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Kacem M, Bennasrallah C, Abroug H, Ben Fredj M, Zemni I, Dhouib W, Gara A, Maatouk A, Aloui I, Nouira S, Bouanene I, Sriha Belguith A. Burden and predictions of hospitalized injuries in a low-middle income country: results from a Tunisian university hospital. Libyan J Med 2023; 18:2266238. [PMID: 37807671 PMCID: PMC10563618 DOI: 10.1080/19932820.2023.2266238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 09/29/2023] [Indexed: 10/10/2023] Open
Abstract
Injuries are responsible for a high premature mortality and disability. They are poorly explored in low and middle income-countries. We aimed to estimate the burden of hospitalized injuries in the Monastir governorate (Tunisia) according to the nature of the injury, trends and projections of hospitalizations for injuries up until 2024, and to identify the distribution of this disease burden based on age and sex. We performed a descriptive study from 2002 to 2012 including all hospitalizations for injuries. Data were collected from morbidity and mortality register of the University Hospital of Monastir (Tunisia). We estimated the burden of injuries using the Disability Adjusted Life Years (DALYs). We described injuries (crude prevalence rate (CPR) and age standardized prevalence rate (ASR)), related mortality (lethality and standardized mortality ratio (SMR)), trends and prediction for 2024. A total of 18,632 hospitalizations for injuries representing 10% of all hospitalizations during study period were recorded. Per 1000 inhabitants per year, CPR was 3.36 and the ASR was 3.44. The lethality was of 17.5 deaths per 1000 injured inpatients per year and the SMR was of 2.95 (Confidence Interval of 95%: 2.64-3.29). Burden related to injuries was 2.36 DALYs per 1000 population per year, caused mainly by Years of Life Lost (83.4%), most frequent among men aged under 40 years. The predicted ASR for 2024 was 4.46 (3.81-5.23) per 1000 person-years. Injuries to the head was the most prevalent (20.7%) causing 67.7% of DALYs; and increasing by 226% through 2024. Injuries had a high prevalence and an important burden in a Tunisian university hospital. Prediction showed increased prevalence for 2024. Preventive measures and a trauma surveillance register should be implemented soon.
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Affiliation(s)
- Meriem Kacem
- Department of Preventive Medicine, University of Monastir, Monastir, Tunisia
| | - Cyrine Bennasrallah
- Department of Preventive Medicine, University of Monastir, Monastir, Tunisia
| | - Hela Abroug
- Department of Preventive Medicine, University of Monastir, Monastir, Tunisia
| | - Manel Ben Fredj
- Department of Preventive Medicine, University of Monastir, Monastir, Tunisia
| | - Imen Zemni
- Department of Preventive Medicine, University of Monastir, Monastir, Tunisia
| | - Wafa Dhouib
- Department of Preventive Medicine, University of Monastir, Monastir, Tunisia
| | - Amel Gara
- Department of Preventive Medicine, University of Monastir, Monastir, Tunisia
| | - Ameni Maatouk
- Department of Preventive Medicine, University of Monastir, Monastir, Tunisia
| | - Issam Aloui
- Orthopedic Department, University of Monastir, Monastir, Tunisia
| | - Samir Nouira
- Emergency Department, University of Monastir, Monastir, Tunisia
| | - Ines Bouanene
- Department of Preventive Medicine, University of Monastir, Monastir, Tunisia
| | - Asma Sriha Belguith
- Department of Preventive Medicine, University of Monastir, Monastir, Tunisia
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Swanson MH, Morgan CH, Johnston A, Schwebel DC. Caregiver accounts of unintentional childhood injury events in rural Uganda. JOURNAL OF SAFETY RESEARCH 2023; 85:101-113. [PMID: 37330860 DOI: 10.1016/j.jsr.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/06/2022] [Accepted: 01/23/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE Complex environmental, social, and individual factors contribute to unintentional childhood injury events. Understanding context-specific antecedents and caregiver attributions of childhood injury events can inform the development of locally-targeted interventions to reduce injury risk in rural Uganda. METHODS Fifty-six Ugandan caregivers were recruited through primary schools and completed qualitative interviews regarding 86 unintentional childhood injury events. Descriptive statistics summarized injury characteristics, child location and activity, and supervision at time of injury. Qualitative analyses informed by grounded theory identified caregiver attributions of injury causes and caregiver actions to reduce injury risk. RESULTS Cuts, falls, and burns were the most common injuries reported. At the time of injury, the most common child activities were farming and playing and the most common child locations were the farm and kitchen. Most children were unsupervised. In cases where supervision was provided, the supervisor was typically distracted. Caregivers most often attributed injuries to child risk-taking but also identified social, environmental, and chance factors. Caregivers most often made efforts to reduce injury risk by teaching children safety rules, but also reported efforts to improve supervision, remove hazards, and implement environmental safeguards. CONCLUSION Unintentional childhood injuries have a significant impact on injured children and their families, and caregivers are motivated to reduce child injury risk. Caregivers frequently perceive child decision-making a primary factor in injury events and respond by teaching children safety rules. Rural communities in Uganda and elsewhere may face unique hazards associated with agricultural labor, contributing to a high risk of cuts. Interventions to support caregiver efforts to reduce child injury risk are warranted.
