Keeping our heads above water: A systematic review of fatal drowning in South Africa

Background. Drowning is defined as the process of experiencing respiratory impairment from submersion/immersion in liquid, and can have one of three outcomes ­ no morbidity, morbidity or mortality. The World Health Organization African region accounts for approximately 20% of global drowning, with a drowning mortality rate of 13.1 per 100 000 population. The strategic implementation of intervention programmes driven by evidence-based decisions is of prime importance in resource-limited settings such as South Africa (SA).Objective. To review the available epidemiological data on fatal drowning in SA in order to identify gaps in the current knowledge base and priority intervention areas. Methods. A systematic review of published literature was conducted to review the available epidemiological data describing fatal drowning in SA. In addition, an internet search for grey literature, including technical reports, describing SA fatal drowning epidemiology was conducted.Results. A total of 13 published research articles and 27 reports obtained through a grey literature search met the inclusion and exclusion criteria. These 40 articles and reports covered data collection periods between 1995 and 2016, and were largely focused on urban settings. The fatal drowning burden in SA is stable at approximately 3.0 per 100 000 population, but is increasing as a proportion of all non-natural deaths. Drowning mortality rates are high in children aged <15 years, particularly in those aged <5. Conclusions. This review suggests that SA drowning prevention initiatives are currently confined to the early stages of an effective injury prevention strategy. The distribution of mortality across age groups and drowning location differs substantially between urban centres and provinces. There is therefore a need for detailed drowning surveillance to monitor national trends and identify risk factors in all SA communities

Factors associated with unintentional injury among the paediatric age population in the hospitals of Amhara National Regional State, Ethiopia

Background:Childhood unintentional injuries cause nearly 875,000 deaths each year. The aim of this study was to assess the prevalence and factors associated with unintentional injury of children presenting to the hospitals of Amhara Regional State, Ethiopia.Methods:In a hospital-based, cross-sectional study undertaken in one month, from April 1 to 30th 2016,893 children less than 18 years of age were included. Data were collected using an interviewer- administered questionnaire. Training was given to all data collectors and supervisors. Data was entered into EPI info version 7 and then exported to SPSS version 20, for further analysis.Results:Unintentional injury caused 62% (554) of all injuries in attending children. Several factors affected the likelihood of injuries, namely the age of the child, age of the parents or guardians, sex of the child, and whether the child lived with the parents. Modifiable factors were the child's behaviour,awareness of danger, the child's level of educational, if the child's parent had received adequate injury counselling, and whether a child was left in the care of another child. The source of light in the house,and house floor material were also significant factors at p < 0.05.Conclusion:The prevalence of unintentional injury was high. Many of the factors associated with injuries are modifiable and safety issues for children need urgent attention

Injuries in Children and Adolescents seen during 2006 at the Emergency Department of the National District Hospital; Bloemfontein

Most children and adolescents recover fully from injuries. However; permanent disabilities may occur. The objective of the study was to investigate the prevalence and profile of injuries in children and adolescents five to 19 years of age seen at the emergency department of the National District Hospital in Bloemfontein. Methods: A retrospective descriptive study was conducted. Demographic and injury-specific information obtained from hospital records of 2006 was entered into a data-capturing form. Data were analysed by using descriptive statistics.and 43.5 of injuries occurred in the age group 15 to 19 years. Approximately half (51.7) were Afrikaans-speaking and resided in suburban areas (50). Most injuries occurred at home (40.2) between 12h00 and 17h00 (38.7). Falls (33.7) were the most common cause of injury. Soft tissue injuries (35.9) occurred most commonly; fol lowed by lacerations (33.0) and fractures (16.7). Upper limb injuries (42.1) were seen more than lower limb injuries (27.8). Facial injuries occurred in 12 of cases. X-rays were performed in 57.9 of cases. Most patients (93.3) received medication; while 22 were referred for specialist treatment. All cases except one were discharged from the emergency department. Parents accompanied patients in 65.6 of cases. Results: The prevalence of injuries in this age group was 20.3. Two hundred and nine records were investigated. The majority of cases were male (68.3). The median age was 15 years; Conclusions: Optimal treatment should be given to the injured child or adolescent to avoid possible long-term injuryrelated sequelae. Preventive strategies should be formulated; enforced and evaluated

Motorcycle Road Traffic Injuries in Southern Nigeria: The Small Motorcycle as a Prevention Strategy

