坎帕拉市儿童意外伤害模式、发生率及后果：对国家儿科急诊科监测数据的分析
Unintentional childhood injury patterns, odds, and outcomes in Kampala City: an analysis of surveillance data from the National Pediatric Emergency Unit.
作者信息
Mutto Milton, Lawoko Stephen, Nansamba Catherine, Ovuga Emilio, Svanstrom Leif
机构信息
Pincer Group International Ltd, Karolinska Institutet, Department of Public Health Sciences, Social Medicine, Sweden.
出版信息
J Inj Violence Res. 2011 Jan;3(1):13-8. doi: 10.5249/jivr.v3i1.56.
BACKGROUND
Unintentional Childhood Injuries pose a major public health challenge in Africa and Uganda. Previous estimates of the problem may have underestimated the childhood problem. We set to determine unintentional childhood injury pattern, odds, and outcomes at the National Paediatric Emergency unit in Kampala city using surveillance data.
METHODS
Incident proportions, odds and proportional rates were calculated and used to determine unintentional injury patterns across childhood (1-12 years).
RESULTS
A total of 556 cases recorded between January and May 2008 were analyzed: majority had been transported to hospital by mothers using mini-buses, private cars, and motorcycles. Median distance from injury location to hospital was 5 km. Homes, roads, and schools were leading injury locations. Males constituted 60% of the cases. Play and daily living activities were commonest injury time activities. Falls, burns and traffic accounted for 70.5% of unintentional childhood injuries. Burns, open wounds, fractures were commonest injury types. Motorcycles, buses and passenger-cars caused most crashes. Play grounds, furniture, stairs and trees were commonest source of falls. Most burn injuries were caused by liquids, fires and hot objects. 43.8% of cases were admitted. 30% were discharged without disability; 10%, were disabled; 1%, died. Injury odds and proportional incidence rates varied with age, place and cause. Poisoning and drowning were rare. Local pediatric injury priorities should include home, road and school safety.
CONCLUSIONS
Unintentional injuries are common causes of hospital visit by children under 13 years especially boys. Homes, roads and educational facilities are commonest unintentional injury sites. Significant age and gender differences exist in intentional injury causation, characteristics and outcomes. In its current form, our surveillance system seems inefficient in capturing poisoning and drowning. The local prevention priorities could include home, road and school safety; especially dissemination and uptake of proven interventions. Burns should be focus of domestic injury prevention among under-fives. Commercial passenger motorcycles require better regulation and control.
背景
儿童意外伤害是非洲及乌干达面临的一项重大公共卫生挑战。此前对该问题的估计可能低估了儿童意外伤害问题。我们利用监测数据，在坎帕拉市的国家儿科急诊科确定儿童意外伤害模式、几率及后果。
方法
计算事件比例、几率和比例率，以确定1至12岁儿童的意外伤害模式。
结果
对2008年1月至5月期间记录的556例病例进行了分析：大多数患儿由母亲乘坐小型巴士、私家车和摩托车送往医院。受伤地点到医院的中位距离为5公里。家庭、道路和学校是主要的受伤地点。男性占病例的60%。玩耍和日常生活活动是最常见的受伤时段活动。跌倒、烧伤和交通事故占儿童意外伤害的70.5%。烧伤、开放性伤口、骨折是最常见的损伤类型。摩托车、公共汽车和乘用车引发的碰撞事故最多。操场、家具、楼梯和树木是最常见的跌倒源头。大多数烧伤是由液体、火灾和热物体造成的。43.8%的病例入院治疗。30%治愈出院无残疾；10%有残疾；1%死亡。伤害几率和比例发病率随年龄、地点和原因而变化。中毒和溺水很少见。当地儿科伤害预防重点应包括家庭、道路和学校安全。
结论
意外伤害是13岁以下儿童尤其是男孩就医的常见原因。家庭、道路和教育设施是最常见的意外伤害场所。在意外伤害的成因、特征和后果方面存在显著的年龄和性别差异。以目前的形式，我们的监测系统在捕捉中毒和溺水方面似乎效率低下。当地的预防重点可包括家庭、道路和学校安全；特别是推广和采用经证实的干预措施。烧伤应成为五岁以下儿童家庭伤害预防的重点。商业客运摩托车需要更好的监管和控制。
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