Kumar Mohan, Pathak Vineet Kumar, Tripathi Saparya, Upadhyay Anita, Singh Vivek V, Lahariya Chandrakant
Department of Community Medicine, KMCH Institute of Health Sciences and Research, Coimbatore, India.
Integrated Department of Health Policy, Epidemiology, Preventive Medicine and Pediatrics, Foundation for People Centric Health System, New Delhi, India.
Indian J Community Med. 2023 Sep-Oct;48(5):648-658. doi: 10.4103/ijcm.ijcm_887_22. Epub 2023 Sep 7.
Childhood injuries are a major public health challenge in India and globally. This systematic review was conducted to understand the burden and spectrum of childhood injuries, with a focus on unintentional injuries, among children 5-14 years of age and to suggest approaches to prevention that can be adopted in the Indian context. This systematic review was conducted with the standard approach and use of keywords. A total of 33 studies which were found to be relevant were analyzed. Road traffic accidents (RTAs) contribute to nearly 85% of all unintentional injuries and related deaths and 90% of disability-adjusted life years (DALYs) lost in developing countries. Poor traffic regulation, heavy traffic load, and poor skill of identifying the dangerous road crossing sites make the children's age group vulnerable and prone to RTA. Children with poor skill of identification and response to dangerous road crossing sites, along with heavy unregulated traffic were found to be the major reasons for such accidents and make this age group more vulnerable. Public health-based prevention approaches need to be based upon legislation, regulation, and enforcement, as well as environmental modification, education and skill development, emergency medical care using levels of prevention, and principles of targeted prevention to effectively address child health challenges. Addressing child injuries should be a key component of all endeavors aimed at enhancing child mortality and morbidity rates, as well as the overall welfare of children, both at the national and global levels. It is imperative to prioritize policies focused on preventing unintentional injuries across all age groups, with particular attention to children.
儿童伤害是印度乃至全球面临的一项重大公共卫生挑战。本系统综述旨在了解5至14岁儿童伤害的负担和范围，重点关注意外伤害，并提出可在印度采用的预防方法。本系统综述采用标准方法并使用关键词进行。共分析了33项相关研究。道路交通事故（RTA）在发展中国家导致了近85%的意外伤害及相关死亡，以及90%的伤残调整生命年（DALY）损失。交通监管不力、交通负荷大以及识别危险道路交叉点的技能差，使得儿童这一年龄组易受伤害且容易发生道路交通事故。识别和应对危险道路交叉点的技能差的儿童，再加上无管制的繁忙交通，被发现是此类事故的主要原因，使得这一年龄组更加脆弱。基于公共卫生的预防方法需要基于立法、监管和执法，以及环境改造、教育和技能发展、利用预防级别提供的紧急医疗护理和有针对性预防原则，以有效应对儿童健康挑战。应对儿童伤害应成为所有旨在提高儿童死亡率和发病率以及儿童总体福利的努力的关键组成部分，无论是在国家还是全球层面。必须优先制定侧重于预防所有年龄组意外伤害的政策，尤其要关注儿童。