Background: The commonest mode of public transportation in Uyo is by motorcycle. There are two sizes of motorcycle in common use - the big one (Qlink or Skygo model; made in China) and the small one (C90; made in China). The study was carried out to determine if there is a lower risk of RTI severe enough to be brought to the hospital; attributable to using a small motorcycle. Methods: Motorcycle RTI victims admitted at the Accident and Emergency department of the University of Uyo Teaching Hospital (UUTH); were reviewed prospectively over a 15 month period. Three community visual surveys of the proportion of small to large motorcycles were also conducted. Results: A total of 131 RTI victims were reviewed over 15 months. The visual surveys of motorcycles in Uyo revealed that the mean proportion of small to large is 38 to 62; a ratio of 1:1.6. Eighty-three (63.3) of the 131 RTI's involved motorcycles. 74 of these occurred in large motorcycles. There was a statistically significant relationship between motorcycle size and occurrence of an RTI severe enough to be brought to hospital. Conclusion: There is a lower risk of RTI severe enough to be brought to hospital; from using a small motorcycle

Pedestrian Injuries Resulting from Road Traffic Accidents : the Azare Experience

BACKGROUND: Road traffic accident (RTA) is a leading cause of serious morbidity and mortality world wide. The pedestrians are not spared from this epidemic. OBJECTIVE: The aim of this study is to identify factors that puts the pedestrian at risk of injuries from RTA and the anatomical regions most commonly involved in our environment and suggest ways of curbing them. METHODS : This was a one-year retrospective study of 122 pedestrian casualties resulting from road traffic accident attending the Accident and Emergency (A/E) Unit of the Federal Medical Centre; Azare. RESULTS : Majority of the patients (72) were males with a male to female ratio of 2.6 :1. Children and adolescents constitute 54;1 of the casualties. Motorcycles were responsible for most of the pedestrian injuries (73). The head and neck was the most frequently injured anatomical region of the body (43.4); followed by the extremities (37). The months of August and January were the peak periods of injuries. CONCLUSION: The safety of pedestrian is seriously threatened by the growing popularity of commercial motorcycles on our roads. Preventive measures are advocated to ensure only licensed cyclists are allowed on the roads. Adequate personnel training to manage head injury in our centers is also advised. More patrol by the road safety agents is advised in the months of January and August

Patterns of accidents among children visiting Jimma University Hospital; South West of Ethiopia

BACKGROUND:Accidents are now becoming the leading causes of morbidity and mortality after the first year of life; hence the need to analyze the pattern in prospective manner will help plan preventive measures as well as indicate the magnitude of the problem.OBJECTIVE:To assess the pattern of childhood accidents among children under 15 years of age.METHODS:A cross-sectional analysis was undertaken in and out patient service settings of Jimma University specialized hospital, from July 2003 to June 2004. The information was collected using structured and pre-tested questionnaire, on factors related to socio-demographic and economic variables as well as on the nature and type of accident and analysed by SPSS Version 12.0.RESULTS:Of the total 452 cases of accidents 79 (17.5%), 271 (60.0%) and 102(22.6%) of the subjects were within age group of 0-4, 5-9, and 10-14 years, respectively. The predominant observed accidents among all age groups were laceration wounds, 304 (67.3%) and soft tissues contusions, 111 (24.6%). Traumatic injury other than car accident accounted for 82.38%, burn 15.0%, poisoning 1.3% and car accident 1.3%. Burn was common among children 5 - 9 years. There was statitically significant association between age and type of accident and nature of injury (p <0.05). Two hundred eight one of the accident occurred at home (62.2%), followed by school (14.8%), high way (16.8%) and in sport fields (6.2%). One hundred twenty four (27.4%), 76(16.8%) and 252(55.8%) ended with complete recovery, recovery with major and minor sequelae respectively.CONCLUSION:The study, has tried to indicate that accidents are becoming a public health problem in the area which needs designing a local as well as a national strategy on child accident prevention, control and management

Use of Seatbelts by Vehicle Occupants in University College Hospital; (U.C.H) Ibadan; Nigeria

Road traffic accidents are a major cause of death and disability worldwide. A number of mechanisms have been put in place to reduce the ensuing injuries; one of which is the use of seatbelts.This observational study was carried out to determine seatbelt use by vehicle occupants in University College Hospital (U.C.H). Trained research assistants observed drivers and other vehicleoccupants as they drove into the only fuel station within the hospital premises between 8.30a.m and 6.00 p.m. over a six-day period. Data on vehicle occupant characteristics; presenceand use of installed seat belts was documented using a modified version of the FIA foundation sample seatbelt wearing observation form. A total of 570 occupants in 402 vehicles were observed. There were 402 drivers and 117 and 50 front and rear seat occupants respectively. The only child observed was unrestrained and seated on an adults lap in the front. Seat belt use by the drivers; front and rear seat passengers were 76 (18.9); 16 (13.7) and 2 (4) respectively. A higher proportion 29 (29.9) of all female drivers compared with male drivers 47 (15.4) were restrained (X2 = 9.152; p = 0.02). Overall seat belt use observed was 16.5and driver use was only 18.9in spite of the existence of a law mandating use of seatbelt by drivers. Better enforcement of the current law is necessary and it should be extended to coverother vehicle occupants. The hospital environment presents a good opportunity to educate the public on the importance of seatbelt use utilizing various health education methods