Tercero F, Andersson R, Peña R, Rocha J, Castro N
Department of Preventive Medicine, Health and Demography Research Centre, National Autonomous University of Nicaragua, León, Nicaragua.
Public Health. 2006 Feb;120(2):106-14. doi: 10.1016/j.puhe.2005.07.005. Epub 2005 Nov 2.
Although injuries constitute a major public health problem worldwide, the magnitude and nature of this problem is difficult to establish in low-income settings due to the lack of valid and representative data. In Nicaragua, several parallel studies have been carried out attempting to assess levels and patterns of injury using various sources of information. The objective of this study was to describe the magnitude and profile of moderate and severe injuries in a well-defined community in Nicaragua. The study was conducted using a household-based survey design. Randomized cluster sampling provided information from 10,797 households (63,886 inhabitants). The outcomes included fatal and non-fatal injuries registered during a recall period of 6 weeks. Seven percent of all injuries were classified as moderate or severe. The estimated annual incidence rate of moderate/severe injuries was 27.6 per 1000 [95% confidence intervals (CI): 26.4-29.2], while the mortality and impairment rates were 108.9 (95% CI: 83.5-134.4) and 95.3 (95% CI: 71.4-119.2) per 100,000 inhabitants, respectively. Home and traffic areas were the main environments associated with injury occurrence. The most affected groups were the elderly, children and males. No differences were found between urban and rural areas. Only 9% of all cases, including minor injuries, sought hospital treatment. The main causes of non-fatal injuries were falls, traffic and cuts, whereas fatalities were largely associated with intentional injuries. For every death due to injury, there was one permanent disability, 25 moderate/severe injuries and 354 minor injuries. This study provides a broad description of injury magnitudes and patterns in a defined Nicaraguan community, and demonstrates the aggregate injury pyramid of the same community. It also identifies the issue of severity and concludes with a recommendation to apply different criteria of severity. Our results support the call for a careful evaluation of injury data sources and severity scores when planning injury prevention programmes.
尽管伤害是全球范围内一个重大的公共卫生问题，但由于缺乏有效且具代表性的数据，在低收入地区很难确定该问题的严重程度和性质。在尼加拉瓜，已经开展了多项平行研究，试图利用各种信息来源评估伤害的程度和模式。本研究的目的是描述尼加拉瓜一个明确界定的社区中中度和重度伤害的严重程度和概况。该研究采用基于家庭的调查设计。随机整群抽样提供了来自10797户家庭（63886名居民）的信息。结果包括在6周回忆期内登记的致命和非致命伤害。所有伤害中有7%被归类为中度或重度。中度/重度伤害的估计年发病率为每1000人27.6例[95%置信区间（CI）：26.4 - 29.2]，而死亡率和致残率分别为每10万居民108.9例（95% CI：83.5 - 134.4）和95.3例（95% CI：71.4 - 119.2）。家庭和交通区域是与伤害发生相关的主要环境。受影响最大的群体是老年人、儿童和男性。城乡之间未发现差异。所有病例（包括轻伤）中只有9%寻求医院治疗。非致命伤害的主要原因是跌倒、交通伤和割伤，而死亡主要与故意伤害有关。每有一例因伤害导致的死亡，就有一例永久性残疾、25例中度/重度伤害和354例轻伤。本研究对尼加拉瓜一个特定社区的伤害严重程度和模式进行了广泛描述，并展示了该社区的总体伤害金字塔。它还确定了严重程度问题，并以应用不同严重程度标准的建议作为结论。我们的结果支持在规划伤害预防计划时仔细评估伤害数据来源和严重程度评分的呼吁。