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Risk Factors of Cooking-related Burn Injury Among Under-Four Children in Northwest Ethiopia: A Community-Based Cross-Sectional Study. Indian Pediatr 2023. [DOI: 10.1007/s13312-023-2808-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
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Sundal H, Ulvund I. Experiences after international clinical placement as nursing students in a paediatric ward. Nurse Educ Pract 2023; 66:103512. [PMID: 36463733 DOI: 10.1016/j.nepr.2022.103512] [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: 02/01/2022] [Revised: 05/10/2022] [Accepted: 11/16/2022] [Indexed: 11/26/2022]
Abstract
AIM The aim of this study is to investigate nurses' experiences after participating in an international clinical placement programme as nursing students while staying for one to three weeks in a paediatric ward. BACKGROUND Student mobilisation is expected to increase the quality of education. Hence, offering international clinical placement programme in low- and high-income countries is a commonly used learning activity in bachelor programmes in nursing. Many studies have mainly examined the general experiences gained from international clinical placement programme but have not specifically focussed on the setting of paediatric wards in hospitals. Nursing students are required to acquire knowledge of paediatric nursing with children as patients. DESIGN AND METHOD In this qualitative study, a hermeneutic, phenomenological approach was adopted. Data were collected through individual interviews with eight nurses after they participated in an international clinical placement programme as nursing students in a paediatric ward. RESULTS Meetings with children's destinies as patients were overwhelming, being an observer provided insights into and an overview of paediatric nursing, access to the resources required for treating children is limited, nurses had a different role and parents had an extended caring role. CONCLUSION All participants gained knowledge of children as patients at a hospital and also gained knowledge of the parents' and nurses' roles and the treatment methods of various diseases that are relevant to paediatric nursing. This helped provide them with the cultural knowledge, awareness and sensitivity required, given the contrasting situation at their home country.
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Affiliation(s)
- Hildegunn Sundal
- Molde University College, Norway, Faculty of Health Sciences and Social Care, PO. Box 2110, 6402 Molde, Norway.
| | - Ingeborg Ulvund
- Molde University College, Norway, Faculty of Health Sciences and Social Care, PO. Box 2110, 6402 Molde, Norway.
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Adane MM, Admasie A, Shibabaw T. Prevalence and risk factors of cooking-related burn injury among under-five-years old children in a resource-limited setting: a community-based cross-sectional study in Northwest Ethiopia. Int J Inj Contr Saf Promot 2022; 30:220-231. [PMID: 36137170 DOI: 10.1080/17457300.2022.2125534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Cooking-related child burn injury causes a greater health burden in low-and-middle-income countries. Therefore, a community-based cross-sectional study was conducted among 5830 under-five-years old children in a resource-limited community in Northwest Ethiopia to determine the prevalence and risk factors of this child health problem. Data were collected by trained nurses using a questionnaire and the logistic regression analysis method was applied to identify factors linked with burn injury. Injury prevalence was 6.2% (95% CI:5.5-6.8); and this burden was linked with several risk factors such as lower literacy status of caretakers [AOR = 2.21 (95% CI:1.05-4.67)], overcrowding [AOR = 2.35(95% CI:1.25-4.43], lack of separate kitchen [AOR =2.19 (95% CI:1.56-3.07)], using traditional cookstove [AOR = 2.04 (95% CI:1.23-3.36)], and lack of child supervision [AOR = 2.27 (95% CI:1.63-3.17)]. In conclusion, children experience a high burden of burn injury. Thus, stakeholders should work to reduce child burn injury by modifying the aforementioned risk factors.
