Epidemiology of Paediatric Injuries in Rwanda Using a Prospective Trauma Registry
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Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
Oxford Univ Press , Great Clarendon St, Oxford, England, Ox2 6dp
Abstract
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.
Description
Keywords
Craniocerebral, Epidemiology, Trauma, Traffic accidents, Burns, Communicable diseases, Child, Demography, Geographic area, Mothers, Pediatrics, Rwanda, Wounds and injuries, Morbidity, Mortality, Physiology, Assault, Mechanism of injury, Towns, Patient-focused outcomes, Prevention, Pedestrian, Pre-hospital care
Citation
Petroze, R.T., Martin, A.N., Ntaganda, E., Kyamanywa, P., St-Louis, E., Rasmussen, S.K., Calland, J.F. and Byiringiro, J.C. (2020). Epidemiology of paediatric injuries in Rwanda using a prospective trauma registry. BJS open, 4(1), pp.78-85.