Division of Pediatric Surgery, University of North Carolina at Chapel Hill, Houpt Physicians' Office Building, Campus Box 7223, 170 Manning Drive, Chapel Hill, NC, 27599-7223, USA.
Pediatr Surg Int. 2021 May;37(5):649-657. doi: 10.1007/s00383-020-04849-z. Epub 2021 Jan 18.
Intentional injuries pose a significant, yet underreported threat to children in sub-Saharan Africa. We sought to evaluate intentional injuries trends and compare outcomes between unintentional and intentional injuries in pediatric patients presenting to a tertiary care facility in Malawi.
We performed a review of pediatric (≤15 years old) trauma patients presenting to Kamuzu Central Hospital, Lilongwe, Malawi, from 2009 to 2018. Patient characteristics and outcomes were compared based on the injury intent, using bivariate and multivariate regression analysis.
We included 42,600 pediatric trauma patients in the study. Intentional injuries accounted for 5.9% of all injuries. Children with intentional injuries were older (median, 10 vs. 6 years, p < 0.001), more likely to be male (68.4% vs. 63.9%, p < 0.001), and had significantly lower mortality (0.8% vs. 1.4%, p = 0.02) than those with unintentional injuries There was no significant change in the incidence of or mortality associated with intentional injuries. On multivariable regression, increasing age, head and cervical spine injury, night-time presentation, penetrating injury, and alcohol use were associated with increased risk of intentional harm.
Intentional injury remains a significant cause of pediatric trauma in Malawi without decreasing hospital presentation incidence or mortality. In sub-Saharan Africa, there is a need to develop comprehensive plans and policies to protect children.
II.
在撒哈拉以南非洲，故意伤害对儿童构成了重大但报道不足的威胁。我们旨在评估故意伤害的趋势，并比较马拉维一家三级保健机构收治的儿科患者中意外伤害和故意伤害的结果。
我们对 2009 年至 2018 年期间在马拉维利隆圭的卡姆祖中央医院就诊的儿科（≤15 岁）创伤患者进行了回顾性研究。根据损伤意图，使用双变量和多变量回归分析比较患者特征和结果。
我们纳入了 42600 名儿科创伤患者。故意损伤占所有损伤的 5.9%。与意外伤害相比，故意损伤的儿童年龄更大（中位数 10 岁比 6 岁，p<0.001），男性更多（68.4%比 63.9%，p<0.001），死亡率显著更低（0.8%比 1.4%，p=0.02）。意外伤害的发生率或死亡率没有明显变化。多变量回归分析显示，年龄增长、头部和颈椎损伤、夜间就诊、穿透伤和酒精使用与故意伤害的风险增加相关。
在马拉维，故意伤害仍然是儿童创伤的一个重要原因，并没有减少医院就诊的发生率或死亡率。在撒哈拉以南非洲，需要制定全面的计划和政策来保护儿童。
II 级。
