Caracterización epidemiológica de lesiones no intencionales en edad pediátrica. 2004-2019

Introducción: el término lesión no intencional en la literatura científica es relativamente nuevo; la acepción más utilizada ha sido "accidente". Objetivo: describir las características epidemiológicas de las lesiones no intencionales en menores de 15 años y el pronóstico para el año 2020. Métodos: se realizó un estudio observacional, descriptivo, ambispectivo, en menores de 15 años atendidos en el Hospital Provincial Pediátrico Docente "General Milanés", de Bayamo, Granma, en el período 2004-2019. La muestra estuvo constituida por 17 595 pacientes. Se utilizó la estadística descriptiva para el procesamiento de la información obtenida (tasa, media, desviación estándar). Resultados: la tasa media de mortalidad en el período 2004-2019 fue de 0,7446 por 1000 habitantes, predominó el sexo masculino, superando en cada año el 50 % de la casuística, existió predominio de los pacientes del área de salud que atiende el policlínico ″René Vallejo Ortiz″ (n=5314, para 30,20 %), seguido de los atendidos por el policlínico ″Bayamo Oeste″ (n=4484, para 25,48 %), La contusión fue la lesión no intencional más frecuente (12 644 pacientes; 71,86 %); seguido de las heridas (2550 pacientes; 14,49 %). En los dos primeros trimestres del año se produjo el mayor número de lesiones no intencionales. Conclusiones: hubo predominio del sexo masculino, el grupo de 1 a 4 años y el área de salud que atiende el policlínico ″René Vallejo″. Las contusiones, seguidas de las heridas, fueron las lesiones no intencionales más frecuentes; la mayoría de los pacientes no requirió de ingreso hospitalario. El patrón estacional fue casi homogéneo, con una tendencia estable de ese evento de salud.

Introduction: the term unintentional injury in the scientific literature is relatively new; the most used meaning has been "accident". Objective: to Describe the epidemiological characteristics of unintentional injuries in children under 15 years of age and the prognosis for the year 2020. Methods: an observational, descriptive, ambispective study was carried out in children under 15 years of age treated at the "General Milanés" Provincial Pediatric Teaching Hospital in Bayamo, Granma, in the period 2004-2019. The sample consisted of 17,595 patients. Descriptive statistics were used: for the processing of the information obtained (mean, standard deviation). Results: the average rate in the period 2004-2019 was 0.7446 per 1000 inhabitants, the male sex predominated, exceeding 50% of the casuistry in each year, there was a predominance of patients in the health area that attends the polyclinic ″René Vallejo Ortiz″ (n=5,314, for 30.20%), followed by those attended by the ″Bayamo Oeste″ polyclinic (n=4,484, for 25.48%), contusion was the most frequent unintentional injury (12,644 patients 71.86%); followed by wounds (2550 patients; 14.49%). The highest number of unintentional injuries occurred in the first two quarters of the year. Conclusions: there was a predominance of the male sex, the group from 1 to 4 years old and the health area served by the ″René Vallejo″ polyclinic. Contusions, followed by wounds, were the most frequent unintentional injuries; most of the patients did not require hospital admission. The seasonal patteern was almost homogeneous, with a stable trend of that salt event.

Introdução: o termo lesão não intencional na literatura científica é relativamente novo; O significado mais comumente usado tem sido "acidente". Objetivo: descrever as características epidemiológicas das lesões não intencionais em menores de 15 anos e o prognóstico para o ano de 2020. Métodos: foi realizado um estudo observacional, descritivo e ambispectivo em crianças menores de 15 anos atendidas no Hospital Pediátrico Provincial de Ensino "General Milanés" em Bayamo, Granma, no período de 2004 a 2019. A amostra foi composta por 17.595 pacientes. A estatística descritiva foi utilizada para processar as informações obtidas (taxa, média, desvio padrão). Resultados: a taxa média de mortalidade no período 2004-2019 foi de 0,7446 por 1000 habitantes, predominou o sexo masculino, ultrapassando 50% da casuística em cada ano, houve predomínio de pacientes na área da saúde atendidos pela policlínica "René Vallejo Ortiz" (n=5314, para 30,20%), seguidos pelos atendidos pela policlínica "Bayamo Oeste" (n=4484, para 25,48%), a contusão foi a lesão não intencional mais frequente (12.644 pacientes; 71,86%); seguido de feridas (2550 pacientes; 14,49%). Os doisprimeiros trimestres do ano viram o maior número de lesões não intencionais. Conclusões: houve predomínio do sexo masculino, do grupo de 1 a 4 anos e da área da saúde atendida pela policlínica René Vallejo. As contusões, seguidas das feridas, foram as lesões não intencionais mais frequentes; A maioria dos pacientes não necessitou de internação. O padrão sazonal foi quase homogêneo, com tendência estável desse evento de saúde.

