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Al-Hajj S, El Haj R, Chaaya M, Sharara-Chami R, Mehmood A. Child injuries in Lebanon: assessing mothers' injury prevention knowledge attitude and practices. Inj Epidemiol 2023; 10:27. [PMID: 37340480 DOI: 10.1186/s40621-023-00434-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 04/27/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Childhood injury is a neglected public health problem with a sizeable burden on children's well-being and their families. This study aims to describe the pattern and types of childhood injuries and to determine the level of mothers' Knowledge, Attitude, and Practices (KAP) towards childhood injury prevention in Lebanon. The study further examines the association between childhood injury occurrence and mothers' supervision. METHODS This cross-sectional study recruited mothers of children aged up to 10 years from multiple sites (i.e., a medical center, a private clinic, a healthcare facility, and a refugee camp clinic). Data were collected on mothers' KAP toward childhood injuries using self-administrated questionnaires. A summation score for KAP correct answers was calculated and descriptive and statistical analyses were performed to measure the association between the outcomes. RESULTS A total of 264 mothers were surveyed and injury data were collected on their 464 children. The prevalence of childhood injury was 20% in the past 12 months, mostly sustained by males (53.8%) and children aged 5-10 years (38.7%). The most common type of injury was fall (48.4%), followed by burns (%7.5), and sports injuries (7.5%). Hospitalized children were more likely to be males and older than 5 years (p < 0.001). More than one-third of the mothers demonstrated poor knowledge, while the majority showed poor practice (54.4%), and fair attitude (45.6%) towards child injury prevention. Children of working mothers have three times higher odds of sustaining injuries (OR: 2.95, 95% CI: 1.60;5.47) compared to those of non-working mothers, accounting for possible confounders (p = 0.001). CONCLUSION Childhood injuries represent a major health problem in Lebanon. Findings from this study showed that mothers are less knowledgeable and unprepared to prevent their children from getting injured. Educational programs are much needed to address the gap in the mothers' KAP toward child injury prevention. Further studies are recommended to understand the cultural context and examine its key determinants to identify effective strategies and develop tailored interventions for preventing childhood injuries.
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Affiliation(s)
- Samar Al-Hajj
- Epidemiology and Population Health Department, Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon.
| | - Rawan El Haj
- Epidemiology and Population Health Department, Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
| | - Monique Chaaya
- Epidemiology and Population Health Department, Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
| | | | - Amber Mehmood
- College of Public Health, University of South Florida, Tampa, FL, USA
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Lee MC, Tseng WC, Hsu LM, Shin SD, Jamaluddin SF, Tanaka H, Son DN, Hong KJ, Riyapan S, Haedar A, Lin HY, Huang EPC, Hsieh MJ, Ma MHM, Sun JT, Chiang WC. Epidemiology and Prehospital Care of Pediatric Unintentional Injuries Among Countries with Different Economic Status in Asia: A Cross-National, Multi-Center Observational Study. PREHOSP EMERG CARE 2023; 27:227-237. [PMID: 35380921 DOI: 10.1080/10903127.2022.2062804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Injury is a major cause of morbidity and mortality in children. However, the epidemiology and prehospital care for pediatric unintentional injuries in Asia are still unclear. METHODS A total of 9,737 pediatric patients aged <18 years with unintentional injuries cared for at participating centers of the Pan-Asian Trauma Outcome Study (PATOS) from October 2015 to December 2020 were reviewed retrospectively. Patients were divided into two groups: those <8 and those ≥8 years of age. Variables such as patient demographics, injury epidemiology, Injury Severity Score (ISS), and prehospital care were collected. Injury severity and administered prehospital care stratified by gross national income were also analyzed. RESULTS Pediatric unintentional injuries accounted for 9.4% of EMS-transported trauma cases in the participating Asian centers, and the mortality rate was 0.88%. The leading cause of injury was traffic injuries in older children aged ≥8 years (56.5%), while falls at home were common among young children aged <8 years (43.9%). Compared with younger children, older children with similar ISS tended to receive more prehospital interventions. Uneven disease severity was found in that older children in lower-middle and upper-middle-income countries had higher ISS compared with those in high-income countries. The performance of prehospital interventions also differed among countries with different gross national incomes. Immobilizations were the most performed prehospital intervention followed by oxygen administration, airway management, and pain control; only one patient received prehospital thoracentesis. Procedures were performed more frequently in high-income countries than in upper-middle-income and lower-middle-income countries. CONCLUSIONS The major cause of injury was road traffic injuries in older children, while falls at home were common among young children. Prehospital care in pediatric unintentional injuries in Asian countries was not standardized and might be insufficient, and the economic status of countries may affect the implementation of prehospital care.