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Affiliation(s)
- Mesafint Molla Adane
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Amha Admasie
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tebkew Shibabaw
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Kejela S, Seyoum N. Acute pain management in the trauma patient population: are we doing enough? A prospective observational study. JOURNAL OF TRAUMA AND INJURY 2022. [DOI: 10.20408/jti.2021.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Workneh BS, Mekonen EG, Ali MS. Determinants of knowledge, attitude, and practice towards first aid among kindergarten and elementary school teachers in Gondar city, Northwest Ethiopia. BMC Emerg Med 2021; 21:73. [PMID: 34154534 PMCID: PMC8215869 DOI: 10.1186/s12873-021-00468-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background Injuries continue to be an important cause of morbidity and mortality in the developed and developing world. School-age children are more likely to experience unintentional injuries in the school, while they are playing and teachers are the primarily responsible body for keeping the welfare of the students. Knowing the knowledge, attitude, and practice of kindergarten and elementary school teachers towards first aid will be used as an input for policymakers to intervene and provide training. Therefore, this study was aimed to assess knowledge, attitude, practice, and associated factors towards first aid among kindergarten and elementary school teachers in Gondar city, Northwest Ethiopia, 2021. Methods An institution-based cross-sectional study was conducted from January 01 to 20, 2021. A simple random sampling technique was employed to recruit 346 participants. A structured pretested self-administered questionnaire was used to collect data. Data were entered in Epi-info version 7, analyzed using SPSS version 21, and presented by frequencies, percentages, tables, and graphs. Bivariable relationships between the independent and outcome variable were investigated using a binary logistic regression model and a multivariable analysis was run to control potential confounding factors. Variables with a p-value < 0.05 were considered as factors significantly associated and the strength of association was determined using an odds ratio with a 95% CI. Results Only 41.1% of the teachers had good knowledge of first aid. Nearly two-thirds (64.8%) of the teachers had a favorable attitude towards first aid. The majority (85.8%) of the teachers who faced a child in need of first aid in their school gave first aid. Factors like working experience [AOR: 2.45; 95% CI (1.26, 4.73)], school level [AOR: 4.72; 95% CI (1.96, 11.4)], school type [AOR: 4.23; 95% CI (2.07, 8.64)], and having information about first aid [AOR: 2.09; 95% CI (1.11, 3.92)] were significantly associated with knowledge. School-level [AOR = 5.4, 95% CI (2.18–11.67)], school type [AOR = 0.45, 95% CI (0.21–0.94)], and working experience [AOR = 0.33, 95% CI (0.13–0.86)] were the factors significantly associated with attitude. Conclusion Less than half and nearly two-thirds of the teachers had good knowledge and a favorable attitude towards first aid. The majority of the teachers who encountered a child in need of first aid gave first aid. Having higher working experience, working in elementary and private schools, and having previous information increases the odds of having good knowledge. Teachers who work in elementary and private schools and have the lower working experience had higher odds of favorable attitude towards first aid. It is better to give attention to the training of staff on first aid specifically for teachers working in kindergarten and governmental schools and new employees and consider integrating first aid in teachers’ training curriculum.
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Affiliation(s)
- Belayneh Shetie Workneh
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Enyew Getaneh Mekonen
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Mohammed Seid Ali
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Moshiro R, Furia FF, Massawe A, Mmbaga EJ. Pattern and risk factors for childhood injuries in Dar es Salaam, Tanzania. Afr Health Sci 2021; 21:817-825. [PMID: 34795740 PMCID: PMC8568247 DOI: 10.4314/ahs.v21i2.42] [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] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Injuries contribute to morbidity and mortality in children. This study was carried out to describe the pattern of childhood injuries and associated risk factors in Dar es Salaam, Tanzania. Methods This case control study was conducted in six selected health facilities in Dar es Salaam, Tanzania. Data were collected using a structured questionnaire. Cases and controls were children below 18 years who had suffered injuries and those without injury associated condition respectively. Results A total of 492 cases and 492 controls were included in the study, falls (32%), burns (26%), Road Traffic Injuries (14%) and cuts (10%) were the major types of injuries identified. Younger parents/guardians {Adjusted odds ratio (AOR)= 1.4; 95% CI: 1.4 -3.6}, more than six people in the same house (AOR= 1.8; 95% CI: 1.3–2.6), more than three children in the house {AOR= 1.4; 95% CI (1.0–2.0)}, absence of parent/guardian at time of injury occurrence (AOR= 1.6; 95% CI: 1.1–2.3), middle socio-economic (AOR=1.6; 95%CI: 1.1–2.4) and low socio-economic status (AOR= 1.5; 95% CI: 1.0–2.1) were independent risk factors for childhood injury. Conclusion Falls, burns and road traffic injuries were the main injury types in this study. Inadequate supervision, overcrowding, lower socio-economic status and low maternal age were significant risk factors for childhood injuries.