Lesiones no intencionales en menores de 18 años / Unintentional Injuries in Children under Eighteen Years of Age

Introducción: Las lesiones no intencionales se consideran un problema de salud en el mundo, las tasas se elevan de forma marcada. En Cuba ocupan una de las primeras causas de morbilidad en la edad pediátrica. Objetivo: Describir las principales características epidemiológicas de las lesiones no intencionales en menores de 18 años en Matanzas. Métodos: Se realizó un estudio descriptivo en Matanzas entre el 2013 y el 2018. El universo estuvo constituido por las 4464 lesiones no intencionales ocurridas en menores de 18 años durante el periodo analizado. Para el análisis de las variables se utilizaron tasas crudas por 10 000 habitantes. Resultados: Las tasas de morbilidad en la provincia estuvieron entre 45,2 y 58,2 por 10 000 habitantes. Los municipios de mayor riesgo resultaron Matanzas y Limonar. La mayoría de las lesiones no intencionales ocurrieron en el hogar, las caídas fueron las más frecuentes y provocaron lesiones leves. Conclusiones: Las lesiones no intencionales constituyen un problema de salud. Es necesario evaluar y controlar los factores de riesgo en los distintos tipos de accidentes para prevenir o disminuir su incidencia a través de estrategias de información, educación y comunicación. Lograr que las familias estén conscientes de la vulnerabilidad de los niños es un factor esencial y básico en todos los esfuerzos que tengan como objetivo la prevención de las lesiones no intencionales en esta etapa de la vida(AU)

Introduction: Unintentional injuries are considered a health concern worldwide. Their rates rise drastically. In Cuba, they occupy one of the leading causes of morbidity in pediatric age. Objective: To describe the main epidemiological characteristics of unintentional injuries in children under 18 years of age in Matanzas. Methods: A descriptive study was carried out in Matanzas, between 2013 and 2018. The universe consisted of 4464 unintentional injuries experienced, during the period analyzed, by children under 18 years of age. Crude rates per 10 000 inhabitants were used for the analysis of the variables. Results: The morbidity rates in the province were between 45.2 and 58.2 per 10 000 inhabitants. The municipalities with the highest risk were Matanzas and Limonar. Most of the unintentional injuries occurred at home. Falls were the most frequent and caused minor injuries. Conclusions: Unintentional injuries constitute a health concern. It is necessary to assess and control the risk factors for the different types of accidents, in order to prevent or reduce their incidence, through information, education and communication strategies. Making families aware of the vulnerability of children is an essential and basic aspect in all efforts aimed at preventing unintentional injuries at this stage of life(AU)

Clinical analysis of 1 379 children hospitalized for unintentional injuries: Case series from a single center / 中国小儿急救医学

Objective:To prevent the occurrence of children′s unintentional injuries, clinical characteristics were analyzed for 1 379 children hospitalized for unintentional injuries over a 5-year period at the First Affiliated Hospital of Xiamen University.Methods:We searched the First Affiliated Hospital of Xiamen University Pediatric Refined Management Database for all cases of children aged 0-14 years who were hospitalized for unintentional injuries from January 1, 2015 to December 31, 2019.Descriptive statistics were calculated for age, gender, season of injury, location of residence, education level of the child′s parents/guardians, injury etiology and outcome, and cost of treatment.Results:Of 1 379 cases, 894 children(64.8%) were boys and 485(35.2%) were girls.The majority of cases were 1-5 years old(61.6%, n=849). The top three causes of unintentional injuries were foreign bodies(38.1%, n=526), falls(27.0%, n=372), and burns(17.1%, n=236). Children′s unintentional injuries occurred most frequently during the summer(29.0%). More children came from rural locations(56.3%, n=777). Approximately half of the parents/guardians had attained an education level of junior high school or below(50.5%, n=696). There were 47 cases(3.4%) resulting in death or permanent injury and 292 cases(21.2%) resulting in disability.Children injured in traffic accidents had the longest average length of hospital stay [11(7, 18)d] and incurred the highest healthcare costs per case[11 130.32(5 389.69, 24 216.90)RMB]. Conclusion:Children′s unintentional injuries are concentrated among rural boys aged 1-5 years, foreign bodies are the most common cause of unintentional injuries.Children from families with low parental/guardian education levels may be at heightened risk of unintentional injuries.

Instrumento para evaluar conocimientos en enfermeros sobre lesiones no intencionales en la infancia temprana / An Instrument for Assessing Nurses' Knowledge about Unintentional Injuries in Early Childhood

RESUMEN Introducción: Las lesiones no intencionales en la infancia temprana representan un problema de salud por su frecuencia, magnitud, severidad y trascendencia. La prevención de dichas lesiones es compleja y, en la atención primaria, el profesional de enfermería puede y debe ejercer una importante función dirigida a tal fin. Objetivo: Describir el diseño y validación de un instrumento para la evaluación del nivel de conocimientos que tienen los enfermeros sobre lesiones no intencionales en la infancia temprana. Métodos: Estudio metodológico que basó el diseño del instrumento en la literatura científica y la validación en criterio de expertos, que incluyó enfermeras nacionales e internacionales, pedagogos, médicos pediatras y epidemiólogos. El nivel de competencia fue medido por el coeficiente K. La concordancia se midió mediante el Índice Kappa de Cohen. Para medir la comprensión se realizó prueba piloto, con16 enfermeras del Policlínico Área I del municipio Cienfuegos. La confiablidad de consistencia interna se calculó con coeficiente Alfa de Cronbach mediante el programa estadístico Epidat. Resultados: Se obtuvo un instrumento fiable y válido que permite evaluar el nivel de conocimientos sobre lesiones no intencionales en la infancia temprana. Conclusiones: La utilización del instrumento diseñado y validado fue punto de referencia para la identificación nivel de conocimiento y el diseño de intervenciones educativas en la comunidad(AU)

