EPIDEMIOLOGY OF CHILDHOOD INJURY

A review of childhood injuries at the Wesley Guild Hospital, a compone nt of Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, N igeria, showed that 1,471 patients seen in the children's emergency ro om during a period of 4 years (1992-1995) were there as a result of tr auma, representing 9% of all patients seen. The case notes and acciden t and emergency cards of 1,224 were available for review. Ages ranged from 2 months to 15 years, with a mean of 6.9 years, and 40% of the pa tients were between 5 and 10 years of age. More males were affected th an females, with a ratio of 1.5:1. Road traffic crashes were the most common causal factor, responsible for 324 injuries (26.5%). About 90% of these were pedestrians knocked down by automobiles and motorcycles. Passengers accounted for about 10% of the cases. Falls occurred in 30 5 patients (25%); 229 patients fell while on level ground either playi ng or running, accounting for 75%. There were 122 patients (10%) with misplaced foreign bodies; about 60% of these were recovered from the e ars, and 26.3% from the nostrils. Edible seeds were the most common fo reign bodies, followed by beads. Injuries from bites occurred in 108 p atients, with dog and snake bites taking the lead. Burns, mainly from scalding, occurred in 89 patients. Other rare injuries were knife woun ds, gunshot wounds, and injuries resulting from assaults. The home was the most common site of injury (570 patients, 46.7%) followed by stre ets or roadways (363 patients, 29.7%); 19.5% of injuries occurred at s chool. The most common anatomic region affected was the head and neck, followed by the limbs. One hundred ninety-seven patients (16%) had bo ny fractures, femurs being the most affected bone. Head injury was see n in 104 patients, representing 8.5%, although only 17 of these injuri es were severe. There were 10 cases of abdominal injury and 9 cases of chest injury, representing 0.8 and 0.7%, respectively. Wound infectio n occurred in 6.4% of the patients. Death occurred in 19 patients, acc ounting for 1.6%; 10 of these patients had severe head injuries. Road traffic injuries and burns accounted for the greatest number of compli cations. The findings of this study suggest that trauma is an importan t factor in childhood morbidity and mortality in our environment, with road traffic injuries taking the lead. Preschool pedestrian children were most commonly affected, the majority of them on errands for their parents. We believe that the majority of these injuries are preventab le.