RESUMO
BACKGROUND: Injury remains a major cause of death and disability worldwide. AIMS: This study describes the characteristics of childhood injury at three hospitals in Maputo, Mozambique. METHODS: An observational, prospective convenience study was conducted in June and July 2007. We prospectively collected data on 335 children (0-14 years) who presented to three hospitals in Maputo during the study period. RESULTS: The prevalence of trauma-related complaints on presentation to the hospital in this study was 12%, with higher rates in boys (59%) and in those between the ages of 5-9 years (34.9%). Falls were the most common mechanism of injury (40.6%), followed by burns (19.1%) and road traffic injuries (RTI) (14.3%). The majority of falls occurred in the home (61.8%) and were unintentional. (94.1%) Burns were predominantly due to hot liquids (82.8%) and less frequently due to fire (17.2%). The majority of burns involved the patient alone (62.5%). The majority of RTIs were pedestrians struck by vehicles (81.2%). A substantial number of patients presented more than 24 h after injury (23.3%). Children from households living with a lower family income in general suffered trauma more often regardless of the mechanism. CONCLUSIONS: Childhood injury accounts for a substantial burden of disease in Maputo, Mozambique. This study highlights the fact that many of these injuries are consistent with the injury patterns seen in children in other low and middle income countries, and are amenable to prevention, access, and emergency care programs targeted at children and their families, schools, and the local and national community.
RESUMO
BACKGROUND: Emergency physicians routinely treat victims of intimate partner violence (IPV) and patients with mental health symptoms, although these issues may be missed without routine screening. In addition, research has demonstrated a strong association between IPV victimization and mental health symptoms. OBJECTIVES: To develop a brief mental health screen that could be used feasibly in an emergency department to screen IPV victims for depressive symptoms, posttraumatic stress disorder (PTSD) symptoms, and suicidal ideation. METHODS: The authors conducted a pretest/posttest validation study of female IPV victims to determine what questions from the Beck Depression Inventory II, Posttraumatic Stress Diagnostic Scale, and Beck Scale for Suicide Ideation would predict moderate to severe levels of depressive symptoms, PTSD symptoms, and suicidal ideation. A principal components factor analysis was conducted to determine which questions would be used in the brief mental health screen. Scatter plots were then created to determine a cut point. RESULTS: Scores on the brief mental health screen ranged from 0 to 8. A cutoff score of 4 was used, which resulted in positive predictive values of 96% for the brief mental health screen for depression, 84% for PTSD symptoms, and 54% for suicidal ideation. In particular, four questions about sadness, experiencing a traumatic event, the desire to live, and the desire to commit suicide were associated with moderate to severe mental health symptoms in IPV victims. CONCLUSIONS: The brief mental health screen provides a tool that could be used in an emergency department setting and predicted those IPV victims with moderate to severe mental health symptoms. Using this tool can assist emergency physicians in recognizing at-risk patients and referring these IPV victims to mental health services.