ABSTRACT Introduction: Unintentional injuries in early childhood represent a health problem due to their frequency, magnitude, severity and transcendence. The prevention of such injuries is complex and in the primary care, the nursing professional can and should exercise an important function directed to that end. Objective: Describe the design and validation of an instrument for evaluation of the level of knowledge nurses have about unintentional injuries in early childhood. Methods: Methodological study that based the design of the instrument on the scientific literature and the validation in criterion of experts, who It included national and international nurses, pedagogues, pediatric doctors and epidemiologists. The level of competence was measured by the coefficient K. The concordance was measured by Cohen's Kappa Index. To measure comprehension, a pilot test was carried out, with 16 nurses from the Policlínico Área I of the Cienfuegos municipality. The reliability of internal consistency was calculated with the Cronbach's Alpha coefficient using the statistical program Epidat. Results: A reliable and valid instrument was obtained that allows assessing the level of knowledge about unintentional injuries in early childhood. Conclusions: The use of the designed and validated instrument was a point of reference for the identification level of knowledge and the design of educational interventions in the community(AU)

Lesiones no intencionales por vehículos a motor en pediatría. Estudio epidemiológico en pacientes internados en el Hospital de Niños "Ricardo Gutiérrez" / Unintentional injuries by motor vehicles in pediatrics. Epidemiological study of admitted patients to the "Ricardo Gutierrez" Children's Hospital

Introducción: El trauma es la causa más frecuente de muerte en niños mayores de 1 año en Argentina y presenta elevada morbilidad y alto costo para el sistema de salud. Los traumatismos por vehículo a motor (VAM) son una de las causas más frecuentes de lesiones graves. Objetivo: Identificar las causas, cinemática, topografía lesional y analizar el impacto de los factores epidemiológicos relacionados con traumatismos por VAM en pacientes internados en el Hospital de Niños "Ricardo Gutiérrez" (HNRG). Analizar factores de riesgo pasibles de intervención. Métodos: Estudio observacional, prospectivo, analítico y de predictores. Se incluyeron 47 niños de 0 a 18 años, internados por lesiones por VAM entre el 1 de abril de 2015 al 31 de marzo de 2017. Se confeccionó una ficha médica con datos obtenidos de las historias clínicas y entrevista a los padres. Los pacientes se dividieron en tres grupos: pasajeros, peatones y biciclistas. La severidad se valoró según el Índice de Trauma Pediátrico (ITP) en dos grupos para identificar factores de riesgo para trauma grave (ITP≤8) mediante un modelo de regresión logística. Variables predictivas: características demográficas del paciente y sus padres, nivel y factores de riesgo socio-económicos, datos del incidente, asistencia inicial, evolución y su causa. Para analizar la injuria topográfica, se estratificaron tres grupos etarios. Resultados: En el 36.2% la causa del evento fue negligencia. En el 68.1% de los eventos el mecanismo lesional fue atropello. La topografía más frecuente fue Sistema Nervioso Central (SNC) 42.6% aislado y 57.5% asociado a otras lesiones. Se estimó un aumento de la probabilidad de riesgo de ingresar a cuidados intensivos de 15,27 veces, cada vez que ITP pasa de >8 a grave. Conclusiones: En más del 66% de los eventos las causas fueron: negligencia e imprudencia. El mecanismo lesional más frecuente fue el atropello. Los menores de 3 años presentaron trauma aislado de SNC (66%). Los pacientes con ITP bajo presentaron elevada probabilidad de requerir cuidados intensivos. Se recomienda enfatizar en educación, prevención e investigación para generar propuestas multisectoriales, fijar prioridades y monitorizar las intervenciones

Introduction: In our country trauma is the most frequent cause of death in children more than one year old, representing a high morbidity and an economic burden for the health system. Motor vehicle trauma (MVT) is one of the most frequent causes of severe injuries. Objective: To identify the causes, the kinematics and the injury topography and to analyze the impact of the epidemiological factors related to MVT of admitted patients to the "Ricardo Gutierrez" Children's Hospital. Modifiable risk factors were also analyzed. Methodology: Observational, prospective, analytical and predictive study. Forty seven (47) children between the ages of 0 and 18 years were included, all of them admitted with MVT injuries between April 1st 2015 and March 31st 2017, with follow up until discharge. A medical record was created with data from clinical history and interviews with parents. The enrolled inpatients were subdivided into three (3) groups: passengers, pedestrians and cyclists. Injury severity was assessed by the "Pediatric Trauma Index" (PTI) in two groups to identify risk factors for severe trauma (PTI ≤8) through a logistic regression model. Predictive variables: demographic characteristics in hospitalized children and their parents, socio-economic level and risk factors, event information, initial assistance and evolution of the clinical case. Injury topography was stratified in three (3) age groups. Results: Car hit was responsible for 68.1% of the events. Negligence was found in 36.2% of the causes. Central nervous system (CNS) was the most frequent topography: isolated in 42.6% and associated with other lesions in 57.5%. Identified risk factors: when PTI was >8 or critical, the risk probability to be admitted into intensive care units increased by 15.27 times. Conclusion: Car crash was the most frequent injury mechanism. Negligence and imprudence were 2/3 of the events causes. Children under three (3) years presented isolated CNS trauma (66%). PTI ≤8 was associated with high probability of intensive care requirement. Education, prevention programs and research are necessary in order to generate multisectoral proposals, to fix priorities, including monitoring and surveillance interventions

