Evaluating the level of disaster preparedness of Tunisian University Hospitals using the Hospital Safety Index: a nationwide cross-sectional study

Background: Mid-way through the 'Sendai Framework for Disaster Risk Reduction 2015-2030', many nations are spending time, money and effort to enhance their level of preparedness facing disasters, on the other hand communities, countries and even continents are being left behind. Objectives: This study was conducted aiming at evaluating the level of disaster preparedness and response of Tunisian University Hospitals. Methods: This is a cross-sectional nationwide study conducted in Tunisia, from November 2020 to April 2021. Including 9 Tunisian University Hospitals and using the Hospital Safety Index. The data were analysed using the 'Module and safety index calculator'. Results: This study showed that 7 out of the 9 University Hospitals were assigned the 'B' category of safety with overall safety indexes that ranges between 0.37 and 0.62. Also, 4 out of 9 University Hospitals had safety scores less than 0.20 regarding their emergency and disaster management. Conclusions: This is the first study to evaluate disaster preparedness and response of university hospitals in Tunisia and in north Africa. It showed that the lack of knowledge, resources and willingness, are the most important issues that needs to be addressed in order to enhance the preparedness of Tunisian hospitals

A model to facilitate self-management of human immunodeficiency virus in students within a university setting and promoting their mental health

Background: The introduction of antiretroviral treatment (ART) has resulted in people with HIV living longer. Antiretroviral treatment demands a lifelong commitment from patients not only in terms of adherence to the medication but also in relation to lifestyle changes in general. This poses a challenge to a student living with HIV (SLHIV) who only spends a few years at university before entering the workplace and relocating. It also means that the care, support and treatment received at the university will no longer be available to them as these services are only offered to enrolled students. It is imperative for practitioners at universities to help SLHIV effectively manage their illness.Aim: The aim of the article is to illustrate the process followed to develop a model that could serve as a frame of reference to facilitate the management of HIV as an integral part of the mental health of SLHIV within a university.Setting: The model is designed for professional practitioners in university settings who support students living with HIV in managing their illness.Methods: A theory-generative, qualitative, exploratory, descriptive and contextual study design was utilised. The central concept was derived from the experiences of practitioners and SLHIV by conducting individual interviews using appreciative inquiry. The common themes and categories identified in the interviews served as a basis for the identification of the central concept for the study. The process included the identification, definition and classification of the central concept and essential attributes. The conceptual framework was then described. Measures to ensure trustworthiness were also adhered to in the study and approval for the study was granted (Ethical clearance #2014-071).Results: The central concept was identified as the 'facilitation of self-management'. It was defined and classified, and these definitions and classifications were used as the basis for the model. Thereafter, the model was described.Conclusion: The model can be used as a frame of reference to assist SLHIV in effectively managing their illness

Predictors of mortality in COVID-19 patients at Kinshasa University Hospital, Democratic Republic of the Congo (from March to June 2020)

Introduction: since the 1st case of coronavirus disease 2019 (COVID-19) in Kinshasa on March 10th 2020, mortality risk factors have not yet been reported. The objectives of the present study were to assess survival and to identify predictors of mortality in COVID-19 patients at Kinshasa University Hospital.Methods: a retrospective cohort study was conducted, 141 COVID-19 patients admitted at the Kinshasa University Hospital from March 23 to June 15, 2020 were included in the study. Kaplan Meier's method was used to described survival. Predictors of mortality were identified by COX regression models.Results: of the 141 patients admitted with COVID-19, 67.4 % were men (sex ratio 2H:1F); their average age was 49.6±16.5 years. The mortality rate in hospitalized patients with COVID-19 was 29% during the study period with 70% deceased within 24 hours of admission. Survival was decreased with the presence of hypertension, diabetes mellitus, low blood oxygen saturation (BOS), severe or critical stage disease. In multivariate analysis, age between 40 and 59 years [adjusted Hazard Ratio (aHR): 4.07; 95% CI: 1.16 - 8.30], age at least 60 years (aHR: 6.65; 95% CI: 1.48-8.88), severe or critical COVID-19 (aHR: 14.05; 95% CI: 6.3-15.67) and presence of dyspnea (aHR: 5.67; 95% CI: 1.46-21.98) were independently and significantly associated with the risk of death.Conclusion: older age, severe or critical COVID-19 and dyspnea on admission were potential predictors of mortality in patients with COVID-19. These predictors may help clinicians identify patients with a poor prognosis

