MU, Khan UR, Khan NU. Parental knowledge attitude and practices about chemical and medicinal poisons: A hospital based study from Karachi, Pakistan. Injury 2023; 54 Suppl 4:110481. [PMID: 37573064 DOI: 10.1016/j.injury.2022.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 10/31/2022] [Accepted: 11/07/2022] [Indexed: 08/14/2023]
Abstract
BACKGROUND Unintentional poisoning is among the leading cause of death in children less than 20 years age. The incidence of unintentional poisoning in Low-income countries LMICs is four times higher compared to high-income countries (HICs). In Pakistan a 10% (25/211) incidence of unintentional poisonings among 0-15-year-old children has been reported. Most of the poisoning occur because of household chemical and medicines. This study aimed to assess the knowledge, attitude, and practices (KAP) of parents in Karachi regarding poisonous household chemicals and medicines. METHODS This KAP study was conducted at Aga Khan University Hospital, Karachi from May to August 2019. A maximum sample of 384 was calculated using a 50% knowledge about household chemicals. Data were collected about parental knowledge, attitude and practices about poisons and chemicals at home and presented as frequency and percentages. Chi-square test of independence (or Fisher's exact test) was used. Data were analyzed using SPSS version 20. RESULTS A total of 364 parents of 0-16-year-old children completed the survey out of which 229 were mothers and 127 were fathers (eight had missing data). We had 70% of parents that kept chemicals and medicines locked in cabinets and 80% chose to never leave medicines unattended, there are still 20-30% parents that need improvement in the parental knowledge and practices for storing chemicals and medicines. A general lack of knowledge regarding poisoning first aid and emergency response centers was noted. CONCLUSIONS Two-pronged approach for future interventions could be useful; (1) Improving the knowledge and practice among the remaining 20-30% through repeated awareness' sessions for the community. (2) Information regarding PCCS needs to be made readily available to the parents which is a measure useful in cases a child poisoning occurs.
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Affiliation(s)
- Feroza Perveen
- Department of Pharmacy, Aga Khan University Hospital Karachi, Pakistan
| | - Naveed Ahmed
- Department of Emergency Medicine, Aga Khan University Hospital Karachi, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan
| | - Sarwat Masud
- Department of Emergency Medicine, Aga Khan University Hospital Karachi, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan
| | | | - Uzma Rahim Khan
- Department of Emergency Medicine, Aga Khan University Hospital Karachi, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan
| | - Nadeem Ullah Khan
- Department of Emergency Medicine, Aga Khan University Hospital Karachi, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan.
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Khan UR, Ali A, Raheem A, Naseer A, Wright K, Bhatti J. Injury hazard assessment in schools: Findings from a pilot study in Karachi, Pakistan. Injury 2023; 54 Suppl 4:110666. [PMID: 37573068 DOI: 10.1016/j.injury.2023.02.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 02/19/2023] [Accepted: 02/25/2023] [Indexed: 08/14/2023]
Abstract
INTRODUCTION Injuries are a major public health concern and one of the leading causes of death and disability worldwide. Childhood injuries contribute to a major proportion of this burden. OBJECTIVE To identify injury hazards within school premises and playgrounds in Karachi, Pakistan. METHODS This observational cross-sectional study took place in 107 public and private schools of Karachi, Pakistan using a self-structured standard injury risk assessment tool. This tool was developed after an extensive literature review, expert consultation, and field visits to a few local schools. Data related to school demographics, administrative data and injury hazards within the school boundaries were collected in schools offering education from nursery to secondary grades (through 10th grade, matriculation). Descriptive analysis were calculated. RESULTS Out of 107 schools, only 12 were recording school-related injuries. A quarter (25%) of schools had some type of disaster drill exercises and built-in fire exits. Fire alarms were placed in 10 schools (9%), all of which were private. In 16 schools (15%), students had access to rooftop doors. There were multiple injury hazards in the school playgrounds. More than half of the schools had hazardous playground surfaces, such as slippery, concrete and uneven ground. Over 80% of schools were not supervising the children during playtime and did not have a separate play area for children under 6 years old. In 38 schools (22%), there were multiple injury hazards in the play rides, such as broken equipment, rusted parts, and sharp edges. Moreover, nine schools (7%) had loose nuts, bolts, edges, belts, steps, or rails in their play rides. Inside, almost a quarter (24%, n = 76) of schools did not have proper insulation of electric wires. Protruded metal nails, which could be high risk for prick and cut injuries, were observed in 20% of the observed furniture. CONCLUSION In conclusion, there are multiple injury hazards in the private and public schools of Karachi, Pakistan.