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Affiliation(s)
- Robert Moshiro
- Department of Paediatrics, Muhimbili National Hospital, Dar es Salaam, Tanzania
- Department of Paediatrics and Child Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Francis F Furia
- Department of Paediatrics, Muhimbili National Hospital, Dar es Salaam, Tanzania
- Department of Paediatrics and Child Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Augustine Massawe
- Department of Paediatrics, Muhimbili National Hospital, Dar es Salaam, Tanzania
- Department of Paediatrics and Child Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Elia John Mmbaga
- Department of Epidemiology and Biostatistics, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Iyun A, Ademola S, Olawoye O, Michael A, Aderibigbe R, Iyun O, Oluwatosin O. Glycerolised skin allografts for extensive burns in low- and middle-income countries. JOURNAL OF WEST AFRICAN COLLEGE OF SURGEONS 2021; 11:35-41. [PMID: 36132972 PMCID: PMC9484497 DOI: 10.4103/jwas.jwas_55_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/07/2022] [Indexed: 11/23/2022]
Abstract
Introduction: There has been a significant improvement in the outcome of treatment of large surface area burns in developed countries. A major contributory factor is an early excision and skin grafting of burn wounds. The initial coverage of large surface area deep burn wounds requires the use of temporary skin substitutes such as allografts due to limited skin autografts. Cadaveric skin allografts are the commonest source of skin allografts in use; however, there may be religious, cultural, cost, or other factors mitigating its availability and routine use in low- and middle-income countries (LMICs). Human skin allografts may be used fresh or stored in tissue banks to ensure its ready availability. The purpose of this review is to promote glycerolised skin allografts as a means of skin preservation in low-resource countries above other modalities cryopreservation due to its cost advantages and relative ease of operation. Materials and Methods: A literature search for articles related to human skin allograft use in burn care, skin banks, and glycerolised skin allografts in LMICs was done using PubMed, EMBASE, and Web of Science databases. The key words used were ‘allograft’ and ‘burn’ with a filter in the search for human studies. The relevant references in the articles obtained were also searched for and included in the review Results: Sixty-three journal articles were reviewed for contents in line with the objectives of this study. Conclusion: Glycerolised skin graft is a viable option for coverage of extensive burns in LMICs.
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Bedry T, Tadele H. Pattern and Outcome of Pediatric Traumatic Brain Injury at Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia: Observational Cross-Sectional Study. Emerg Med Int 2020; 2020:1965231. [PMID: 32399303 PMCID: PMC7204112 DOI: 10.1155/2020/1965231] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/26/2019] [Accepted: 12/13/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) is the most common cause of death/disability in children. The Glasgow coma scale and other parameters are used for treatment/follow-up of TBI. Childhood TBI data are scarce from sub-Saharan Africa. The study aimed to determine the pattern and predictors of the TBI outcome in Southern Ethiopia. METHODS An observational cross-sectional study was conducted from September 2017 to September 2018 at Hawassa University Hospital. Structured questionnaires were used for data collection. Significant associations were declared at a P value of <0.05. RESULTS There were 4,258 emergency room (ER) visits during the study period, and TBI contributed to 317 (7.4%) cases. The mean age of study subjects was 7.66 ± 3.88 years. Boys, predominantly above 5 years of age, comprise 218 (68.8%) of the study subjects with a male to female ratio of 2.2 : 1. Pedestrian road traffic accidents (RTA), 120 (37.9%), and falls, 104 (32.8%), were the commonest causes of TBI. Mild, moderate, and severe TBI were documented in 231 (72.9%), 61 (19.2%), and 25 (7.9%) of cases, respectively. Most of the TBI cases presented within 24 hrs of injury, 258 (81.4%). Recovery with no neurologic deficit, 267 (84.2%); focal neurologic deficit, 30 (9.5%); depressed mentation, 10 (3.2%); and death, 10 (3.2%), were documented. Signs of increased intracranial pressure (ICP) at admission [AOR: 1.415 (95% CI: 1.4058-9.557)], severe TBI [AOR: 2.553 (95% CI: 1.965-4.524)], presence of hyperglycemia [AOR: 2.318 (95% CI: 1.873-7.874)], and presence of contusion, diffuse axonal injury (DAI), or intracranial bleeding on the head computed tomography (CT) scan [AOR: 2.45 (95% CI: 1.811-7.952)] predicted poor TBI outcome. CONCLUSION TBI contributed to 7.4% of pediatric ER visits. Pedestrian RTA and falls, early presentation (<24 hours of injury), and mild form of TBI among boys were the most common documented patterns. ICP, hyperglycemia, severe TBI, and presence of contusion, DAI, or intracranial bleeding on head CT predicted poor outcome. Strategies to ensure road safety and to prevent falls and animal-related injuries and TBI follow-up for ICP and glycemic controls are recommended.
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Affiliation(s)
- Tuji Bedry
- Department of Pediatrics and Child Health, College of Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Henok Tadele
- Department of Pediatrics and Child Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Ogada EA, Gebreab AH, Potokar TS. Review of the epidemiology of burn injuries in Ethiopia; implications for study design and prevention. BURNS OPEN 2019. [DOI: 10.1016/j.burnso.2019.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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