Prospective longitudinal study investigating predictors of childhood injuries from Growing Up in New Zealand cohort: study protocol

BackgroundInjury is one of the leading causes of mortality and morbidity worldwide and yet preventable and predictable. In New Zealand (NZ), unintentional injury is the leading cause of emergency department visits, hospitalisations and death among children, making it a significant public health concern.ObjectiveTo identify the factors that place young children in NZ at an increased risk of unintentional injury.MethodsThis study will investigate injuries among children from the prospective Growing Up in NZ birth cohort of 6853 children and their families. The primary outcome of interest is injury events where medical treatment was sought. The data sources include parental reports of child injury and Accident Compensation Corporation—NZ’s no-fault injury compensation system—injury claims. The linked datasets will be utilised to examine the distribution of life course exposures and outcome data using descriptive statistics. A temporal multilevel model will then be developed to examine relationships between neighbourhood, child and family characteristics and injury from birth to 5 years of age for all children for whom parental consent to link data were obtained.DiscussionThe findings of this research will help to identify how the multiplicity of influences between children, family and their broader societal context acting across time affect their risk of experiencing a preschool injury. This information will provide an evidence base to inform context-relevant strategies to reduce and prevent childhood injuries.

Childhood Injury Pattern During Covid 19 Pandemic: A Population - based Study in Rural Area in Basrah City (Iraq)

Background: Children injuries are a major public health problem globally and considered as an important social health issue that needs an urgent care and action, regards as a health consideration in the whole world, influencing both developed and developing countries. The increased exposure to potentially hazardous home environments and activities caused by stay-at-home orders and closures of schools due to COVID-19 pandemic may be responsible for a new spate of injuries among children in 2020. method: population based cross sectional study done in rural area (Al-Jazeera/Shatt Al-Arab). This cross sectional study involved households with at least one child in age group of less than 18 years, in rural area in Basra city (2020). Objectives: To determine the magnitude of childhood injuries during COVID-19 pandemic in terms of incidence, to determine nature and causes of injuries and factors that may affect the incidence of childhood injuries that is associated with quarantine and homestay for long periods during pandemic. A total of 652 children under 18 years of age (according to the definition of WHO) were included in the study, 109 children had injuries during the pandemic year (2020). Result: The incidence rate of injury in the area was 167.1/ 1000 children, males show higher incidence rate of injury rather than females. the effect of child sex, mother education and age on the incidence of injury were highly significant, while age of child and birth order were not significant. Soft tissue injuries and burns were the leading causes of injuries in our household study. General improvement and modification of sociocultural environment are recommended, children and adolescent education about safety and necessary precaution. establishing of injury surveillance system is important for preventing and control of injuries Governments and healthcare authorities should proactively implement appropriate intervention programs and better resources to prevent these home injuries during lockdown.

Epidemiology of childhood injuries in Saudi Arabia: a scoping review

Background Injury is the leading cause of death among Saudi children. Despite that, much remains unknown on the epidemiology and the extent of burden. This scoping review aims to describe previous literature on injury burden, including types, causes, and outcomes. Methods We conducted a scoping literature search of English published articles on injuries among Saudi children between 0 to 18 years old using Scopus, MEDLINE, and Web of Science between January 2000 and December 2020. The primary outcome was the type and the cause of childhood injuries. Data extraction was based on specified data elements that included study characteristics and epidemiological parameters. The STROBE checklist was used to assess the quality of publications. Results The initial review identified 3,384 studies. Of which, 36 studies met the inclusion criteria. A total of 20,136 children were included; of them, 69% were males. Among studies that examined overall injuries, falls represented 31.9%, while 25.1% were due to Motor Vehicle Collision (MVC). The leading cause of fractures was falls (37.9%), followed by MVC (21.5%). The leading cause was flames (52.1%) followed by scald (36.4%) for burns. While for poisoning, medications were the leading cause of (39.9%), followed by toxic household products (25.7%). Weighted mortality rates were 5.2% for overall injuries, 8.3% for fractures of the skull and spine, and 17.4% for burns. Conclusions MVC and falls are associated with the highest share of injuries in the kingdom. These findings can guide prevention efforts to reduce injury burden and improve population health. Further population-based research is warranted to explore the determinants of childhood injuries across all regions of Saudi Arabia.

Creating safe spaces to prevent unintentional childhood injuries among the Bedouins in southern Israel: A hybrid model comprising positive deviance, community-based participatory research, and entertainment-education

Background Despite several intervention programs, the Bedouin population living in the Southern District of Israel has the highest mortality rate among children and adolescents from unintentional injuries. Our research questions asked: (1) How does increasing the involvement and participation of Bedouin community members influence the issue of unintentional injuries among children? (2) How does reframing of the technical issue of safety into security influence community involvement and cooperation? Objectives 1) To identify effective and efficacious positive deviance practices through community-based participatory research with adults, children, and professionals in the Bedouin community. 2) To create wider and deeper connections and cohesion between and among diverse Bedouin communities by seeding and sparking opportunities for social networking and cross-learning. Methods The study used a qualitative multi-method approach to generate a hybrid intervention model for reducing unintentional childhood injuries among the Bedouins. To frame the issue of unintentional injuries from the lived perspective of the Bedouins, we employed the Positive Deviance (PD) and Community Based Participatory Research (CBPR) approach. Drawing upon theatrical traditions, entertainment-education (EE), was employed as a way to narratively engage and persuade the Bedouins. Results Our research resulted in: (1) the emergence of several PD ideas and practices for preventing and avoiding children’s injuries; (2) the actual creation of a safe and secure playroom for children at a neighborhood mosque; and (3) the creation of cascading and cross-learning social networks between and among members of the Bedouin community spread across various locations. Conclusion This study helped in reframing the technical issue of accidents and safety into the notion of sacredness and security, enhanced the association between emotions and cognition by means of experiential and EE methods, and stimulated creative thinking and the emergence of new culturally and contextually relevant ideas and practices through the PD process. It demonstrated the synergistic power of using a hybrid model that combined the rigor and vigor of different health communication approaches to address a significant disparity in the burden of child accidents faced by the Bedouins. Our study generated solutions that emerged from, and directly benefitted, Bedouin children—those, who face overwhelming risk of injury and death from preventable accidents.