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Affiliation(s)
- Uzma Rahim Khan
- Department of Emergency Medicine, Aga Khan University, Karachi, 74800, Pakistan.
| | - Asrar Ali
- Department of Emergency Medicine, Aga Khan University, Karachi, 74800, Pakistan
| | - Ahmed Raheem
- Department of Emergency Medicine, Aga Khan University, Karachi, 74800, Pakistan
| | - Aeman Naseer
- Medical College, Aga Khan University, Karachi, 74800, Pakistan
| | | | - Junaid Bhatti
- Sunnybrook Health Sciences Centre, 2075 Bayview Ave, G1 54, Toronto, ON, M4N 3M5, Canada
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Khan NU, Khan U, Khudadad U, Ali A, Raheem A, Waheed S, Razzak JA. Trends in mortality related to unintentional poisoning in the South Asian region from 1990 to 2019: analysis of data from the Global Burden of Disease Study. BMJ Open 2023; 13:e062744. [PMID: 36754559 PMCID: PMC9923325 DOI: 10.1136/bmjopen-2022-062744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
OBJECTIVE This study aimed to estimate the burden of unintentional poisoning in South Asian countries from 1999 to 2019. DESIGN An ecological study conducted at the regional level for South Asian countries, based on data from the Global Burden of Disease Study 2019. SETTING We extracted unintentional poisoning data from the Global Burden of Disease Study data set from 1990 to 2019 to assess trends in mortality, disability-adjusted life-years (DALYs), years of life lost, years lived with disability (YLDs) and causative agents in South Asian countries (Bangladesh, Bhutan, India, Nepal and Pakistan). OUTCOME MEASURES We determined the per cent change and 95% CI for the period between 1990 and 2019 by age, gender and country. We also conducted Poisson regression to measure the percentage change in the rate per year. RESULTS The absolute number of deaths due to unintentional poisoning in South Asia decreased (-32.6%) from 10 558 deaths in 1990 to 7112 deaths in 2019. The age standardised death rate from unintentional poisoning in South Asia has seen a downward trend (-55.88%), declining from 0.87 (0.67-1.01) age-standardised per 100 000 population in 1990 to 0.41 (0.34-0.47) in 2019. Among age groups, under 9 years and 10-19 years have seen downward trends for death and DALYs, accounting for -93.5% and -38.3%, respectively. YLDs have seen an upward trend (5.9%), increasing from 10 461.7 per 100 000 in 1990 to 11 084 per 100 000 in 2019. YLDs in women increased by 7.4%, from 11 558.2 per 100 000 to 12 418.3 per 100 000. The incidence rate ratios (IRRs) adjusted by all age groups and gender for DALYs in all South Asian countries has reduced significantly (IRR 0.97, 95% CI 0.96 to 0.97) from 1990 to 2019. CONCLUSION This study showed reduction in death and DALYs due to unintentional poisoning in South Asia except YLDs which is showing an increasing trend. Public health systems should continue efforts to minimise and prevent disabilities arising from unintentional poisoning in South Asia.