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Affiliation(s)
- Meng-Chang Lee
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Chieh Tseng
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Li-Min Hsu
- Department of Traumatology and Critical Care, National Taiwan University Hospital, Taipei City, Taiwan
| | - Sang Do Shin
- Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | | | - Hideharu Tanaka
- Graduate School of Emergency Medical Service System, Kokushikan University, Tokyo, Japan
| | - Do Ngoc Son
- Center for Critical Care Medicine, Bach Mai Hospital, Hanoi, Vietnam.,Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Vietnam.,Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Ki Jeong Hong
- Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, Seoul, South Korea
| | - Sattha Riyapan
- Department of Emergency Medicine, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand
| | - Ali Haedar
- Department of Emergency Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Hao-Yang Lin
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Edward Pei-Chuan Huang
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Department of Emergency Medicine, National Taiwan University Hospital, Hsin-Chu city, Taiwan
| | - Ming-Ju Hsieh
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Matthew Huei-Ming Ma
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Department of Emergency Medicine, National Taiwan University Hospital, Douliu City, Taiwan
| | - Jen-Tang Sun
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Wen-Chu Chiang
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Department of Emergency Medicine, National Taiwan University Hospital, Douliu City, Taiwan
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Gettig K, Maxson RT. International needs in pediatric trauma. Semin Pediatr Surg 2022; 31:151223. [PMID: 36379159 DOI: 10.1016/j.sempedsurg.2022.151223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Kelly Gettig
- Lead Pediatric Nurse Practitioner, Physical Medicine and Rehabilitation; Director, Traumatic Brain Injury/Concussion Clinic Dell Children's Medical Center, Austin, TX, United States.
| | - R Todd Maxson
- Pediatric Surgery - UAMS Surgeon-in-Chief Rachel Fuller Endowed Chair Associate Trauma Medical Director Arkansas Children's Hospital, United States
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Adane MM, Admasie A, Shibabaw T. Prevalence and risk factors of cooking-related burn injury among under-five-years old children in a resource-limited setting: a community-based cross-sectional study in Northwest Ethiopia. Int J Inj Contr Saf Promot 2022; 30:220-231. [PMID: 36137170 DOI: 10.1080/17457300.2022.2125534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Cooking-related child burn injury causes a greater health burden in low-and-middle-income countries. Therefore, a community-based cross-sectional study was conducted among 5830 under-five-years old children in a resource-limited community in Northwest Ethiopia to determine the prevalence and risk factors of this child health problem. Data were collected by trained nurses using a questionnaire and the logistic regression analysis method was applied to identify factors linked with burn injury. Injury prevalence was 6.2% (95% CI:5.5-6.8); and this burden was linked with several risk factors such as lower literacy status of caretakers [AOR = 2.21 (95% CI:1.05-4.67)], overcrowding [AOR = 2.35(95% CI:1.25-4.43], lack of separate kitchen [AOR =2.19 (95% CI:1.56-3.07)], using traditional cookstove [AOR = 2.04 (95% CI:1.23-3.36)], and lack of child supervision [AOR = 2.27 (95% CI:1.63-3.17)]. In conclusion, children experience a high burden of burn injury. Thus, stakeholders should work to reduce child burn injury by modifying the aforementioned risk factors.
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Affiliation(s)
- Mesafint Molla Adane
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Amha Admasie
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tebkew Shibabaw
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Tupetz A, Friedman K, Zhao D, Liao H, Isenburg MV, Keating EM, Vissoci JRN, Staton CA. Prevention of childhood unintentional injuries in low- and middle-income countries: A systematic review. PLoS One 2020; 15:e0243464. [PMID: 33373371 PMCID: PMC7771986 DOI: 10.1371/journal.pone.0243464] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 11/21/2020] [Indexed: 11/29/2022] Open
Abstract
Injuries are a leading cause of death and disability among children. Numerous injury prevention strategies have been successful in high-income countries, but the majority of unintentional injuries happen to children living in low- and middle-income countries (LMICs). This project aims to delineate the childhood injury prevention initiatives in LMICs. For inclusion, peer-reviewed articles needed to address unintentional injury, include children <18, assess a prevention-related intervention, contain a control group, and be published after 1988. Two pairs of reviewers evaluated articles independently to determine study eligibility. 74 articles were included. 30 studies addressed road traffic injuries, 11 drowning, 8 burns, 3 falls, 8 poisonings, and 21 an unspecified injury type. The findings show positive effects on injury outcome measures following educational interventions, the need for longer follow-up periods after the intervention, the need for effectiveness trials for behavior change, and the need for an increase in injury prevention services in LMICs. This is the first systematic review to summarize the prevention initiatives for all types of childhood unintentional injuries in LMICs. Increased attention and funding are required to go beyond educational initiatives with self-reported measures and little follow-up time to robust interventions that will reduce the global burden of unintentional injuries among children.
