[Epidemiology of home accidents in childhood: experience in the Division of General Pediatrics in Southern Tunisia]

Foreign body ingestion in children: Clinical features and complications

INTRODUCTION

The ingestion of foreign body (FB) is a common problem in paediatrics. Children are curious by nature and tend to explore environment by inserting objects into their mouths.

AIM

To update our epidemiological and clinical data and adapt clinical management in order to limit morbidity associated with this fairly frequent accidental pathology.

METHODS

Retrospective descriptive study including children aged less than 15 years, hospitalized in the Children's Medicine Department B of the Tunis Children's Hospital from 1 January 2016 to 31 December 2021 having ingested a FB.

RESULTS

Forty-four children were included and admitted for foreign body ingestion, with a sex ratio of 1.4. The mean age was 4 years 4 months. Most children were asymptomatic on admission. In the others, digestive forms predominated (n=19). The average consultation time was 10.8 hours. The FBs were mainly foams and corrosives (75%), represented by batteries in 52% of cases and coins in 22% of cases. Thoraco-abdominal X-rays carried out on all patients revealed a radio-opaque foreign body in 95% of cases. The most frequent location was the colon (n=17). Endoscopy was chosen in 14 patients and was extractive in five. The mean time from admission to endoscopic extraction was 10.6 hours. The mean time to expulsion by natural route was 49 hours. Complications were noted in two patients: ulceration of the oesophageal mucosa and dyspnoea following rigid endoscopy in one case.

CONCLUSION

This study has shown that the ingestion of foreign body in children is a frequent and potentially serious accident.

Patterns of Unnatural Deaths Among Children and Adolescents: Autopsy Study (2011-2018)

BACKGROUND AND AIMS

The problem of unnatural death in children is still relevant because of their vulnerability. This work aimed to describe the epidemiological profile and patterns of these medicolegal deaths in children and adolescents in northern Tunisia.

METHODS

We conducted a retrospective study from January 2011 to December 2018, within the Forensic Department of Charles Nicolle Hospital in Tunis. All children who died of unnatural causes were included (767 cases).

RESULTS

An overall male predominance was observed (sex ratio = 2.4). Accidental deaths represent the most common manner of death (81.4%) involving most frequently domestic accidents occurring in children aged between 1 and 4 years. In cases of suicide, the highest risk profile was a female child aged between 15 and 18 years. The suicide occurred most often in the victim's home with hanging representing the common means of suicide. For the criminal form, the most common means in those cases were stabbing and blunt injuries.

CONCLUSION

Our study delivered a broad picture of unnatural deaths among children in Tunisia. These deaths, largely absent from child survival initiatives presently on the global agenda, can be prevented if they are addressed strategically, as their injury prevention strategies differ from adults.

Investigation of the Effect of Education Based on the Theory of Planned Behavior on the Mothers’ Preventive Practices Regarding Toddler Home Injuries

Home injuries are among the causes of death and disability in toddlers. Preventing home injuries is an essential part of the child health care program. Using education-based models interventions can promote mothers’ practices regarding home injuries. This study aimed to investigate the effect of education based on the theory of planned behavior (TPB) on the mothers’ preventive practices regarding toddler home injuries. A quasi-experimental study was conducted on 116 mothers referred to comprehensive health centers (58 mothers in each experimental and control group), who were selected using the cluster sampling method. Data were collected using a researcher-developed TPB questionnaire, which was validated by I-CVI (≥0.78), and CVR (≥0.79). Its reliability also confirmed by Cronbach’s alpha coefficients (.52-.93). Afterward, educational intervention was implemented in the experimental group based on TPB in four 45 to 60 minute sessions. After 2 months, the data were recollected from the two groups and analyzed using SPSS software version 16. Comparing the scores of TPB constructs (i.e., perceived behavioral control, behavioral intention, and subjective norms), and mothers’ preventive practices regarding toddler home injuries revealed no statistically significant difference between the 2 groups pre-intervention. However, after the intervention, significant differences were observed between the 2 groups in terms of awareness, the TPB constructs (except for subjective norms), and preventive practices of the mothers ( p < .001). Mothers’ preventive practices regarding toddler home injuries were improved after applying TPB; hence, it is suggested a larger study be completed to confirm the results of this theory-based education.

Parental perception of medications safe storage in the State of Qatar

PURPOSE

The purpose of this study is to identify parental perception of household medication storage.

METHODS

A prospective cross-sectional study utilizing a questionnaire was carried out at Hamad Medical Corporation, the solely tertiary pediatric hospital in the State of Qatar at the time of the study. Qatar is a young developing country with limited data on the awareness of medication storage among adults with children at home and on the safety practices regarding medication storage.

RESULTS

Three hundred and five questionnaires were completed. The vast majority of parents were married, one-third of them were males, and more than three quarters were college graduates and younger than 40 years of age. Almost 80% of the parents had more than three children but less than seven. In addition, 23% of participants were health-care workers. Almost 90% of the participants stored medications in a place that is easy to reach. However, the same percentage stated that those medications were stored in a locked place and that children did not have access to them. Approximately 10% of caregivers store multiple medications in one bottle, and the same percentage of participants do not check the expiration date on the medication labels. In terms of the most common medications stored at home, antihypertensives were on top of the list. Our study has shown that parental education and being a health-care worker were each associated with the difficulty in reaching medications (P = 0.006 and P = 0.011, respectively). Moreover, the percentage of participants who shared medications was significantly higher among those who were not working in the health-care section compared to those who were (P = 0.004). In addition, being a female parent and a college graduate was associated with the possibility of keeping excess or leftover medications at home (P = 0.025).

CONCLUSION

Parents residing in the State of Qatar have some deficiencies in knowledge about medication storage. Parent's attitudes and perceptions are deemed vital objectives for population's health intervention.