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      Unintentional Childhood Injuries in Urban and Rural Ujjain, India: A Community-Based Survey

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          Abstract

          Injuries are a major global public health problem. There are very few community-based studies on childhood injury from India. The objective of this cross-sectional, community-based survey was to identify the incidence, type, and risk factors of unintentional childhood injuries. The study was done in seven villages and ten contiguous urban slums in Ujjain, India. World Health Organization (WHO) tested tools and definitions were used for the survey, which included 2518 households having 6308 children up to 18 years of age, with 2907 children from urban households and 3401 from rural households. The annual incidence of all injuries was 16.6%, 95% Confidence Interval 15.7–17.5%, ( n = 1049). The incidence was significantly higher among boys compared to girls (20.2% versus 12.7%, respectively), was highest in age group 6–10 years of age (18.9%), and in urban locations (17.5%). The most commonly identified injury types were: physical injuries (71%), burns (16%), poisonings (10%), agriculture-related injuries (2%), near drowning (2%), and suffocations (2%). The most common place of injury was streets followed by home. The study identified incidence of different types of unintentional childhood injuries and factors associated with increased risk of unintentional injuries. The results can help in designing injury prevention strategies and awareness programs in similar settings.

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          The global burden of unintentional injuries and an agenda for progress.

          According to the World Health Organization, unintentional injuries were responsible for over 3.9 million deaths and over 138 million disability-adjusted life-years in 2004, with over 90% of those occurring in low- and middle-income countries (LMIC). This paper utilizes the year 2004 World Health Organization Global Burden of Disease Study estimates to illustrate the global and regional burden of unintentional injuries and injury rates, stratified by cause, region, age, and gender. The worldwide rate of unintentional injuries is 61 per 100,000 population per year. Overall, road traffic injuries make up the largest proportion of unintentional injury deaths (33%). When standardized per 100,000 population, the death rate is nearly double in LMIC versus high-income countries (65 vs. 35 per 100,000), and the rate of disability-adjusted life-years is more than triple in LMIC (2,398 vs. 774 per 100,000). This paper calls for more action around 5 core areas that need research investments and capacity development, particularly in LMIC: 1) improving injury data collection, 2) defining the epidemiology of unintentional injuries, 3) estimating the costs of injuries, 4) understanding public perceptions about injury causation, and 5) engaging with policy makers to improve injury prevention and control.
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            The cost of injury and trauma care in low- and middle-income countries: a review of economic evidence.

            Injuries are a significant cause of mortality and morbidity, of which more than 90% occur in low- and middle-income countries (LMICs). Given the extent of this burden being confronted by LMICs, there is need to place injury prevention at the forefront of public health initiatives and to understand the costs associated with injury. The aim of this article is to describe the extent to which injury-related costing studies have been conducted in LMICs.
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              Global childhood unintentional injury surveillance in four cities in developing countries: a pilot study

              OBJECTIVE: To determine the frequency and nature of childhood injuries and to explore the risk factors for such injuries in low-income countries by using emergency department (ED) surveillance data. METHODS: This pilot study represents the initial phase of a multi-country global childhood unintentional injury surveillance (GCUIS) project and was based on a sequential sample of children 5 years, 32 (2%) were < 1 year old. Injuries were especially frequent (34%) during the morning hours. They occurred in and around the home in 56% of the cases, outside while children played in 63% and during trips in 11%. Of all the injuries observed, 913 (56%) involved falls; 350 (22%), road traffic injuries; 210 (13%), burns; 66 (4%), poisoning; and 20 (1%), near drowning or drowning. Falls occurred most often from stairs or ladders; road traffic injuries most often involved pedestrians; the majority of burns were from hot liquids; poisonings typically involved medicines, and most drowning occurred in the home. The mean injury severity score was highest for near drowning or drowning (11), followed closely by road traffic injuries (10). There were 6 deaths, of which 2 resulted from drowning, 2 from falls and 2 from road traffic injuries. CONCLUSION: Hospitals in low-income countries bear a substantial burden of childhood injuries, and systematic surveillance is required to identify the epidemiological distribution of such injuries and understand their risk factors. Methodological standardization for surveillance across countries makes it possible to draw international comparisons and identify common issues.
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                Author and article information

                Journal
                Children (Basel)
                Children (Basel)
                children
                Children
                MDPI
                2227-9067
                08 February 2018
                February 2018
                : 5
                : 2
                : 23
                Affiliations
                [1 ]Department of Paediatrics, R. D. Gardi Medical College, Ujjain 456006, India; dr.adityamathur121@ 123456gmail.com (A.M.); lovemehra2000@ 123456gmail.com (L.M.)
                [2 ]Department of Public Health & Environment, R. D. Gardi Medical College, Ujjain 456006, India; vishaldiwan@ 123456hotmail.com
                [3 ]Global Health—Health Systems and Policy, Department of Public Health Sciences, Karolinska Institutet, Stockholm SE-171 76, Sweden
                [4 ]Department of Women and Children’s Health, International Maternal and Child Health Unit, Uppsala University, Uppsala SE-751 85, Sweden
                Author notes
                [* ]Correspondence: drashish.jpathak@ 123456gmail.com ; Tel.: +91-930-223-9899
                Author information
                https://orcid.org/0000-0003-2404-9231
                https://orcid.org/0000-0002-7576-895X
                Article
                children-05-00023
                10.3390/children5020023
                5835992
                29419791
                73677e98-bbe2-45b4-9648-9d979242718f
                © 2018 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 31 December 2017
                : 05 February 2018
                Categories
                Article

                childhood injuries,incidence,epidemiology,risk factors,india

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