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Affiliation(s)
- Anna Tupetz
- Duke Global Health Institute, Durham, North Carolina, United States of America
- Department of Emergency Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Kaitlyn Friedman
- Duke Global Health Institute, Durham, North Carolina, United States of America
| | - Duan Zhao
- Duke Kunshan University, Kunshan, Suzhou, Jiangsu, China
| | - Huipeng Liao
- Duke Global Health Institute, Durham, North Carolina, United States of America
| | - Megan Von Isenburg
- Duke Global Health Institute, Durham, North Carolina, United States of America
| | - Elizabeth M. Keating
- Division of Pediatric Emergency Medicine, Division of Public Health, University of Utah, Salt Lake City, Utah, United States of America
| | - Joao Ricardo Nickenig Vissoci
- Duke Global Health Institute, Durham, North Carolina, United States of America
- Department of Emergency Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Catherine A. Staton
- Duke Global Health Institute, Durham, North Carolina, United States of America
- Department of Emergency Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
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Peachey KL, Lower T, Rolfe M. Protecting the future: Fatal incidents on Australian farms involving children (2001-2019). Aust J Rural Health 2020; 28:385-393. [PMID: 32776384 DOI: 10.1111/ajr.12650] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/11/2020] [Accepted: 06/07/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To assess the demographic and causal factors, plus trends in rates of fatal farm incidents involving children (<15 years) in Australia over the 2001-2019 period. DESIGN A descriptive retrospective epidemiological study of the National Coronial Information System. SETTING Australia. PARTICIPANTS Cases involving children (<15 years), where incidents have occurred on a farm (1 January 2001-31 December 2019). RESULTS There has been essentially no change in the fatality rate for farm-related child injury deaths across Australia in the 2001-2019 period (-0.009/year). Men and children aged 0-4 years were significantly more likely to be involved in these incidents. Most cases were recreational in nature (81%), with seven agents (water bodies, quads [all-terrain vehicles], tractors, utes, cars, motorbikes and horses), accounting for 75% of cases. Water bodies were responsible for over 31% of deaths. CONCLUSION The lack of progress addressing child farm injury mortality requires urgent attention. The overall rates and pattern of injury-related deaths have stagnated, necessitating new and innovative approaches to address the issue. The emerging National Injury Prevention Plan might provide scope to improve the focus on and implementation of evidence-based approaches.
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Affiliation(s)
| | - Tony Lower
- AgHealth Australia, University of Sydney, Dubbo, NSW, Australia
| | - Margaret Rolfe
- University Centre for Rural Health, University of Sydney, Lismore, NSW, Australia
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Nevriana A, Pierce M, Dalman C, Wicks S, Hasselberg M, Hope H, Abel KM, Kosidou K. Association between maternal and paternal mental illness and risk of injuries in children and adolescents: nationwide register based cohort study in Sweden. BMJ 2020; 369:m853. [PMID: 32269017 PMCID: PMC7190076 DOI: 10.1136/bmj.m853] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To determine the association between parental mental illness and the risk of injuries among offspring. DESIGN Retrospective cohort study. SETTING Swedish population based registers. PARTICIPANTS 1 542 000 children born in 1996-2011 linked to 893 334 mothers and 873 935 fathers. EXPOSURES Maternal or paternal mental illness (non-affective psychosis, affective psychosis, alcohol or drug misuse, mood disorders, anxiety and stress related disorders, eating disorders, personality disorders) identified through linkage to inpatient or outpatient healthcare registers. MAIN OUTCOME MEASURES Risk of injuries (transport injury, fall, burn, drowning and suffocation, poisoning, violence) at ages 0-1, 2-5, 6-9, 10-12, and 13-17 years, comparing children of parents with mental illness and children of parents without mental illness, calculated as the rate difference and rate ratio adjusted for confounders. RESULTS Children with parental mental illness contributed to 201 670.5 person years of follow-up, while children without parental mental illness contributed to 2 434 161.5 person years. Children of parents with mental illness had higher rates of injuries than children of parents without mental illness (for any injury at age 0-1, these children had an additional 2088 injuries per 100 000 person years; number of injuries for children with and without parental mental illness was 10 235 and 72 723, respectively). At age 0-1, the rate differences ranged from 18 additional transport injuries to 1716 additional fall injuries per 100 000 person years among children with parental mental illness compared with children without parental mental illness. A higher adjusted rate ratio for injuries was observed from birth through adolescence and the risk was highest during the first year of life (adjusted rate ratio at age 0-1 for the overall association between any parental mental illness that has been recorded in the registers and injuries 1.30, 95% confidence interval 1.26 to 1.33). Adjusted rate ratios at age 0-1 ranged from 1.28 (1.24 to 1.32) for fall injuries to 3.54 (2.28 to 5.48) for violence related injuries. Common and serious maternal and paternal mental illness was associated with increased risk of injuries in children, and estimates were slightly higher for common mental disorders. CONCLUSIONS Parental mental illness is associated with increased risk of injuries among offspring, particularly during the first years of the child's life. Efforts to increase access to parental support for parents with mental illness, and to recognise and treat perinatal mental morbidity in parents in secondary care might prevent child injury.
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Affiliation(s)
- Alicia Nevriana
- Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Matthias Pierce
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health Sciences, University of Manchester, Manchester, UK
| | - Christina Dalman
- Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden
- Center for Epidemiology and Community Medicine, Stockholm Region, Stockholm, Sweden
| | - Susanne Wicks
- Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden
- Center for Epidemiology and Community Medicine, Stockholm Region, Stockholm, Sweden
| | - Marie Hasselberg
- Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Holly Hope
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health Sciences, University of Manchester, Manchester, UK
| | - Kathryn M Abel
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health Sciences, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Kyriaki Kosidou
- Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden
- Center for Epidemiology and Community Medicine, Stockholm Region, Stockholm, Sweden
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