Opiniones, prácticas y conocimientos de pediatras sobre la prevención de lesiones no intencionales / Pediatricians' opinions, practices and knowledge about unintentional injuries prevention

El objetivo fue describir opiniones, prácticas y conocimientos de pediatras sobre prevención de lesiones no intencionales (LNI) Metodología: estudio descriptivo y analítico por encuesta anónima y auto-administrada a pediatras, en Mendoza, en 2015. Resultados: N: 210. La edad media de los pediatras fue 44, 55 años, 65, 2% mujeres. Doscientos (95, 22%) realizan prevención de lesiones, 76% lo hace en la mayoría de las consultas, usando método verbal principalmente. El 94, 29% (198) opinaron que la prevención mejora la seguridad en el hogar y 185 (88, 1%) que debiera hacerse en todas las consultas. Entre pediatras con menos de 10 años de antigüedad (N= 84), el 79, 6% respondió correctamente sobre sillitas, ahogamiento, andador y caídas; entre los de mayor antigüedad (N= 126) hubo 61, 9% de respuestas correctas (p= 0, 007) Conclusiones: Los pediatras son conscientes de su rol en prevención de LNI, refieren realizar actividades de prevención y conocen sobre el tema, sobre todo los más jóvenes.

Introduction: The objective of this study was to address the pediatrician's opinions, practices and knowledge on the prevention of unintentional injuries. Design: descriptive and analytical study by anonymous and self-administered survey to pediatricians, in Mendoza, in 2015. Results: N: 210. The mean age of pediatricians was 44.55 years old, 65.2% were women. 200 (95.22%) performed injury prevention, 76% did it in most of the visits, using verbal method mainly. 198 (94.29%) believed that prevention improves home safety and 185 (88.1%) should be done in all consultations. There were 79.6% correct answers among pediatricians less than 10 years' seniority (N= 84) about child car restraint system, drowning, baby walker use and falls; among the oldest (N= 126) there were 61.9% of correct answers (p= 0.007) Conclusions: Pediatricians are aware of their role in injury prevention, realized prevention activities and knew about the subject, especially the younger ones.

Lesiones no intencionales en niños. Primeras aproximaciones al estudio de modalidades en el ejercicio de la parentalidad detectadas en una investigación de casos múltiples / Unintentional injuries in children. First approaches to the study of parenthood common traits detected in a multiple case research

El presente artículo es un avance de una tesis doctoral sobre accidentes autoprovocados en niños. Esta investigación empírica, cualitativa, exploratoria y descriptiva estudia 12 casos de niños con accidentes reiterados. La investigación abarca dos ejes: el primero explora modalidades de simbolización de fantasías e impulsos agresivos en estos niños, el segundo indaga sobre características de sus padres, aspecto que se focaliza aquí. Se estudian Historias Clínicas y Horas de Juego de niños consultantes a un Servicio Asistencial dependiente de una cátedra universitaria. Para el análisis de las Horas de Juego Diagnósticas se utilizan categorías probadas en investigaciones anteriores y, sobre todo, en la investigación marco (Proyecto 20020130100535BA). Conforme esta investigación ha ido avanzando, detectar características en el ejercicio de la parentalidad ha advenido un tema fundamental. La profundización sobre este tópico provee información relevante para el diseño de estrategias de prevención y de tratamiento.

The present paper is an advance of a doctoral thesis about self- inflected accidents in children. This empirical, cualitative, exploratory and descriptive research. studies 12 cases of children who had suffered repetitive accidents. This investigation involves two axis: the first one explores modalities of symbolization of phantasies and aggressive impulses, the second one inquires about characteristics of their parents, aspect that is focused on this paper. Clinical protocol records and diagnostic playing sessions of children attends in a Clinical Psychology Unit, affiliated with a university chair, are studied. For the analysis of diagnostic playing sessions, categories tested in previous investigations, especially those involved with the framework research are applied (20020130100535BA Project). As this research has progressed, the detection of parenthood common traits has become a fundamental issue. The deepening about this topic provides important data to the design of strategies for prevention and treatment.

Trauma en pediatría: Estudio epidemiológico en pacientes internados en el Hospital de Niños "Ricardo Gutiérrez" / Pediatric trauma: Epidemiological study among patients admitted to Hospital de Niños "Ricardo Gutiérrez"