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Affiliation(s)
- Nadeem Ullah Khan
- Department of Emergency Medicine, The Aga Khan University, Karachi, Pakistan
| | - Uzma Khan
- Department of Emergency Medicine, The Aga Khan University, Karachi, Pakistan
| | - Umerdad Khudadad
- Department of Emergency Medicine, The Aga Khan University, Karachi, Pakistan
| | - Asrar Ali
- Department of Emergency Medicine, The Aga Khan University, Karachi, Pakistan
| | - Ahmed Raheem
- Department of Emergency Medicine, The Aga Khan University, Karachi, Pakistan
| | - Shahan Waheed
- Department of Emergency Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Junaid Abdul Razzak
- Department of Emergency Medicine, Weill Cornell Medicine, New York, New York, USA
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Inbaraj LR, Sindhu KN, Ralte L, Ahmed B, Chandramouli C, Kharsyntiew ER, Jane E, Paripooranam JV, Muduli N, Akhilesh PD, Joseph P, Nappoly R, Reddy TA, Minz S. Perception and awareness of unintentional childhood injuries among primary caregivers of children in Vellore, South India: a community-based cross-sectional study using photo-elicitation method. Inj Epidemiol 2020; 7:62. [PMID: 33308305 PMCID: PMC7734777 DOI: 10.1186/s40621-020-00289-4] [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: 07/16/2020] [Accepted: 10/23/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE We studied the primary caregivers' perception, and further, their awareness of unintentional childhood injuries in south India. METHODS A cross-sectional study was conducted in the rural block of Kaniyambadi, Vellore, among 300 primary caregivers of children aged between 0 and 14 years. A semi-structured interview was conducted with the primary caregivers using a photo-elicitation method, with a visual depiction of ten injury risky scenarios for a child. Scoring was done to assess the perception of environmental hazards in these scenarios, and further, knowledge on the prevention of these injuries. An independent 't' test was done to elicit differences in mean scores and a multivariate regression analysis was applied to ascertain factors independently associated with the scores. RESULTS Primary caregivers had adequate perception regarding risks posed to children in scenarios such as climbing trees (96.2%), playing near construction sites (96%), firecrackers (96.4%) and crossing unmanned roads with no traffic signals (94%). Knowledge of prevention was poor however, in the following scenarios: a woman riding a bicycle without safety features, with child pillion sitting behind bare foot and legs hanging by one side (72.6%); a child playing near a construction site (85.9%); and a child playing with plastic bags (88.3%). Overall, educational status of the primary caregiver and socioeconomic status were associated with poorer perception of risks and knowledge about unintentional childhood injuries and their prevention. CONCLUSIONS Pragmatic community-based childhood interventions incorporated into existing programs, with a special focus on road traffic injuries, burns and suffocation need to be implemented in high-risk settings of rural populations in South India.
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Affiliation(s)
- Leeberk Raja Inbaraj
- Division of Community Health, Bangalore Baptist Hospital, Bangalore, Karnataka, 560024, India. .,Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India.
| | - Kulandaipalayam Natarajan Sindhu
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India.,The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Lalmalsawmi Ralte
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Basir Ahmed
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Chandni Chandramouli
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Evelina Jane
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Nikhil Muduli
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Prakash Joseph
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Renata Nappoly
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Tamma Anusha Reddy
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Shantidani Minz
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India.,Rural Unit for Health and Social Affairs, Christian Medical College, Vellore, Tamil Nadu, India
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Bhatta S, Mytton JA, Deave T. Assessment of home hazards for non-fatal childhood injuries in rural Nepal: a community survey. Inj Prev 2020; 27:104-110. [PMID: 32060131 DOI: 10.1136/injuryprev-2019-043482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/03/2020] [Accepted: 01/07/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Unintentional injuries in and around the home are important causes of preventable death and disability among young children globally. In Nepal, there is a lack of data regarding home injuries and home hazards to guide the development of effective interventions for preventing childhood home injuries. This study aimed to determine the burden of unintentional home injuries in children <5 years in rural Nepal and quantify the injury hazards in their homes. METHODS A survey was conducted in 740 households in rural areas of the Makwanpur district during February and March 2015. The primary carer reported home injuries which occurred in the previous 3 months and data collector observation identified the injury hazards. Injury incidence, mechanism and the proportion of households with different hazards were described. Multivariable logistic regression explored associations between the number and type of home hazards and injuries. RESULTS Injuries severe enough to need treatment, or resulting in non-participation in usual activities for at least a day, were reported in 242/1042 (23.2%) children <5 years. The mean number of injury hazards per household was 14.98 (SD=4.48), range of 3-31. Regression analysis found an estimated increase of 31% in the odds of injury occurrence associated with each additional injury hazard found in the home (adjusted OR 1.31; 95% CI 1.20 to 1.42). CONCLUSIONS A high proportion of young children in rural Nepal sustained injuries severe enough to miss a day of usual activities. Increased frequency of hazards was associated with an increased injury risk.
