Center for Global Surgical Studies, Department of Surgery, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, San Francisco, USA.
Ministry of Public Health, Yaoundé, Cameroon.
Eur J Trauma Emerg Surg. 2020 Dec;46(6):1403-1412. doi: 10.1007/s00068-019-01104-6. Epub 2019 Apr 11.
Unintentional injury is the leading cause of death among children aged 10-19 years and over 95% of injury deaths occur in low- and middle-income countries (LMICs). As patterns of injury in the pediatric population may differ from those in adults, risks specific to children in LMICs need to be identified for effective injury prevention and treatment. This study explores patterns of pediatric injury epidemiology and cost in Yaoundé, Cameroon to inform injury prevention and resource allocation.
Pediatric (age < 20 years) trauma patient data were collected at the emergency department (ED) of Central Hospital of Yaoundé (CHY) from April through October 2009. Univariate, bivariate, and multivariate analyses were used to explore injury patterns and relationships between variables. Regression analyses were conducted to identify predictors of receiving surgical care.
Children comprised 19% (544) of trauma cases. About 54% suffered road traffic injuries (RTIs), which mostly affected the limbs and pelvis (37.3%). Half the RTI victims were pedestrians. Transportation to CHY was primarily by taxi or bus (69.4%) and a preponderance (71.1%) of the severely and profoundly injured patients used this method of transport. Major or minor surgical intervention was necessary for 17.9% and 20.8% of patients, respectively. Patients with an estimated injury severity score ≥ 9 (33.2%) were more likely to need surgery (p < 0.01). The median ED cost of pediatric trauma care was USD12.71 [IQR 12.71, 23.30].
Injury is an important child health problem that requires adequate attention and funding. Policies, surgical capacity building, and health systems strengthening efforts are necessary to address the high burden of pediatric injuries in Cameroon. Pediatric injury prevention efforts in Cameroon should target pedestrian RTIs, falls, and burns and consider school-based interventions.
意外伤害是 10-19 岁儿童死亡的主要原因，超过 95%的伤害死亡发生在中低收入国家（LMICs）。由于儿科人群的伤害模式可能与成年人不同，因此需要确定 LMIC 中儿童特有的风险，以进行有效的伤害预防和治疗。本研究旨在探讨喀麦隆雅温得儿科伤害的流行病学和成本情况，以为伤害预防和资源配置提供信息。
2009 年 4 月至 10 月，在雅温得中央医院（CHY）急诊科收集儿科（年龄<20 岁）创伤患者数据。使用单变量、双变量和多变量分析来探讨伤害模式以及变量之间的关系。进行回归分析以确定接受手术治疗的预测因素。
儿童占创伤病例的 19%（544 例）。约 54%的儿童遭受道路交通伤害（RTIs），主要影响四肢和骨盆（37.3%）。一半的 RTI 受害者是行人。到 CHY 的交通主要是出租车或公共汽车（69.4%），严重和深度受伤患者中有 71.1%使用这种交通方式。分别有 17.9%和 20.8%的患者需要进行主要或次要手术干预。损伤严重度评分估计≥9（33.2%）的患者更有可能需要手术（p<0.01）。儿科创伤护理的 ED 平均费用为 12.71 美元[IQR 12.71，23.30]。
伤害是一个重要的儿童健康问题，需要给予足够的关注和资金。需要制定政策、进行外科能力建设和加强卫生系统，以解决喀麦隆儿童伤害负担过重的问题。喀麦隆的儿科伤害预防工作应针对行人 RTI、跌倒和烧伤，并考虑开展学校干预措施。