The outcome of patients on hemodialysis at university teaching hospital of Kigali (CHUK) in a period of september 2014 to march 2017 - A retrospective study on patients with acute and chronic renal failure

Background: Kidney dysfunction is both a national and international problem. Its incidence is increasing in the general population, mostly due to the high prevalence of diabetes, hypertension and the long-term consequences of acute kidney injury. The incidence and prevalence of kidney dysfunction necessitating dialysis are unknown in Rwanda as studies are lacking.Methodology: This study describes the outcomes of the patients who received hemodialysis at CHUK. Data was retrospectively collected and statistically analyzed for 152 patients treated in the hemodialysis unit at CHUK between September 2014 and March 2017.Results: The results have shown that 51.3% and 48.7% of the population being studied were identified to have acute kidney injury and chronic kidney failure respectively. The main risk factors for hemodialysis treatment were hypertension (48%), diabetes mellitus (46.7%), eclampsia (13.2%), and volume deficit (15.8%). Hyperkalemia, pulmonary edema, encephalopathy, and other uremic symptoms were present in 39-43% of patients and were the most common indications for hemodialysis. Encephalopathy and poor oxygen saturation were independent risk factors for death. 20.6% could not afford the usual provision of three sessions of hemodialysis per week and therefore didn't receive dialysis as frequently as recommended. Forty-five patients (20.6%) could not afford the usual provision of three sessions of hemodialysis per week and received less frequent dialysis.Conclusion: There is high mortality in patients referred for hemodialysis in CHUK. Almost half of the patients have chronic renal failure and require permanent renal replacement therapy. Many patients limit therapy due to financial reasons

Costs incurred by caregivers of under-five inpatients with community-acquired pneumonia at a university hospital in south-western Ethiopia

Background: Pneumonia is one of the commonest diseases among children in Ethiopia resulting in deaths and hospitalisations. The objective of the current study was to determine the cost incurred by caregivers of under-five children with community-acquired pneumonia admitted to the paediatric ward of Jimma University Specialized Hospital, south-western Ethiopia.Methods: An institution-based cross-sectional study was conducted from 01 January to 28 February 2017, through interviews with caregivers. Data on costs incurred before hospital visit, direct medical and non-medical costs, and indirect costs incurred by caregivers of the children were collected. The collected data were analysed using Statistical Package for Social Sciences version 23.Results: Among the 120 caregivers in the study, a median total cost of 304.5 Ethiopian birr (13.22 USD) was reported. This was mostly contributed by indirect costs associated with earnings lost by caregivers related to travel and stay at hospital with the children. Factors, including permanent residence, family size, hospital stay, wealth index, education and major occupation, were found to have statistically significant association with the level of cost incurred by caregivers.Conclusion: This study identified that a significant level of cost is incurred by caregivers of the children in the hospital, a majority of which was contributed by the lost earnings because of the time spent at the hospital with the children

Laparoscopy in gastro- intestinal tumors

Background: Cancer is a major public health problem worldwide. Many studies have shown that the completion of adjuvant chemotherapy improves the survival rate. Objectives: The aim of the current study was to discuss the efficacy and role of diagnostic and therapeutic laparoscopy as a new trend in managing gastrointestinal tumors. Patients and Methods: This prospective study included a total of 50 patients, whom had gastro-intestinal tumor diagnosed by tissue biopsy and histopathology attending at General Surgery Department, Sayed Galaal Al-Azhar University Hospital. The hospital statistically significant data for the included 50 patients, pre and post diagnostic laparoscopy and surgical intervention were collected and analyzed. Results: A significant percentage of intra-abdominal cancers prove to be inoperable because of metastatic or locally advanced disease despite a preoperative workup suggesting a potentially resectable disease. Conclusion: It could be concluded that diagnostic laparoscopy is accurate staging tool for gastro intestinal tumors as staging method prior to surgery that can change plan to start neoadjuvant chemotherapy (CTR) instead of surgery. Laparoscopic surgery shows also short post- operative patient stay at hospital and early start of CTR