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Affiliation(s)
- Santosh Bhatta
- Centre for Academic Child Health, University of the West of England, Bristol, UK
| | - Julie A Mytton
- Centre for Academic Child Health, University of the West of England, Bristol, UK
| | - Toity Deave
- Centre for Academic Child Health, University of the West of England, Bristol, UK
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Mathur A, Mehra L, Diwan V, Pathak A. Unintentional Childhood Injuries in Urban and Rural Ujjain, India: A Community-Based Survey. CHILDREN (BASEL, SWITZERLAND) 2018; 5:E23. [PMID: 29419791 PMCID: PMC5835992 DOI: 10.3390/children5020023] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 02/04/2018] [Accepted: 02/05/2018] [Indexed: 11/16/2022]
Abstract
Injuries are a major global public health problem. There are very few community-based studies on childhood injury from India. The objective of this cross-sectional, community-based survey was to identify the incidence, type, and risk factors of unintentional childhood injuries. The study was done in seven villages and ten contiguous urban slums in Ujjain, India. World Health Organization (WHO) tested tools and definitions were used for the survey, which included 2518 households having 6308 children up to 18 years of age, with 2907 children from urban households and 3401 from rural households. The annual incidence of all injuries was 16.6%, 95% Confidence Interval 15.7-17.5%, (n = 1049). The incidence was significantly higher among boys compared to girls (20.2% versus 12.7%, respectively), was highest in age group 6-10 years of age (18.9%), and in urban locations (17.5%). The most commonly identified injury types were: physical injuries (71%), burns (16%), poisonings (10%), agriculture-related injuries (2%), near drowning (2%), and suffocations (2%). The most common place of injury was streets followed by home. The study identified incidence of different types of unintentional childhood injuries and factors associated with increased risk of unintentional injuries. The results can help in designing injury prevention strategies and awareness programs in similar settings.
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Affiliation(s)
- Aditya Mathur
- Department of Paediatrics, R. D. Gardi Medical College, Ujjain 456006, India.
| | - Love Mehra
- Department of Paediatrics, R. D. Gardi Medical College, Ujjain 456006, India.
| | - Vishal Diwan
- Department of Public Health & Environment, R. D. Gardi Medical College, Ujjain 456006, India.
- Global Health-Health Systems and Policy, Department of Public Health Sciences, Karolinska Institutet, Stockholm SE-171 76, Sweden.
| | - Ashish Pathak
- Department of Paediatrics, R. D. Gardi Medical College, Ujjain 456006, India.
- Global Health-Health Systems and Policy, Department of Public Health Sciences, Karolinska Institutet, Stockholm SE-171 76, Sweden.
- Department of Women and Children's Health, International Maternal and Child Health Unit, Uppsala University, Uppsala SE-751 85, Sweden.
