04Jun 2018

AN EPIDEMIOLOGICAL ASSESSMENT OF CHILD INJURIES IN ZAGAZIG UNIVERSITY HOSPITALS; PATTERNS AND MANAGEMENT MODALITIES.

  • Department of General Surgery, Faculty of medicine, Zagazig University, Zagazig, Egypt.
  • Public health and community medicine, Faculty of Medicine, Zagazig University.
Crossref Cited-by Linking logo
  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

Background: Trauma is the leading cause of death in childhood. Among children aged from 1 to 14 years, approximately 50% of mortality is related to trauma. Aim: to evaluate child injury in Zagazig University Hospitals in the light of agent-host-environment triangle. Objectives: To study the types and pattern of child injury received in the hospital, to study the outcome of child injury (death, temporary disability or permanent disability) and to formulate suggested preventive measures according to Haddon?s matrix. Patient and methods: This observational cross sectional study was conducted in Zagazig University Hospitals and included children who suffered injuries during the period from April 2013 to April 2015. A pre-designed format was used to collect data in the light of Haddon matrix. Results: School age children were the most commonly injured with the mean age of presentation 6.5 years. Boys to girls? ratio were 2.1: 1and abdominal injuries were the commonest. Mortality rate was (4.47%). Mechanical energy was the most common energy. Road traffic accident was the commonest vector. Roads were the most common site for child injury and more common among children living in low socioeconomic states. Conclusion: we conclude that majority of pediatric injuries are preventable and pediatric epidemiological trends differ from those in adults. Therefore, preventive strategies should be made in pediatric patients on the basis of these epidemiological trends.