Pattern and risk factors for childhood injuries in Dar es Salaam, Tanzania

Background: Injuries contribute to morbidity and mortality in children. This study was carried out to describe the pattern of childhood injuries and associated risk factors in Dar es Salaam, Tanzania. Methods: This case control study was conducted in six selected health facilities in Dar es Salaam, Tanzania. Data were col- lected using a structured questionnaire. Cases and controls were children below 18 years who had suffered injuries and those without injury associated condition respectively. Results: A total of 492 cases and 492 controls were included in the study, falls (32%), burns (26%), Road Traffic Injuries (14%) and cuts (10%) were the major types of injuries identified. Younger parents/guardians {Adjusted odds ratio (AOR)= 1.4; 95% CI: 1.4 -3.6}, more than six people in the same house (AOR= 1.8; 95% CI: 1.3-2.6), more than three children in the house {AOR= 1.4; 95% CI (1.0-2.0)}, absence of parent/guardian at time of injury occurrence (AOR= 1.6; 95% CI: 1.1-2.3), middle socio-economic (AOR=1.6; 95%CI: 1.1-2.4) and low socio-economic status (AOR= 1.5; 95% CI: 1.0-2.1) were independent risk factors for childhood injury. Conclusion: Falls, burns and road traffic injuries were the main injury types in this study. Inadequate supervision, over- crowding, lower socio-economic status and low maternal age were significant risk factors for childhood injuries. Keywords: Childhood injuries; risk factors; Dar es Salaam; Tanzania.

Incidence of childhood injuries and modifiable household risk factors in rural Ghana: a multistage, cluster-randomised, population-based, household survey

ObjectiveWe aimed to describe the incidence of childhood household injuries and prevalence of modifiable household risk factors in rural Ghana to inform prevention initiatives.Setting357 randomly selected households in rural Ghana.ParticipantsCaregivers of children aged <5 years.Primary and secondary outcome measuresChildhood injuries that occurred within 6 months and 200 metres of the home that resulted in missed school/work, hospitalisation and/or death. Sampling weights were applied, injuries were described and multilevel regression was used to identify risk factors.ResultsCaregivers from 357 households had a mean age of 35 years (SD 12.8) and often supervised ≥2 children (51%). Households typically used biomass fuels (84%) on a cookstove outside the home (79%). Cookstoves were commonly <1 metre of the ground (95%). Weighted incidence of childhood injury was 542 per 1000 child-years. Falls (37%), lacerations (24%), burns (12%) and violence (12%) were common mechanisms. There were differences in mechanism across age groups (p<0.01), but no gender differences (p=0.25). Presence of older children in the home (OR 0.15, 95% CI 0.09 to 0.24; adjusted OR (aOR) 0.26, 95% CI 0.13 to 0.54) and cooking outside the home (OR 0.28, 95% CI 0.19 to 0.42; aOR 0.25, 95% CI 0.13 to 0.49) were protective against injury, but other common modifiable risk factors (eg, stove height, fuel type, secured cabinets) were not.ConclusionsChildhood injuries occurred frequently in rural Ghana. Several common modifiable household risk factors were not associated with an increase in household injuries. Presence of older children was a protective factor, suggesting that efforts to improve supervision of younger children might be effective prevention strategies.

A Mixed Method Study to Assess the Effect of Training of Adolescents on Perception and Practices regarding Unintentional Childhood Injuries

Background: Adolescents are the future citizens of any society, who can be trained to become responsible members and also function as change agents in the community to improve children’s health. Child-To-Child Approach is an innovative technique which was used in the present study to improve perception and practices regarding unintentional childhood injuries, by training the adolescent population. Methodology: An intervention study was conducted in two villages of Delhi from April 2017 to July 2019, to test the Child-To-Child Approach in preventing childhood injuries, by training the eldest adolescent in each family of intervention area and encouraging them to disseminate the knowledge to other family members. Present study is a part of the main study and analyses improvement in Perception and Practice (PP) regarding injuries after intervention, as assessed from PP scores of adolescents eligible for training, other adolescents and adult women. Focus group discussions (FGD) for assessing perception were also conducted with adolescents and adult women, at the beginning and end of study. Results: During pre-intervention period, PP scores of all three groups of subjects showed no significant difference between the two areas. Statistically significant improvement was observed in PP scores of all three groups of subjects in the intervention area during the post-intervention phase, in comparison to pre-intervention phase as well as in comparison to scores of control area in post-intervention phase. Findings from the FGD showed that perception of both groups regarding types and reasons of injuries was low in the beginning, but increased markedly in the second FGD in both the groups, compared to the first FGD. Conclusion: These findings indicate that training adolescents and encouraging them to disseminate messages to their siblings and to the adult women of their families, which is the essence of Child-To-Child Approach, is effective in improving the perception and practices regarding unintentional childhood injuries.