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      Injury morbidity in an urban and a rural area in Tanzania: an epidemiological survey

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          Abstract

          Background

          Injuries are becoming a major health problem in developing countries. Few population based studies have been carried out in African countries. We examined the pattern of nonfatal injuries and associated risk factors in an urban and rural setting of Tanzania.

          Methods

          A population-based household survey was conducted in 2002. Participants were selected by cluster sampling. A total of 8,188 urban and 7,035 rural residents of all ages participated in the survey. All injuries reported among all household members in the year preceding the interview and resulting in one or more days of restricted activity were included in the analyis.

          Results

          A total of 206 (2.5%) and 303 (4.3%) persons reported to have been injured in the urban and rural area respectively. Although the overall incidence was higher in the rural area, the incidence of major injuries (≥ 30 disability days) was similar in both areas. Males were at a higher risk of having an injury than females. Rural residents were more likely to experience injuries due to falls (OR = 1.6; 95% CI = 1.1 – 2.3) and cuts (OR = 4.3; 95% CI = 3.0 – 6.2) but had a lower risk of transport injuries. The most common causes of injury in the urban area were transport injuries and falls. In the rural area, cuts and stabs, of which two thirds were related to agriculture, formed the most common cause. Age was an important risk factor for certain types of injuries. Poverty levels were not significantly associated with experiencing a nonfatal injury.

          Conclusion

          The patterns of injury differ in urban and rural areas partly as a reflection of livelihoods and infrastructure. Rural residents are at a higher overall injury risk than urban residents. This may be important in the development of injury prevention strategies.

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          Most cited references31

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          Injury patterns in rural and urban Uganda.

          To describe and contrast injury patterns in rural and urban Uganda. One rural and one urban community in Uganda. Community health workers interviewed adult respondents in households selected by multistage sampling, using a standardized questionnaire. In the rural setting, 1,673 households, with 7,427 persons, were surveyed. Injuries had an annual mortality rate of 92/100,000 persons, and disabilities a prevalence proportion of 0.7%. In the urban setting 2,322 households, with 10,982 people, were surveyed. Injuries had an annual mortality rate of 217/100,000, and injury disabilities a prevalence proportion of 2.8%. The total incidence of fatal, disabling, and recovered injuries was 116/1,000/year. Leading causes of death were drowning in the rural setting, and road traffic in the city. Injuries are a substantial burden in Uganda, with much higher rates than those in most Western countries. The urban population is at a higher risk than the rural population, and the patterns of injury differ. Interventions to control injuries should be a priority in Uganda.
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            The problem of children's injuries in low-income countries: a review.

            Unintentional injuries are the cause of death and disability for millions of children every year in low-income countries. Challenging living conditions, heavy traffic, a lack of safe play space and an absence of child care options, together with a disproportionate vulnerability to injury, combine to put children at high risk. Inaccessible and unaffordable emergency services add to the number of resulting deaths and impairments. Yet this major public health problem receives relatively little attention. Because communicable disease and nutritional problems continue to rank higher as causes of child mortality and morbidity in most of the developing world, injury is perceived as a less serious problem. Existing research is scanty and is largely limited to hospital-based studies, which cannot present a comprehensive picture of either causes or outcomes. Development of preventive measures is hampered not only by limited health budgets, but by a tendency (not unique to low-income countries) to see injuries as random events, and hence as unpredictable and uncontrollable. There is an urgent need for more research that can contribute to effective analyses of the situation, and especially for locally-based research and record keeping, which is most likely to contribute to awareness and to practical and well-targeted prevention measures.
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              The burden of road traffic injuries in developing countries: the 1st national injury survey of Pakistan.

              To assess the burden of road traffic injuries in Pakistan-a developing country in South Asia. A nationally representative household interview survey, to measure the burden of all injuries for all ages and in both genders using a three-month recall period. The overall incidence of injury events was 41 (CI: 39.2-43.8) per 1000 per year and for road traffic injuries 15 (CI: 13.7-16.5) per 1000 per year. The relative risk for road traffic injuries was found to be higher in males, those 16-45 years old, and those in the professional category of laborers and vendors. This first national survey reflects the growing impact of injuries, especially road traffic injuries in Pakistan and portends a challenge for the national health system.
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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                2005
                28 January 2005
                : 5
                : 11
                Affiliations
                [1 ]Centre for International Health, University of Bergen, Norway
                [2 ]Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania
                [3 ]Department of Mathematics, University of Bergen, Norway
                [4 ]MEASURE Evaluation, Carolina Population Center, University of North Carolina at Chapel Hill, USA
                [5 ]Adult Morbidity and Mortality Project and Tanzanian Ministry of Health, Tanzania
                Article
                1471-2458-5-11
                10.1186/1471-2458-5-11
                548509
                15679887
                64607071-ec18-4daf-9b14-c4e0582734c3
                Copyright © 2005 Moshiro et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 24 September 2004
                : 28 January 2005
                Categories
                Research Article

                Public health
                Public health

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