Preoperative fasting times: Prescribed and actual fasting times at Universitas Hospital Annex, Bloemfontein, South Africa

Background. Guidelines recommend a preoperative fasting period of 6 hours for solid food and 2 hours for clear fluids. Because of fixed meal times and imprecise operation starting times, patients often fast for an extended period of time.Objective. To investigate the prescribed preoperative fasting times, and the actual duration of fasting, compared with the internationally accepted fasting times for solid food and clear fluids.Methods. Patients (N=105) aged 14 - 60 years, who were scheduled for elective surgery in the morning session (list starting time 07h00), were included in this prospective study. On arrival in theatre, all patients were asked when they last ate and drank. Anaesthetic records were used to determine the prescribed fasting times and operation starting times. Results. For solids, patients were most frequently prescribed to start fasting from 22h00 to 00h00 (53.3% and 39.1%, respectively). No patient fasted <8 hours. The median duration of fasting was 14 hours and 45 minutes (range 9 hours and 45 minutes - 19 hours and 5 minutes). For fluids, patients were most frequently prescribed to start fasting from 05h00 (46.7%), 00h00 (27.6%) and 22h00 (7.6%). In practice, no patient ingested fluids after 22h30 or <9 hours preoperatively. The median fasting time for oral fluids was 13 hours and 25 minutes (range 9 hours and 37 minutes - 19 hours and 5 minutes).Conclusion. Most patients started fasting too early preoperatively, consequently withholding food and oral fluids for longer than recommended. An increased awareness regarding complications of unnecessarily long fasting times, and interventions to correct this problem, is required

An investigation of diverticular disease among black patients undergoing colonoscopy at Dr George Mukhari Academic Hospital, Pretoria, South Africa

Background. Diverticular disease was previously thought to be non-existent in the black African population. Studies over the past four decades, however, have shown a steady increase in the prevalence of the disease.Objective. To report on the profile and current prevalence of diverticular disease in the black South African (SA) population at Dr George Mukhari Academic Hospital, Pretoria, SA.Methods. A retrospective descriptive study was performed in black SA patients who were diagnosed with diverticular disease by colonoscopy between 1 January and 31 December 2015.Results. Of 348 patients who had undergone colonoscopies and who were eligible for inclusion in this study, 47 were diagnosed with diverticular disease ­ a prevalence of 13.50% (95% confidence interval 10.30 - 17.50). The greatest number of patients diagnosed were in their 7th and 8th decades, with an age range of 46 - 86 (mean 67) years. There was a female predominance of 57.45%. Lower gastrointestinal bleeding was the most common (65.96%) indication for colonoscopy. The left colon was most commonly involved (72.34%), followed by the right colon (55.31%). A substantial number of patients had pancolonic involvement (27.65%).Conclusion. This retrospective study suggests that there has been a considerable increase in the prevalence of diverticular disease among black South Africans, possibly owing to changes in dietary habits and socioeconomic status

Lumbar puncture must it be preceded by the ocular fundus? Misconceptions and bad practices at the University Hospital of Brazzaville

Background: The ocular fundus is the basis for the diagnosis of eye posterior segment lesions. Increasing the pressure of the cerebrospinal fluid that surrounds the optic nerve; whatever the cause; can lead to papilledema which signing intra cranial hypertension. The ophthalmology department of the University Hospital of Brazzaville (UHB) performs about twenty ocular fundus a week. It is not uncommon to read the ocular fundus to exclude intra cranial hypertension and then perform a lumbar puncture. Objective: To remember that the intra-cranial hypertension does not mean that there is a risk of cerebral engagement. Design: Transversal and analytical study. Subjects: Hospitalised patients'. Results: A total of 35 applications form were read. All (100%) had as indication of ocular fundus to exclude intra-cranial hypertension for achieving a lumbar puncture. Conclusion: Confusion between intra-cranial hypertension and the risk of cerebral engagement is still common at the UHB. This has the effect of delaying or not realising the lumbar puncture which is the basis for the diagnosis of meningitis; increasing the morality associated with this serious disease. Do not make a lumbar puncture pending ocular fundus is a medical error that can be fatal for the patient

