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.
PLoS One. 2020 Dec 29;15(12):e0243464. doi: 10.1371/journal.pone.0243464. eCollection 2020.
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.
在儿童群体中，伤害是导致死亡和残疾的主要原因。众多预防伤害的策略在高收入国家取得了成功，但大多数意外受伤事件都发生在中低收入国家（LMICs）的儿童身上。本项目旨在明确中低收入国家的儿童伤害预防措施。纳入标准为：必须为同行评审文章，主题为非故意伤害，涵盖年龄<18 岁的儿童，评估预防相关干预措施，包含对照组，且发表时间在 1988 年之后。两位评审员独立评估文章以确定研究的资格。共有 74 篇文章被纳入。其中 30 项研究涉及道路交通伤害，11 项研究涉及溺水，8 项研究涉及烧伤，3 项研究涉及跌落，8 项研究涉及中毒，21 项研究涉及未明确的伤害类型。研究结果表明，在实施教育干预后，儿童伤害的结局指标出现积极变化；干预后需要更长的随访期；需要进行行为改变效果试验；需要增加中低收入国家的伤害预防服务。这是第一项总结中低收入国家所有类型儿童非故意伤害预防措施的系统评价。需要更多关注和资金投入，将预防措施从以自我报告措施和随访时间短为特点的教育干预，转向更有力的干预措施，以减轻全球儿童非故意伤害负担。