  1. Amira H. Waly, Ismail M. Tantawy and Khalid S. Shreef. Agent?host?environment model of blunt abdominal trauma in children: 5-year experience and preventive inferences in Zagazig University-Egypt. Annals of Pediatric Surgery 2011, 7:61?65.
  2. Bener A, Al-Salman KM, Pugh RN. Injury mortality and morbidity among children in the United Arab Emirates. Eur J Epidemiol. 1998;14:175?8. [PubMed]
  3. Blackwell TH, Kaufman JS. Response time effectiveness: comparison of response time and survival in an urban EMS system. Acad Emerg Med 2002; 9:288-295.
  4. Christoffel, T. & Gallagher, S. S. (2006). Injury Prevention and Public Health Practical Knowledge, Skills and Strategies. 2nd ED. Jones and Bartlett Publishers.
  5. Clarke JR, Trooskin SZ, Doshi PJ, et al. Time to laparotomy for intra-abdominal bleeding from trauma does affect survival for delays up to 90 minutes. J Trauma 2002; 52:420-425.
  6. Cooper A, Jerry D, George W, Holcomb III . et al., (2014). Ashcraf,s pediatric surgery. Chapter 14:early assessment and management of trauma, p:117.
  7. Crandall M, Chiu B, Sheehan K (2006) Injury in the first year of life: risk factors and solutions for high-risk families. J Surg Res 133: 7?10.
  8. Damashek A, Williams NA, Sher K, Peterson L (2009) Relation of caregiver alcohol use to unintentional childhood injury. J Pediatr Psychol 34: 344?353.
  9. Dickinson E, Limmer D, O\'Keefe MF, Grant HD, Murray R (2008). Emergency Care (11th Edition). Englewood Cliffs, New Jersey: Prentice Hall. pp. 848?52.
  10. Dickinson E, Limmer D, O\'Keefe MF, Grant HD, Murray R (2008). Emergency Care (11th Edition). Englewood Cliffs, New Jersey: Prentice Hall. pp. 848?52.
  11. Ehrlich PF, Drongowski A, Swisher-McClure S, et al. (2008) the importance of a preclinical trial: a selected injury intervention program for pediatric trauma centers. J Trauma; 65:189-95.
  12. Ehrlich PF, Maio RF, Drongowski RS, Wagaman M, Cunningham R,Walton M. (2009) Alcohol interventions for trauma patients are not just for adults: justification for brief interventions for the injured adolescent at a pediatric trauma center. J Trauma; [in press].
  13. Fahmy SI, El Sherbini AF. Determining simple parameters for social classification for health research. Bull High Inst Public Health 1983; 235:1-14.
  14. Fathy H. Injury statistics and control program in Egypt. Faculty of medicine, Suez Canal University, Egypt; 2005.
  15. Frederick B and Rogers, MD, MS, FACS. The Journal of Lancaster General Hospital. Spring 2014.Vol. 9.
  16. Grossman DC, Kim A, MacDonald SC, et al. Urban-rural differences in pre-hospital care of major trauma. J Trauma 1997; 42:723-729.
  17. Guyer B., and Gallagher S.S. An approach to the epidemiology of childhood injuries. Pediatric Clin. N. Am., 32 (5): 5 ? 15, 1985.
  18. Haddon W. (1980) Advances in the epidemiology of injuries as a basis for public policy. Public Health Rep; 95:411?21.
  19. Haynes R, Reading R, Gale S (2003) Household and neighborhood risks for injury to 5-14 year old children. Social Science and Medicine 57: 625?636.
  20. Holland A (2005) J:Paediatric Trauma:J Pediatr Child Health:;41(12);623-4 (ISSN:1034-4810).
  21. Kendrick D, Marsh P (2001). How useful are socio-demographic characteristics in identifying children at risk of unintentional injury? Public Health 115: 103?107.
  22. Kendrick D, Mulvaney C, Burton P, Watson M (2005) Relationships between child, family and neighborhood characteristics and childhood injury: a cohort study. Soc Sci Med 61: 1905?1915.
  23. Kleber C, Lefering R, Kleber A, et al. Rescue time and survival of severely injured patients in Germany. Unfallchirurg 2013; 116(4):345-350.
  24. Kraus J, Peek Asa C, Vimalachandra D. Injury control: the public health approach. In: Wallace R, editor. Public health and preventive medicine. 14th ed. Stamford, CT: Appleton & Lange; 1998. pp. 1209?1222.
  25. J. Paulozzi and R. Patel, R, ?Trends in motorcycle fatalities associated with alcohol-impaired driving?United States?1983, 2003,? Morbidity and Mortality Weekly Report, 53(47), 1103-1106, 2004.
  26. Lalloo R, Sheiham A (2003) Risk factors for childhood major and minor head and other injuries in a nationally representative sample. Injury 34: 261?266.
  27. Laursen B, Nielsen JW (2008) Influence of socio-demographic factors on the risk of unintentional childhood home injuries. Eur J Public Health 18: 366?370.
  28. Laursen B, Nielsen JW (2008) Influence of sociodemographic factors on the risk of unintentional childhood home injuries. Eur J Public Health 18: 366?370.
  29. Little, Wendalyn K. (1 March 2010). \"Golden Hour or Golden Opportunity: Early Management of Pediatric Trauma\". Clinical Pediatric Emergency Medicine 11 (1): 4?9. doi: 1016/j.cpem.2009.12.005.
  30. Mukesh Sharma, K. Lahoti, Gaurav Khandelwal, R. K. Mathur, S. S. Sharma, and Ashok Laddha. J Indian Assoc Pediatr Surg. 2011 Jul-Sep;16(3):88?92.doi:? 10.4103/0971-9261.83484 PMCID: PMC3160060.
  31. O?Connor TG, Davies L, Dunn J, Golding J (2000) Distribution of accidents, injuries, and illnesses by family type. ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood. Pediatrics 106: E68.
  32. Peden M, Hyder AA. Conclusions and recommendations. In: Peden M, Oyegbite K, Ozanne Smith J, Hyder AA, Branche C, Rahman AF, et al. editors. World report on child injury prevention. World Health Organization (WHO); 2008. p.72.
  33. Petersburgo DD, Keyes CE, Wright DW, Click LA, Macleod JBA, Sasser SM. The epidemiology of childhood injury in Maputo, Mozambique. Int J Emerg Med. 2010;3:157?63.
  34. Pons PT, Haukoos JS, Bludworth W, et al. Paramedic response time: does it affect patient survival? Acad Emerg Med 2005;12:594-600.
  35. Runyan CW. Using the Haddon Matrix: introducing the third dimension, (1998) Inj Prev; 4:302?7.
  36. Schwebel DC, Brezausek CM (2008) chronic maternal depression and children?s injury risk. J Pediatric Psychol 33: 1108?1116.
  37. Schwebel DC, Brezausek CM (2008) Chronic maternal depression and children?s injury risk. J Pediatr Psychol 33: 1108?1116.
  38. Singhi S, Gupta G, Jain V. Comparison of childhood emergency patients in a tertiary care hospital vs a community hospital. Indian Pediatr. 2004; 41:67?72. [PubMed]
  39. Stiell IG, Nesbitt LP, Pickett W, et al. The OPALS major trauma outcome study: impact of advanced life-support on survival and morbidity. CMAJ 2008;178:1141-1152
  40. Thompson MJ, Rivara FP. Bicycle-related injuries. Am Fam Physician.2001; 63:2007?2014.
  41. Tien HCN, Jung V, Pinto R, et al. Reducing time to treatment decreases mortality of trauma patients with acute subdural hematoma.Ann-Surg2011;253:1178-1183.
  42. Winqvist S, Jokelainen J, Luukinen H, Hillbom M (2007) Parental alcohol misuse is a powerful predictor for the risk of traumatic brain injury in childhood. Brain Inj 21: 1079?1085.

[Omar Atef Elekiabi, Walid A. Mawla, Ibtsam Shehta Harera, Tamer Mohamed El shahidy, Mohamed Farouk Amin and Samar A. Amer. (2018); AN EPIDEMIOLOGICAL ASSESSMENT OF CHILD INJURIES IN ZAGAZIG UNIVERSITY HOSPITALS; PATTERNS AND MANAGEMENT MODALITIES. Int. J. of Adv. Res. 6 (6). 111-120] (ISSN 2320-5407). www.journalijar.com


Walid A. Mawla
Lecturer of General Surgery, Faculty of medicine, Zagazig University, Zagazig, Egypt

DOI:


Article DOI: 10.21474/IJAR01/7193       DOI URL: http://dx.doi.org/10.21474/IJAR01/7193


Share this article