Unintentional injuries among children in resource poor settings: where do the fingers point?

Every year, over 875,000 children between 0 and 18 years of age die as a result of unintentional injuries (UIs), with a higher proportion occurring in low- and middle-income countries (LMICs): the WHO 2008 World Report on Child Injury Prevention shows a child UI death rate 3.4 times greater in LMICs than in high income countries (HICs) (41.7 per million vs 12.2 per million, respectively). Deaths due to injuries from drowning, burns and falls are significantly higher among LMICs at 7.8, 4.3 and 2.1 per million, respectively, as compared to HICs with 1.2, 0.4 and 0.4 per million, respectively. The authors present a review of childhood UIs in LMICs undertaken to determine demographic and socioeconomic risk factors. As in industrialised settings, age, gender and social deprivation are significant factors in determining UI-related vulnerability among children. However, certain patterns are unique to LMICs, including road traffic injuries among child pedestrians, drowning and accidental paraffin poisoning. These demand contextual understanding and the implementation of appropriate injury control measures, which are currently inadequate.