High prevalence of atrial fibrillation in stroke patients admitted to university of Gondar hospital, northwest Ethiopia

Purpose : Even though atrial fibrillation is a common risk factor of stroke which contributes to poor outcome, data concerning this association is scarce in African countries. This study assessed the prevalence of confirmed atrial fibrillation and its effect on outcome in stroke patients admitted to University of Gondar Hospital.Methods: A Hospital based cross-sectional study by record analysis was done from December 2014 to February 2015. All adult stroke patients with documented head CT scan and ECG results admitted to university of Gondar hospital during June 2010 to May 2013 were included. Relevant data including sociodemographics, type of stroke, and presence of atrial fibrillation was collected from patient charts using a data extraction form.Results: A total of 94 patients with mean age of 67.4±12.4 years and Female to male ratio of 1.13:1 were analyzed. The prevalence of AF was 28.7%. It occurred in 34% and 14% of ischemic and hemorrhagic strokes respectively. The in hospital case fatality of stroke associated with and without atrial fibrillation was 22.2% and 8% respectively while the rate of improvement at discharge was 34% and 68% respectively. Atrial fibrillation was associated with a low rate of improvement at discharge (OR= 0.28 CI: 0.1-0.78).Conclusion: Atrial fibrillation is common in stroke patients in our hospital, especially in the elderly population. It is associated with low rate of improvement at discharge. Appropriate screening and treatment of atrial fibrillation is invaluable for the primary and secondary prevention of stroke

Retrospective analysis of pattern and outcome of neonatal surgical cases at Tikur Anbesa university teaching hospital, Addis Ababa, Ethiopia

Back ground/ Purpose:The survival of neonates with surgical condition has greatly improved in developed countries but still poor in developing countries due to several challenges with neonates requiring surgical care. The aim of this study is to determine major causes of surgical neonatal admissions and their immediate outcome.Materials and Methods: A retrospective review of medical records of surgical neonates who were admitted and treated at Tikur Anbesa Hospital between January 1st 2010 and December 31st 2014.Results:There were a total of 652 surgical neonatal admissions during the study period of which 396 were males, 252 females and 4 with indeterminate genitalia with M:F ratio of 1.6:1. Majority of the cases (86.2%) were having congenital diagnoses. Lesions of the gastrointestinal tract (43.3%) mainly anorectal malformations followed by abdominal wall defects (15.5%) were the major pathologies. Two-third of the cases (66.6%) underwent surgical management. The overall hospital mortality following admission was 24.4%. Case fatality rate ranging from 0.03% forHirschsprung's disease to 73.2% for esophageal atresia with or without fistula. The immediate causes of death among these neonates were ascribed to septic shock and respiratory failure. Conclusion:Neonatal surgical admission is common in our institution.Overall mortality after neonatal surgical admission was quite high. Type of principal diagnosis and age of the neonate at admission significantly associated with outcome.Creating awareness about neonatal surgical condition may help to improve the current poor result

Healthcare professionals' awareness, knowledge, attitudes, perceptions and beliefs about Ebola at Gondar University Hospital, Northwest Ethiopia: a cross-sectional study

