Epidemiology of Paediatric Injuries in Rwanda Using a Prospective Trauma Registry
Date
2020Author
Petroze, RT
Martin, AN
Ntaganda, E
Kyamanywa, Patrick
St-Louis, E
Rasmussen, SK
Calland, JF
Byiringiro, JC
Metadata
Show full item recordAbstract
Background: Child survival initiatives historically prioritized efforts to reduce child morbidity and
mortality from infectious diseases and maternal conditions. Little attention has been devoted to paediatric
injuries in resource-limited settings. This study aimed to evaluate the demographics and outcomes of
paediatric injury in a sub-Saharan African country in an effort to improve prevention and treatment.
Methods: A prospective trauma registry was established at the two university teaching campuses of the
University of Rwanda to record systematically patient demographics, prehospital care, initial physiology
and patient outcomes from May 2011 to July 2015. Univariable analysis was performed for demographic
characteristics, injury mechanisms, geographical location and outcomes. Multivariable analysis was
performed for mortality estimates.
Results: Of 11 036 patients in the registry, 3010 (27⋅3 per cent) were under 18 years of age. Paediatric
patients were predominantly boys (69⋅9 per cent) and the median age was 8 years. The mortality rate was
4⋅8 per cent. Falls were the most common injury (45⋅3 per cent), followed by road traffic accidents (30⋅9 percent), burns (10⋅7 per cent) and blunt force/assault (7⋅5 per cent). Patients treated in the capital city, Kigali, had a higher incidence of head injury (7⋅6 per cent versus 2⋅0 per cent in a rural town, P < 0⋅001; odds ratio (OR) 4⋅08, 95 per cent c.i. 2⋅61 to 6⋅38) and a higher overall injury-related mortality rate (adjustedOR 3⋅00, 1⋅50 to 6⋅01; P = 0⋅019). Pedestrians had higher overall injury-related mortality compared withother road users (adjusted OR 3⋅26, 1⋅37 to 7⋅73; P = 0⋅007).
Conclusion: Paediatric injury is a significant contributor to morbidity and mortality. Delineating trauma
demographics is important when planning resource utilization and capacity-building efforts to address
paediatric injury in low-resource settings and identify vulnerable populations.
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