Introducción. En Argentina, el trauma es la causa más frecuente de muerte en niños mayores de 1 año, con una elevada morbilidad y un alto costo para el sistema de salud. Objetivo. Identificar las causas de las lesiones en los pacientes internados por trauma y analizar la asociación entre los factores epidemiológicos y el trauma grave. Población y métodos. Estudio prospectivo. Se incluyeron los niños de 0-18 años internados por trauma no intencional entre abril de 2012 y marzo de 2013. Se dividieron en dos grupos según el índice de trauma pediátrico grave (8 o menor) para identificar factores de riesgo mediante un modelo de regresión logística. Variables predictivas: características demográficas del paciente y sus padres, factores socioeconómicos, datos del incidente, asistencia inicial, evolución y factores de riesgo. Se estratificaron en tres grupos etarios para el análisis de la topografía de la lesión. Resultados. Se incluyeron 237 pacientes. En menores de 3 años, predominó el traumatismo craneoencefálico y, en mayores de 3 años, las fracturas de miembros. En el análisis bivariado, padres extranjeros, indigencia o pobreza, causa inmediata prevenible, altura peligrosa y calefacción insegura resultaron estadísticamente significativos. Por regresión múltiple, quedaron incluidas las variables padres extranjeros, residencia en asentamiento, causa inmediata prevenible y calefacción insegura. Conclusiones. La principal causa de trauma fue la caída de altura y algunos de los factores socioeconómicos explorados se asociaron a mayor riesgo de trauma. Esto podría ser utilizado para elaborar medidas de prevención.

Introduction.In Argentina, trauma is the most common cause of death among children older than 1 year old, has a high morbidity rate, and results in large costs for the health system. Objective.To identify causes of injuries in patients admitted to the hospital due to a trauma, and to analyze the relationship between epidemiological factors and severe trauma. Population and Methods.Prospective study. Children and adolescents aged 0 to 18 years old admitted to the hospital due to unintentional trauma between April 2012 and March 2013 were included. They were divided into two groups based on severity according to the pediatric trauma score (8 or lower) to identify risk factors by means of a logistic regression model. Predictive outcome measures: patients' and parents' demographic characteristics, socioeconomic factors, event data, initial care, course, and risk factors. Patients were stratified into three age groups for the analysis of the type of injury and the anatomic location. Results.Two hundred and thirty-seven patients were included. Traumatic brain injuries were predominant among children younger than 3 years old, while limb fractures were most common among children older than 3 years old. In the bivariate analysis, foreign parents, a state of poverty or destitution, an immediate preventable cause, dangerous heights, and an unsafe heating system were statistically significant outcome measures. Based on multiple regression, outcome measures included were foreign parents, living in a slum area, an immediate preventable cause, and an unsafe heating system. Conclusions.The main cause of trauma was related to falls from heights, and some of the studied socioeconomic factors were associated with a higher risk of trauma. This information may be useful to develop prevention measures.

Prevalence of attention deficit hyperactivity disorder in children with unintentional injuries.

Introduction: Attention deficit hyperactivity disorder (ADHD) is characterized by hyperactivity, inattention and impulsiveness. Risk-taking behaviour and accident proneness are well recognized in these children. Objectives: To estimate the prevalence of ADHD among children attending an Accident Service and to describe the injury profile. Method: Data was gathered from children with unintentional-injuries attending Accident Service on randomly selected days. SNAP IV, an 18-item standardized schedule validated for diagnosis of ADHD, was interviewer-administered to parents. Injury-related data was collected using a semi-structured questionnaire. Results: One hundred and fifty one children, aged 4 to 12 years (mean age 8.5 years), participated in the study. Prevalence of ADHD in this group was 18%. Children with and without ADHD did not differ in mean age and gender distribution. Children with ADHD were more likely to sustain injury needing hospitalization, report previous injury needing hospitalization and were perceived by mothers as injury prone, which were all statistically significant (p<0.05). Conclusions: Prevalence of ADHD among children attending an Accident Service was 18%. Children with ADHD were more likely to sustain injury needing hospitalization (p<0.01). Children with ADHD were perceived by parents as prone to injury (p<0.05).

Unintentional injuries among children admitted in a tertiary care hospital in North Kerala.

World Health Organization global disease update (2004) points out injuries as the sixth leading cause of morbidity and mortality in childhood. A descriptive hospital based study was conducted to find out the common types of unintentional injuries among children admitted for management of unintentional injuries in Pediatric Surgery department and Intensive Care Unit of a tertiary care hospital of North Kerala and to find out the contributing risk factors. A total of 400 children admitted during the study period of 6 months of 2009 constituted the study population. Mechanical injuries comprising of Road traffic accidents and accidental fall were the major cause of unintentional injuries (36%), followed by Poisoning (22.3%). A higher proportion of unintentional injuries were noted to occur among children of younger mothers, overactive child, children belonging to extended or joint families, child left alone or with friends, pre-school children, male child and from urban dwellings. The study highlights the need to identify the different types of unintentional injuries and the risk factors of childhood injuries which require hospitalisation. Identification of risk factors will help to formulate strategies aimed at risk reduction and prevention of childhood injuries.