A poor understanding of Ebola Virus Disease (EVD) among Health Care Professionals (HCPs) may put our lives at risk. We aimed to assess the awareness, knowledge, attitudes, perceptions, beliefs of HCPs towards Ebola at Gondar University Hospital (GUH) in Northwest Ethiopia. We conducted a hospital based, cross-sectional survey among 245 randomly selected HCPs working at GUH from August-October, 2015. A validated, self-administered questionnaire was used to collect the data. We calculated descriptive statistics with P0.05 being statistically significant. Of the 245 participants, 211 (86.1%) completed the study. The majority had heard about EVD and used news media (62%) as a source of information. Still, many were afraid of getting EVD (56.4%; P=0.001). A significant number of HCPs thought EVD can cause paralysis like polio (45%) and can be treated with antibiotics (28.4%). In addition, 46.4% of the HCPs felt anger or fear towards Ebola infected patients (P=0.006). We identified poor knowledge and negative incorrect beliefs among doctors and allied health professionals. There is a need for intensive training for all HCPs reduce EVD risk

Epidemiologie des souches de Klebsiella pneumoniae productrices de Beta-lactamases a spectre elargi dans un hopital universitaire au Senegal; 2011

Objectifs : Au cours de ces dix dernieres annees; la resistance bacterienne aux antibiotiques; particulierement par production de ?-lactamases a spectre elargi (BLSE); est devenue un probleme majeur de sante publique. L'objectif de cette etude est de determiner la prevalence des souches de Klebsiella pneumoniae BLSE au CHNU Le Dantec; Dakar; Senegal. Methodes : Il s'agit d'une etude retrospective sur une periode de 12 mois portant sur 139 souches de K. pneumoniae. La detection des BLSE a ete effectuee par la methode de diffusion par double disque. Resultats : Parmi les 139 souches de K. pneumoniae etudiees; 44 (31;7) etaient productrices de BLSE. Trente trois (75) de ces 44 souches etaient d'origine nosocomiale (p = 0;016). Ces souches etaient surtout isolees chez les patients hospitalises dans les unites de soins intensifs (USI : 45;4 ; p = 0;031) et provenaient principalement de prelevements d'urines (59) et de pus (25). Toutes les souches de K. pneumoniae etaient resistantes a l'Amoxicilline; a la Piperacilline et a la Cefalotine. La majorite des souches de K. pneumoniae BLSE avait en outre une resistance a l'association sulfamethoxazole/trimethoprime (95;2); a la Gentamicine (78;6); a la Ciprofloxacine (67;4) et a l'Amikacine (41). Par contre; elles demeurent tres sensibles a l'Imipeneme et a la Fosfomycine. Conclusion : La resistance des enterobacteries; notamment K. pneumoniae; aux fluoroquinolones par production de BLSE devient de plus en plus preoccupante. Ceci suggere une utilisation plus rationnelle des fluoroquinolones; en particulier dans les traitements de premiere intension des infections du tractus urinaire

Head injury-a neglected public health problem: a four-month prospective study at Jimma University specialized hospital, Ethiopia

BACKGROUND: Trauma, especially head trauma, is an expanding major public health problem and the leading cause of death of the young and productive part of the world's population. Research is mainly done in high-income countries where only a small proportion of the worldwide fatalities occur. The intention of this study was to analyze head injury in a setting where most patients in low- and middleincome countries receive treatment, a referral hospital with general but no neurosurgical service like Jimma University Specialized Hospital. The study aims to provide surgeons, hospital managers and health planners working in similar set-ups with baseline information for further investigation and prevention programs intending to reduce the burden of head injury. METHODS: All head injury patients presented to Jimma University Specialized Hospital between March and June 2010 were included in this prospective research. Epidemiological, clinical and management data were collected for the study. RESULTS: Out of 52 patients, 47 were males. The median age was 20.0 years (SD=13.3). Fights (n=20, 38.5%) and road traffic accidents (n=19, 36.5%) were the most common causes of head injury. Half of the patients sustained mild and 36.5% sustained severe head injury. The initial GCS had a significant correlation with the outcome. The mortality rate was 21.2%. Of all patients 76.9% were managed conservatively. CONCLUSION: Prevention of road traffic accidents and improvement of conservative care were identified as major methods to reduce the burden of head injury in a set-up similar to Jimma. Further studies on head injury patients in low-income countries should be done

Prevalence et facteurs de risque des presentations dystociques aux cliniques universitaires de Kisangani