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One hundred injured patients a day: multicenter emergency room surveillance of trauma in Pakistan. Public Health 2017; 148:88-95. [PMID: 28431334 DOI: 10.1016/j.puhe.2017.03.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 03/07/2017] [Accepted: 03/08/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Injuries increasingly contribute to the global burden of disease in low- and middle-income countries. This study presents results from a large-scale surveillance study on injury from several urban emergency departments (EDs) in Pakistan. The objective is to document the burden of injuries that present to the healthcare system in Pakistan and to test the feasibility of an ED-based injury and trauma surveillance system. STUDY DESIGN Cross-sectional study conducted using active surveillance approach. METHODS This study included EDs of seven tertiary care hospitals in Pakistan. The data were collected between November 2010 and March 2011. All patients presenting with injuries to the participating EDs were enrolled. The study was approved by the Institutional Review Boards of the Johns Hopkins School of Public Health, Aga Khan University, and all participating sites. RESULTS The study recorded 68,390 patients; 93.8% were from the public hospitals. There were seven male for every three female patients, and 50% were 20-39 years of age. About 69.3% were unintentional injuries. Among injuries with a known mechanism (19,102), 51.1% were road traffic injuries (RTIs) and 17.5% were falls. Female, patients aged 60 years or older, patients transferred by ambulance, patients who had RTIs, and patients with intentional injuries were more likely to be hospitalized. CONCLUSION The study is the first to use standardized methods for regular collection of multiple ED data in Pakistan. It explored the pattern of injuries and the feasibility to develop and implement facility-based systems for injury and acute illness in countries like Pakistan.
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Parmeswaran GG, Kalaivani M, Gupta SK, Goswami AK, Nongkynrih B. Assessment of home hazards for childhood injuries in an urban population in New Delhi. Child Care Health Dev 2016; 42:473-7. [PMID: 26892878 DOI: 10.1111/cch.12328] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 01/06/2016] [Accepted: 01/08/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Childhood injuries, especially the unintentional category of injuries, occur most commonly in the environment inside a child's home. The primary objective of the present study was to assess the presence of home hazards for childhood injuries in households in an urban resettlement colony in New Delhi. METHODS A community-based cross-sectional study was carried out in an urban resettlement colony in Delhi. A hazards assessment tool was used to check the presence of hazards in the houses. RESULTS A total of 225 households were included. It was seen that121 (53.7%) had a cooking stove within the reach of the child, and 190 (84.3%) had the gas pipe within reach. Fire hazard was seen in 84% of houses. About 78% of households did not have locked storage for chemicals. CONCLUSION The study revealed a significant burden of hazards for childhood injuries within their own homes, thus emphasizing the need for injury prevention interventions to reduce the number of hazards.
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Affiliation(s)
- G G Parmeswaran
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - M Kalaivani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - S K Gupta
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - A K Goswami
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - B Nongkynrih
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
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Bhatti JA, Farooq U, Majeed M, Khan JS, Razzak JA, Khan MM. Fall-related injuries in a low-income setting: Results from a pilot injury surveillance system in Rawalpindi, Pakistan. J Epidemiol Glob Health 2015; 5:283-90. [PMID: 25725473 PMCID: PMC7320534 DOI: 10.1016/j.jegh.2015.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 01/07/2015] [Accepted: 01/28/2015] [Indexed: 12/01/2022] Open
Abstract
This study assessed the characteristics and emergency care outcomes of fall-related injuries in Pakistan. This study included all fall-related injury cases presenting to emergency departments (EDs) of the three teaching hospitals in Rawalpindi city from July 2007 to June 2008. Out of 62,530 injury cases, 43.4% (N = 27,109) were due to falls. Children (0–15 years) accounted for about two out of five of all fall-related injuries. Compared with women aged 16–45 years, more men of the same age group presented with fall-related injuries (50% vs. 42%); however, compared with men aged 45 years or more, about twice as many women of the same age group presented with fall-related injuries (16% vs. 9%, P < 0.001). For each reported death due to falls (n = 57), 43 more were admitted (n = 2443, 9%), and another 423 were discharged from the EDs (n = 24,142, 91%). Factors associated with death or inpatient admission were: aged 0–15 years (adjusted odds ratio [aOR] = 1.35), aged 45 years or more (aOR = 1.94), male gender (aOR = 1.15), falls occurring at home (aOR = 3.38), in markets (aOR = 1.43), on work sites (aOR = 4.80), and during playing activities (aOR = 1.68). This ED-based surveillance study indicated that fall prevention interventions in Pakistan should target children, older adult women, homes, and work sites.