Study on the status of unintentional injuries in children under age 7 in Guangzhou / 中华流行病学杂志

Objective To understand the pravelence and distribution of unintentional injuries in children under age 7 in Guangzhou. Methods Data was descriptively analyzed from the Guangzhou Unintentional Injuries Surveillance System among 470 770 children under age 7 living scatterly or collectively. Results The incidence rates of unintentional injuries among children in Guangzhou was 1.48%, among which the incidence rates were: living scatterly as 1.11% living collectively as 1.66%, living in urban areas as 1.36% in rural as 2.52%. In order, the proportion of main causes of children's unintentional injuries were as follows: falls (70.54%), animal injuries (8.48%), burn and scald (5.75%), blunt force injuries (3.92%) , and road traffic injuries (RTIs) (3.48%). The main body parts being injured were head and face (60.00%) , wrist and hand (15.48%), knee and leg (11.70%), elbow and forearm (4.54%), shoulder and arm (2.99%). The degrees of children's unintentional injuries were as follows: mild impairment (85.35%), moderate impairment (9.12%) , and severe impairment (0.57%). Places that the patients went were as follows: hospital outpatient department or emergency room (49.66%), inpatient department or ICU (2.06%), home and kindergarten (43.34%). Conclusion The overall incidence rate of children' s unintentional injuries under age 7 in Guangzhou was 1.48%, with main causes as fall, animal injuries,burn and scald, blunt force injuries, and RTIs. There were considerable differences of characteristics and distributions on age and areas among the patients.

Investigation on the unintentional injuries among rural children in Shaanxi province / 中华流行病学杂志

Objective To investigate the current status of unintentional injuries among rural children aged 0-12 years in Shaanxi.Methods Using a three-stage stratified random sampling method to study the status of unintentional injuries among 4668 children aged 0-12 years old during the period of 2010 in rural areas of Shaanxi province.Results The overall incidence of injure was 27.3％,with boys as 28.7％ and girls as 25.6％ respectively(x2=5.91,P=0.015).Age differences in unintentional injuries rate were also significant(x2=9.91,P=0.007),with children under 0-3 years old having the highest rate of injuries,followed by 7-12 and 4-6 year-olds.Falls took the leading type of accidence among both sexes and all age groups.Poorer the family economic situation was,higher the incidence of unintentional injuries appeared.Conclusion Falls was the leading cause of unintentional injuries among rural children in Shaanxi province,with age 0-3 year group appeared the highest to suffer unintentional injuries.Unintentional injuries were associated with the economic status of the families.

Clinical epidemiological characteristics of unintentional injuries among children / 中华创伤杂志

Objective To analyze the epidemiological characteristics of unintentional injuries among children patients at age of ≤ 14 years so as to provide scientific basis for prevention of the children injury. Methods ICD-10 coding was used to retrospectively analyze the epidemiological characteristics of the children patients with unintentional injuries at age of ≤ 14 years admitted from January to December 2009 and the factors affecting the prognosis were discussed. Results There were 3011 patients, with 1991 males (66.12%) and 1 020 females (33.88%). The patients at ages of < 1, 1-4, 5-9 and 10-14 years accounted for 8.24%, 53.30%, 27.90% and 10.56% respectively. The patients from the rural and urban areas accounted for 56.16% and 43.84% respectively. Trauma was the leading sort of injuries in four age groups, accounting for 70.56%, 62.68%, 89.64% and 87.74% respectively. Fall from height was the first cause of unintentional injuries in four age groups, with proportion for 47.58%,36.39%, 51.90% and 56.29% respectively. Muhinomial logistic regression analysis revealed that hospital stay, therapeutic mode ( operation/non-operation), inhabitancy ( urban/rural), causes of injuries and injury severity on admission were the risk factors affecting the prognosis (P < 0.05 ). The rural areas caused higher risk of disability than the urban areas ( OR = 2. 170 ,P < 0.01 ) and non-operation produced higher risk of death than operation (OR = 6.352,P < 0. 01 ). Conclusions The male patients with unintentional injury are more than the female ones, with the highest incidence rate in children at age of 1-4years. Trauma is the main kind of unintentional injury and the fall from height the leading cause of injury.The difference of the rural and urban areas indicates that correct choice of the preventive measures based oh the condition of the local area can attain effective prevention and control of the unintentional injuries.

The Jamaica Injury Surveillance System a profile of the intentional and unintentional injuries in Jamaican Hospitals / El Sistema de Vigilancia de Lesiones en Jamaica (SVLJ) u n perfil de las lesiones intencionales y no intencionales en hospitales de Jamaica

BACKGROUND: Injuries in Jamaica are a major public health problem as demonstrated by a hospital based computerized injury surveillance system established in 1999 that provides a risk profile for injuries. SUBJECTS AND METHOD: Injury data from 2004 were selected to provide an annual profile, as comprehensive injury data were available from nine public hospitals. These nine public hospitals provide care for 70% of the Jamaicans admitted to hospitals annually. RESULTS: Data are presented on unintentional injuries where falls caused 44%, lacerations 27% and accidental blunt injuries were 17% of these. For motor vehicle related injuries, 55% were sustained while commuting by motorcars, 17% while riding motorbikes/bicycles and 16% of those injured were pedestrians. Most violence related injuries were due to fights (76%) with acquaintances (47%) who used sharp objects (40%) to inflict the injury. CONCLUSION: The Jamaica Injury Surveillance System (JISS) data, augmented by data collected on injuries from the health centres and the sentinel surveillance system, give a measure of the magnitude of the impact of injuries on the health services. The JISS provides data on the profile of injuries seen and treated at health facilities in Jamaica. In collaboration with police data and community-based surveys, it can be used to complete the risk profiles for different types of injuries. The data generated at the parish, regional and national levels form the basis for the design and monitoring of prevention programmes, as well as serve to support and evaluate policy, legislative control measures and measures that impact on interventions.