Introduction : La decouverte d'une presentation dystocique reste toujours une situation angoissante et pour le praticien et pour la gestante ainsi que son entourage. C'est dans cet optique que nous avons voulu determiner leur frequence; leurs facteurs de risque ainsi que le risques qui leurs sont associes dans nos milieux. Materiel et Methode : nous avons mene une etude retrospective aux cliniques universitaires de Kisangani. Pour determiner les facteurs de risque des presentations dystociques et les risques qui leurs sont associes; nous avons compare les cas des presentations dystociques a ceux des cephaliques de sommet. Resultats : La frequence des presentations dystociques etait de 6;5 avec le siege representant 5;2 et la transversale 1;3. Les facteurs de risque retrouves etaient le non suivi des CPN (Fisher exact=0;0148); la grossesse gemellaire (Fisher exact=0;0194); un exces de liquide amniotique ou l'hydramnios (Fisher exact=0;0118) et une insertion basse du placenta (Fisher exact=0;0101). L'accouchement par siege etait associe au faible score d'APGAR a la 5e minute (Fisher exact=0;0480). Conclusion : Cette etude revele que la frequence des presentations dystociques reste elevee dans nos milieux et que certains de leurs facteurs de risque retrouves doivent etre pris en compte dans la surveillance de la grossesse. Il est donc capital pour les praticiens de les connaitre pour pouvoir prendre des decisions a temps pour le bon pronostic de la grossesse

Profil epidemiologique des traumatises par accidents de trafic routier aux cliniques universitaires de Kisangani

Introduction : Les accidents de trafic routier sont frequents a Kisangani et representent un grave probleme de sante publique. Materiel et Methode : Nous avons conduit une etude retrospective realisee dans le departement de chirurgie des Cliniques Universitaires de Kisangani sur une periode de six mois d'activites. Resultats : Les traumatismes par Accident du Trafic Routier representent 17;8 de la totalite des urgences admises durant la periode allant de mois de juillet a celui de decembre 2012. Tous les ages sont concernes; avec une predominance de la tranche d'ages 15 a 44 ans; soit 61;14 ; le sexe ratio hommes/femmes est de 2. Les taximen moto et taximen velo sont plus touches dans l'ordre respectif de 36;8 et 27;9. Les victimes residant les communes de Makiso representent 35;2. En dehors des blesses legers incluant les lesions cutaneo-muqueuses de moindre gravite qui representent 31;6des cas; les lesions traumatiques uniques representent 66;2 et concernent le crane 34;7; les membres 27;5. Les contusions thoracique et abdominale ont successivement represente 1;6 et 2 des cas. La letalite precoce est de 5;7 .Conclusion : L'absence d'une prise en charge pre-hospitaliere et d'un service de ramassage adequat des victimes a Kisangani rendent compte pour une bonne part de ce taux eleve de morbidite et de mortalite

Computerised tomographic patterns in patients with head injury at the university of Benin teaching hospital

Background: Head injuries rank high among morbidities due to trauma. Computerised tomography is an important modality in the investigation of these cases. However; literature on this subject in the south-south geopolitical zone of Nigeria is sparse. This study therefore aimed to document the computerized tomographic features of patients with head injury managed at the University of Benin Teaching Hospital (UBTH). Materials and Methods: A prospective study involving patients with head injury referred for CT scan from the Accident and Emergency Unit of UBTH over a 12-month period. A total of 100 patients were studied; using non-enhanced cranial CT scans. Findings were recorded and data analysis using SPSS done. Results: The age group 21-30 years was most frequently involved. Sex preponderance was 4.3:1 (male: female). Twenty-six patients had normal CT scans. The most common abnormal finding was intracerebral hemorrhage 35 cases (33). This was followed by skull fractures; 23 cases (31); subdural hemorrhage; 16 cases (21); cerebral edema; 11 cases (15). Others included mass effect; nine cases (12). Conclusion: CT plays a very significant role in management of head injuries; as demonstrated in this study; by making such diagnoses that guided eventual patient management. Intracerebral hemorrhage was the most common abnormal finding in this report. Regular use of CT in moderate to severe cases of head injury is advocated

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