Abstract

Trauma is a major cause of morbidity and mortality in
children worldwide and has been described as a neglected
epidemic in developing countries1.2. According to estimates
by the World Health Organisation (WHO), trauma accounted
for 10% of all deaths in children and adolescents globally in
2013 with 95.2% of all these occurring in the developing
world 3. There is insufficient data locally on the epidemiology
and pattern of injuries seen in children . Such information is
necessary to facilitate proper planning and development of
capacity to handle these challenges. As a pilot effort, we
aimed to investigate the pattern of injuries in children at our
hospitals which are 2 of the 3 centres proving tertiary health
care services in Ogun State, Southwestern Nigeria and attend
to over 2000 pediatric emergencies annually.
OBJECTIVES
To determine the pattern of childhood injuries at two tertiary
hospitals in Southwestern Nigeria.
METHODS
A five month cross sectional hospital based study was carried
out at the two tertiary hospitals from September 2015 to
January 2016. Data of all children aged 0-15 years who
presented with injuries at the children’s emergency rooms of
the 2 centres were retrieved from a prospectively recorded
pediatric surgery database. Data was analysed with SPSS 23.
RESULTS
A total of 76 children aged 0 – 15 years were admitted for
treatment of injuries at the emergency rooms of the 2
hospitals. Trauma accounted for 9.6 % of all admissions into
the children emergency rooms and 55% of all pediatric
surgical emergencies during the study period. The mean age
of injured children was 7.8 years . Children aged 6-10 years
had the highest frequency of injuries (23%). Sex distribution
ratio was 1.4: 1 with a male preponderance. Most injuries
occurred at home and on the streets/roadways, 41.3?ch,
respectively. Other less common sites were
school/playgrounds, 13.3% and shops/markets 4% The most
common aetiologies of pediatric trauma were Road traffic
accident -28 (36.8%) , falls -25 (32.9 %) and burns-13 (17.1
%) . Fractures (26.3 %), head injuries (21%) and burns (17.1
%) were the most common injuries . Average length of stay
was 11.1 days, with injuries accounting for 837 total hospital
days. Forty-seven percent of injured children required a
surgical procedure. The most common procedures performed
were reduction of fractures (27.6 %), wound closure (7.9 %),
exploratory laparotomy (5.2 %) and skin grafting (2.6%). Inhospital
mortality was 1.3 % . Sixteen percent of patients
who had severe injuries such as severe head injury and severe
burns were referred to other trauma centres for specialist
management
RTA, 36.8
falls, 32.9
Burns, 17.1
others, 11.8
assault, 1.3 Figure 1. Aetiology of Trauma
0
2
4
6
8
10
12
< 1> freq u e
n c
y
Age groups
RTA
Falls
Burns
others
Figure 2. Aetiology of injuries in various age groups
0
2
4
6
8
10
12
RTA falls burns others
Chart Title
< 1> Figure 3. Distribution of aetiologies in the different age groups
Table 1. Data from the 2 study centres
RTA Falls Burns Assaults Others Total
FMCA 21 13 12 1 9 56
BUTH 7 12 1 0 0 20
DISCUSSION/CONCLUSIONS
Childhood injuries contribute significantly to the burden on
inpatient services at the two hospitals. The age /sex
distribution of injured children and pattern of injuries seen is
comparable to findings locally and internationally4,5,6. Most
injuries occurred while at home and their incidence could be
reduced by increased vigilance by parents and guardians.
There is a need for expansion of trauma facilities and
capacity in the two centres to facilitate provision of
specialized neurosurgical care and management of severe
burn injuries .
REFERENCES
1. Nwomeh BC, Ameh EA. Pediatric trauma in Africa. Afr J Trauma. 2003; 1:7-13.
2. Gosselin RA, Spiegel DA, Coughlin R, Zirkle LG. Injuries: the neglected burden in
developing countries. Bulletin of the World Health Organisation 2009. 87: 246-246.
3. WHO Global burden of Disease 2013.
4. Adesunkanmi AR, Oginni LM, Oyelami AO, Badru OS. Epidemiology of childhood
injury. J Trauma. 1998 ; 44 (3): 506-12.
5. Ekenze SO, Anyanwu KK, Chukwumam DO. Childhood trauma in Owerri (South
Eastern) Nigeria. Niger J Med. 2009; 18(1) : 79-83.
6. Shen C, Sanno-Duanda B, Bickler SW. Pediatric trauma at a government referral
hospital in the Gambia. WAJM. 2003; 22(4): 287-90.
CONTACT
Corresponding Author : DR OA ADESANYA, Pediatric Surgery Unit, Department of Surgery,
Federal Medical Centre, Abeokuta. E mail: opeadesanya2002@yahoo.com .
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