ANTECEDENTES: Las lesiones constituyen un problema importante de la salud pública en Jamaica, como lo demuestra el sistema de vigilancia computarizada de las lesiones, establecido en 1999, el cual proporciona un perfil de riesgo de las lesiones. SUJETOS Y MÉTODO: Datos de lesiones ocurridas en el 2004 fueron seleccionados a fin de ofrecer un perfil anual, ya que se disponía de un conjunto amplio de datos de nueve de los hospitales públicos. Estos nueve hospitales públicos dan atención al 70% de los jamaicanos ingresados a los hospitales cada año. RESULTADOS: Se presentan datos sobre lesiones no intencionales, según los cuales las caídas representaron el 44%, las laceraciones el 27% y las contusiones accidentales el 17%. En cuanto a las lesiones relacionadas con automóviles, el 55% fueron producidas durante la transportación diaria en vehículos automotores a centros de trabajo o estudio; el 17% se produjo en viajes en motos o bicicletas; y el 16% de los heridos fueron peatones. La mayoría de las lesiones relacionadas con la violencia se debieron a peleas (76%) con conocidos (47%) que usaron objetos perforocortantes (40%) para infligir las heridas. CONCLUSIÓN: Los datos del SVLJ, aumentados con los datos sobre lesiones recopilados en los centros de salud y el sistema de vigilancia centinela, dan una medida de la magnitud del impacto de las lesiones en los servicios de salud. El SVLJ proporciona datos sobre el perfil de las lesiones vistas y tratadas en los centros de salud de Jamaica. En colaboración con datos de la policía y encuestas a nivel de la comunidad, el sistema puede ser usado para completar los perfiles de riesgo en relación con diferentes tipos de lesiones. Los datos generados a nivel provincial, regional y nacional constituyen la base para el diseño y monitoreo de los programas de prevención. Asimismo, sirven para apoyar y evaluar políticas, legislaciones, medidas de control así como medidas relativas al impacto de las intervenciones.

Prevención de accidentes en adultos mayores: [revisión] / Prevention of injuries in the elderly: [review]

Las lesiones accidentales constituyen una proporción importante de la carga de enfermedad de los adultos mayores. Teniendo en cuenta que la mayoría de los accidentes son potencialmente prevenibles, se identifica la necesidad prioritaria de establecer medidas efectivas con el fin de evitarlos y detener la cascada de sus temibles consecuencias. Este artículo presenta una revisión del tema en el que se evalúan el impacto del problema, los factores de riesgo y las diferentes estrategias de intervención con su respectivo grado de evidencia, que nos proporcione las herramientas necesarias en nuestra práctica diaria para elaborar un perfil de riesgo individual y estructurado que nos permita prevenir y abordar esta problemática desde un enfoque multidimensional e interdisciplinario.

Unintentional injuries constitute an important proportion of the global burden of disease for the elderly. A larger part of the accidents are potentially preventable, so that it isnecessary to establish effective measures to avoid them and to stop their dreadful outcomes. This article reviews this aspect, to evaluate the problem impact, the risk factors, and several targeted multidimensional and multifactorial interventions to prevent injuries among older people, as a tool for our daily medical practice in order to build a complete risk profile to intervene this problem with interdisciplinary approaches.

Call for more research on injury from the developing world: Results of a bibliometric analysis.

Background & objectives: Injury prevention is a daunting health challenge as public health systems particularly in the developing world are least prepared to respond to this issue. In 2005, an estimated 5.4 million people worldwide died from injuries over 90 per cent in low- and middle-income countries. The main objective of this bibliometric analysis was to document injury literature published on low- and middle- income countries, and also to quantify literature on road traffic injuries by countries before and after the World Health Day on Road Safety celebrated in April 2004. Methods: A systematic search was done using MeSH terms on PubMed. Papers on road traffic injuries were assessed by country/cluster and by publication date for two periods (March 2001 - March 2004) and (April 2004 - April 2007). The rate of articles published per million population was calculated. Finally, a comparison was made between disease burden in disability adjusted life years (DALYs) and quantum of papers published. The search was performed on April 29, 2007. Results: PubMed had 8.26 million articles listed; of which, 72 per cent were in English and only 2 per cent were on unintentional injuries. For papers in all languages including English on road traffic injuries, 41 per cent were from US, 36 per cent from Europe (other than Eastern Europe). Two most populous countries, China and India contributed only 0.9 and 0.7 per cent papers on road traffic injuries, respectively. On neoplasm there were 280 articles published per million population whereas for road traffic injuries, rate was 4 articles per million population. Northern Africa, India and China had less than one article on road traffic injuries per 1,000 road traffic related deaths. The percentage change in English papers on road traffic injuries for the period 2004-2007 in comparison to period 2001-2004 was +191 per cent for China, +118 per cent for India, and +106 per cent for Middle East. Unintentional injuries overall represented 18 per cent of the burden in terms of DALYs and represented only 2 per cent of all published articles. Interpretation & conclusion: The results noticeably reflected the small proportion of papers on injuries, the dominance of US, and the apparent increase in percentage of road traffic injuries papers from low- and middle- income countries after World Health Day on Road Safety in 2004. Policies on injury prevention and safety in developing countries will be effective if based on local evidence and research, and designed to suit the social, political, and economic circumstances found in developing countries.

