171620 Childhood Injuries in Asia and the Middle East: Results of a Pilot Study

Tuesday, October 28, 2008

David E. Sugerman, MD MPH , Emergency Medicine, Johns Hopkins Medical Institutes, Baltimore, MD
Adnan A. Hyder, MD, MPH, PhD , International Health, and Health Policy & Management, The Johns Hopkins University, Baltimore, MD
Prasanthi Puvanachandra, MD, MPH , School of Public Health, Johns Hopkins University, Baltimore, MD
Hesham Elsayed, MD , Faculty of Medicine, Professor and Chair of Pediatrics, Suez Canal University, Ismalia, Egypt
Fazlur Rahman, MD , Epidemiology, Dhaka Medical College, Dhaka, BC, Bangladesh
Junaid A. Razzak, MD PhD , Emergency Medicine, Aga Khan University, Karachi, Pakistan
Objective: To determine the epidemiology of childhood injuries in low income African and Middle Eastern countries using emergency department surveillance.

Methods: The Global Childhood Unintentional Injury Surveillance (GCUIS) study employed quota sampling of children 0-11 years old presenting to particular emergency departments in Bangladesh, Pakistan, and Egypt for selected months in 2007. Children with an unintentional injury of both genders were enrolled.

Results: As of January 2008, our team received 553 cases from Bangladesh, 551 cases from Egypt, and 550 cases from Pakistan. Out of a total of 1654 cases, 1092 were male (66%) and 562 (34%) female. 992 cases occurred in the 5+ age group (60%) while very few occurred among infants under 1 year of age (n=33; 2%). Falls outnumbered all other injuries in each country, with the highest proportion seen in Egypt (~60% of injuries). Road traffic injuries (RTI) followed falls with the highest proportion in Pakistan (20%). Burns were the third most common injury, with a much higher proportion seen in Bangladesh (24%). The proportion of poisoning was highest in Pakistan, while the proportion of near drowning/drowning was highest in Egypt.

Conclusions: The burden of childhood injuries on hospitals in developing countries in substantial. Ongoing child injury surveillance using systematic approaches in low income nations is required to identify the epidemiology of injuries, their risk factors, and plan for timely interventions. Standardization of methods and data allow for cross-country comparisons and enhanced capacity to identify common issues as demonstrated in this study.

Learning Objectives:
1. List the major risk factors for unintentional injury by type in the developing world. 2. Articulate the standardized methods used in low income, multi-country surveillance. 3. Develop appropriate unintentional injury prevention strategies for the developing countries in Asia and Africa.

Keywords: Injuries, International Public Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I HELPED CONCEIVE THE PROPOSAL, WRITE THE GRANT FOR FUNDING, AND WRITE THE ABSTRACT AND MANUSCRIPT.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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