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Affiliation(s)
- Junaid A Bhatti
- Sunnybrook Health Sciences Centre Research Institute, Toronto, Canada; Department of Surgery, University of Toronto, Toronto, Canada; Institute for Clinical Evaluative Sciences, Toronto, Canada.
| | - Umar Farooq
- Surgical Unit I, Department of Surgery, Holy Family Hospital, Rawalpindi, Pakistan
| | - Mudassir Majeed
- Surgical Unit I, Department of Surgery, Holy Family Hospital, Rawalpindi, Pakistan
| | - Jahangir S Khan
- Surgical Unit I, Department of Surgery, Holy Family Hospital, Rawalpindi, Pakistan
| | - Junaid A Razzak
- Department of Emergency Medicine, The Aga Khan University, Karachi, Pakistan
| | - Muhammad M Khan
- Surgical Unit I, Department of Surgery, Holy Family Hospital, Rawalpindi, Pakistan
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Qiu X, Wacharasin C, Deoisres W, Yu J, Zheng Q. Characteristics and predictors of home injury hazards among toddlers in Wenzhou, China: a community-based cross-sectional study. BMC Public Health 2014; 14:638. [PMID: 24953678 PMCID: PMC4076497 DOI: 10.1186/1471-2458-14-638] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Accepted: 06/13/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Home hazards are associated with toddlers receiving unintentional home injuries (UHI). These result in not only physical and psychological difficulties for children, but also economic losses and additional stress for their families. Few researchers pay attention to predictors of home hazards among toddlers in a systematic way. The purpose of this study is firstly to describe the characteristics of homes with hazards and secondly to explore the predicted relationship of children, parents and family factors to home hazards among toddlers aged 24-47 months in Wenzhou, China. METHODS A random cluster sampling was employed to select 366 parents having children aged 24 - 47 months from 13 kindergartens between March and April of 2012. Four instruments assessed home hazards, demographics, parent's awareness of UHI, as well as family functioning. RESULTS Descriptive statistics showed that the mean of home hazards was 12.29 (SD = 6.39). The nine kinds of home hazards that were identified in over 50% of households were: plastic bags (74.3%), coin buttons (69.1%), and toys with small components (66.7%) etc. Multivariate linear regression revealed that the predictors of home hazards were the child's age, the child's residential status and family functioning (b = .19, 2.02, -.07, p < .01, < .05 and < .01, respectively). CONCLUSIONS The results showed that a higher number of home hazards were significantly attributed to older toddlers, migrant toddlers and poorer family functioning. This result suggested that heath care providers should focus on the vulnerable family and help the parents assess home hazards. Further study is needed to find interventions on how to manage home hazards for toddlers in China.
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Affiliation(s)
- Xianyun Qiu
- School of Nursing, Wenzhou Medical University, University-town, Wenzhou, Zhejiang, P,R, China.
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Abstract
Among 1-19-year olds, unintentional injuries accounted for 12% of 5.1 million global deaths from injuries in 2010. Despite this high burden, childhood injuries have not received much attention in global health. This paper describes the major causes of deaths from childhood unintentional injuries and provides a review of interventions for reducing this burden. About 627,741 deaths were due to unintentional injuries in 2010 among 1-19-year olds. The proportionate mortality increased with age-from 12.6% among 1-4-year olds to 28.8% among 15-19-year olds. Deaths from Western sub-Saharan Africa and South Asia accounted for more than 50% of all deaths. Rates in these regions are 68.0 and 36.4 per 100 000 population, respectively, compared to 6.4 in Western Europe. Road traffic injuries (RTI) are the commonest cause of death, followed by deaths from drowning, burns and falls. Male children are more predisposed to unintentional injuries except for burns which occur more frequently among females in low and middle income countries (LMICs). Effective solutions exist--including barriers for preventing drowning; safer stoves for burns; child restraint systems for RTI--but the effectiveness of these measures need to be rigorously tested in LMICs. The general lack of a coordinated global response to the burden of childhood unintentional injuries is of concern. The global community must create stronger coalitions and national or local plans for action. Death rates for this paper may have been underestimated, and there is need for longitudinal studies to accurately measure the impact of injuries in LMICs.
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Affiliation(s)
- Olakunle Alonge
- International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, , Baltimore, Maryland, USA
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