Repercussões no contexto familiar de injúrias não-intencionais em crianças / The repercussion from unintentional injuries in children on the family context

O objetivo desta pesquisa é estudar as características da criança como vítima de injúrias não-intencionais e seu familiar-acompanhante, descrever as repercussões dessas injúrias na família e identificar a concepção de familiares-acompanhantes sobre fatores de risco no domicílio e o conhecimento de práticas preventivas. Estudo descritivo, realizado com 29 familiares e/ou acompanhantes de crianças internadas em um hospital de emergência, em Fortaleza, Ceará, em 2005. A maioria das crianças tinha entre 5 a 10 anos, do sexo masculino, e prevaleceu a injúria no trânsito. Em relação aos acompanhantes, predominou renda de até um salário mínimo e eles afirmaram que conhecem os tipos mais comuns de injúrias com crianças e os modos de evitá-los. As repercussões atingem as dimensões emocionais, econômicas e sociais, somando-se verbalizações de medo, culpa e arrependimento, protesto e resignação. Conclui-se que o tema precisa ser amplamente discutido, mobilizando pessoas em instâncias formadoras de opiniões para reorientação da práxis na Saúde e Educação.

The objective of this work is to study the characteristics of the child when victim of unintentional injury, as well as those of his family caregiver. This was accomplished by describing the repercussion of those injuries in the family and identifying the family caregivers' conception of risk factors in the home, as well as their knowledge of preventive practices. A descriptive study was conducted with 29 relatives or caregivers of injured children at an emergency hospital in Fortaleza, Ceará, Brazil, in 2005. Most of the children were between 5 and 10 years old and were male; the most prevalent instances of injury were traffic-related. Regarding the caregivers, the most prevalent income range for this group was up to minimum wage. They reported knowing the most frequent types of injuries to children, as well as the ways to avoid them. The repercussions within the family context reach emotional, economical, social and cultural dimensions, with expressions of fear, guilt, regret, protest and resignation. It is concluded that this subject needs to be widely discussed, mobilizing opinion-makers to the reorientation of the praxis in health and education.

The economic burden of unintentional injuries

This study aims to estimate the costs of various unintentional injuries in Ba Vi district during one year, and to describe how the economic burden of unintentional injuries was distributed between households, government and the health insurance agency. Our cohort study involved four cross sectional household surveys among sampled communities in Ba Vi district during the year 2000, each asking about injuries in the preceding 3 months. The costing system in public health care in Viet Nam was applied as well as information from the victims. The total cost of injuries for the Ba Vi district was estimated to be 3.412.539.000 VND. Equivalent to the yearly income of 1800 people. 90% of this economic burden fell on households, only 8% on government and 2% on the health insurance agency. The cost of a severe injury to the victim corresponded to approximately 7 months of earned income. Home and traffic injuries together accounted for more than 80% of the total cost, 45% and 38% respectively.

El trabajo materno y la gravedad de lesiones accidentales en niños / Mother's work and severity of unintentional injuries in children

El objetivo de la investigación fue establecer la asociación entre la gravedad de las lesiones accidentales que provocan la demanda de atención hospitalaria en niños menores de cinco años, y el trabajo materno. Se utilizó un diseño de casos y controles en seis hospitales pediátricos del Distrito Federal; los niños lesionados cuya atención requirió hospitalización, cirugía, terapia intensiva o que fallecieron como consecuencia de la lesión constituyeron los casos y aquéllos cuya atención fue resuelta en el servicio de urgencias, los controles. El tamaño de la muestra fue de 700 niños (359 casos y 350 controles). Las variables fueron el trabajo materno, las características tanto en niños como socioeconómicas, el cuidado infantil y los riesgos de la vivienda. Los resultados estadísticamente significativos con una p< 0.05, fueron: cuando la madre trabaja en condiciones aceptables se encontró un "efecto protector", razón de momios (RM) 0.44; si es menor de 24 años, RM 1.40; si tiene escolaridad baja , RM 2.3; cuando se brindó una atención inadecuada RM 2.76, y si hubo un retraso en la demanda mayor de 60 min, RM 1.68. El estudio permite identificar los factores de riesgo asociados con lesiones graves y con el trabajo materno

A study was conducted in children under five years old, in order to establish the association between the mother's work and the severity of unintentional injuries. The study was carried out at the emergency room of six pediatric hospitals in Mexico City. Cases were children with major injuries that required hospitalization, intensive care, surgery, or who died as a result of the injury. Controls were children of similar age, with minor injuries resolved at the emergency room. Sample size was 350 cases and 350 controls. Variables were grouped according to: mother's occupation; characteristics of the child, socioeconomic status, child care, and those related with home risk factors. Results showed a protective effect on severity of injuries when the mother worked outside home in comparison to mothers who do not work, (or 0.79, 95%CI 0.57-1.07). No differences were found with respect to sex and age of children. Mother age under 24 years old and low schooling (<3 years of elementary school) were statistically significant with a risk of major injuries (or 2.30, 95%ci 1.5-3.4). Delay of demand of medical care after 60 minutes of injury occurrence is related with a risk of major injury (or 1.68, 95% CI 1.2-2.3). No differences related with household risk factors were found. Results provide valuable information about risk factors related with injury severity and the association with mother's work.