Presentation of Pediatric Unintentional Injuries at Rural Hospitals in Rwanda: A Retrospective Study

Background: Injuries are a leading cause of mortality among children globally, with children in low- and middle-income countries more likely to die if injured compared to children in high-income countries. Timely and high-quality care are essential to reduce injury-related morbidity and mortality. O...

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Autores principales:	Irene Bagahirwa, Madeleine Mukeshimana, Teena Cherian, Theoneste Nkurunziza, Ziad El-Khatib, Jean Claude Byiringiro, Loise Ng’ang’a, Emmanuel Rusingiza, Robert Riviello, Gilles Francois Ndayisaba, Bethany L. Hedt-Gauthier
Formato:	article
Lenguaje:	EN
Publicado:	Ubiquity Press 2020
Materias:	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/8e74b14f58164062b9eda12aeaab958a
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spelling	oai:doaj.org-article:8e74b14f58164062b9eda12aeaab958a2021-12-02T12:18:16ZPresentation of Pediatric Unintentional Injuries at Rural Hospitals in Rwanda: A Retrospective Study2214-999610.5334/aogh.2711https://doaj.org/article/8e74b14f58164062b9eda12aeaab958a2020-09-01T00:00:00Zhttps://annalsofglobalhealth.org/articles/2711https://doaj.org/toc/2214-9996Background: Injuries are a leading cause of mortality among children globally, with children in low- and middle-income countries more likely to die if injured compared to children in high-income countries. Timely and high-quality care are essential to reduce injury-related morbidity and mortality. Objectives: This study describes patterns, management, and outcomes of children 0–15 years presenting with unintentional injuries at three district hospitals in rural Rwanda between January 1 and December 31, 2017. Methods: Using a retrospective cross-sectional study design, we assessed the demographic and clinical characteristics, care provided, and outcomes of the children using data extracted from patient medical charts. We describe the patient population using frequencies and proportions as well as median and interquartile ranges. Findings: Of the 449 injured children who sought care at the three rural district hospitals, 66.2% (n = 297) were boys. The main causes of injury were falls (n = 261, 58.1%), burns (n = 101, 22.5%), and road traffic injuries (n = 67, 14.9%). Burns were the most common injury among children aged 0–5 years while falls were the leading injury type among the 5–15 years age group. Vital signs were inconsistently completed ranging between 23.8–89.1% of vital sign items. Of the injured children, 37.0% (n = 166) received surgery at the district hospital, general practitioners performed 80.9% (n = 114) of surgeries, 87.4% (n = 145) of operated patients received no anesthesia, and 69.3% (n = 311) were admitted to the district hospital, while 2.7% (n = 12) were transferred to tertiary facilities for higher-level care. Conclusions: The presentation of child injuries—namely falls, burns, and road traffic accidents—is similar to what has been reported in other sub-Saharan African countries. However, more needs to be done to improve the completion and documentation of vital signs and increase availability of surgical specialists. Finally, targeted strategies to prevent burns and motorcycle-related injuries are recommended prevention interventions for this rural population.Irene BagahirwaMadeleine MukeshimanaTeena CherianTheoneste NkurunzizaZiad El-KhatibJean Claude ByiringiroLoise Ng’ang’aEmmanuel RusingizaRobert RivielloGilles Francois NdayisabaBethany L. Hedt-GauthierUbiquity PressarticleInfectious and parasitic diseasesRC109-216Public aspects of medicineRA1-1270ENAnnals of Global Health, Vol 86, Iss 1 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
spellingShingle	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270 Irene Bagahirwa Madeleine Mukeshimana Teena Cherian Theoneste Nkurunziza Ziad El-Khatib Jean Claude Byiringiro Loise Ng’ang’a Emmanuel Rusingiza Robert Riviello Gilles Francois Ndayisaba Bethany L. Hedt-Gauthier Presentation of Pediatric Unintentional Injuries at Rural Hospitals in Rwanda: A Retrospective Study
description	Background: Injuries are a leading cause of mortality among children globally, with children in low- and middle-income countries more likely to die if injured compared to children in high-income countries. Timely and high-quality care are essential to reduce injury-related morbidity and mortality. Objectives: This study describes patterns, management, and outcomes of children 0–15 years presenting with unintentional injuries at three district hospitals in rural Rwanda between January 1 and December 31, 2017. Methods: Using a retrospective cross-sectional study design, we assessed the demographic and clinical characteristics, care provided, and outcomes of the children using data extracted from patient medical charts. We describe the patient population using frequencies and proportions as well as median and interquartile ranges. Findings: Of the 449 injured children who sought care at the three rural district hospitals, 66.2% (n = 297) were boys. The main causes of injury were falls (n = 261, 58.1%), burns (n = 101, 22.5%), and road traffic injuries (n = 67, 14.9%). Burns were the most common injury among children aged 0–5 years while falls were the leading injury type among the 5–15 years age group. Vital signs were inconsistently completed ranging between 23.8–89.1% of vital sign items. Of the injured children, 37.0% (n = 166) received surgery at the district hospital, general practitioners performed 80.9% (n = 114) of surgeries, 87.4% (n = 145) of operated patients received no anesthesia, and 69.3% (n = 311) were admitted to the district hospital, while 2.7% (n = 12) were transferred to tertiary facilities for higher-level care. Conclusions: The presentation of child injuries—namely falls, burns, and road traffic accidents—is similar to what has been reported in other sub-Saharan African countries. However, more needs to be done to improve the completion and documentation of vital signs and increase availability of surgical specialists. Finally, targeted strategies to prevent burns and motorcycle-related injuries are recommended prevention interventions for this rural population.
format	article
author	Irene Bagahirwa Madeleine Mukeshimana Teena Cherian Theoneste Nkurunziza Ziad El-Khatib Jean Claude Byiringiro Loise Ng’ang’a Emmanuel Rusingiza Robert Riviello Gilles Francois Ndayisaba Bethany L. Hedt-Gauthier
author_facet	Irene Bagahirwa Madeleine Mukeshimana Teena Cherian Theoneste Nkurunziza Ziad El-Khatib Jean Claude Byiringiro Loise Ng’ang’a Emmanuel Rusingiza Robert Riviello Gilles Francois Ndayisaba Bethany L. Hedt-Gauthier
author_sort	Irene Bagahirwa
title	Presentation of Pediatric Unintentional Injuries at Rural Hospitals in Rwanda: A Retrospective Study
title_short	Presentation of Pediatric Unintentional Injuries at Rural Hospitals in Rwanda: A Retrospective Study
title_full	Presentation of Pediatric Unintentional Injuries at Rural Hospitals in Rwanda: A Retrospective Study
title_fullStr	Presentation of Pediatric Unintentional Injuries at Rural Hospitals in Rwanda: A Retrospective Study
title_full_unstemmed	Presentation of Pediatric Unintentional Injuries at Rural Hospitals in Rwanda: A Retrospective Study
title_sort	presentation of pediatric unintentional injuries at rural hospitals in rwanda: a retrospective study
publisher	Ubiquity Press
publishDate	2020
url	https://doaj.org/article/8e74b14f58164062b9eda12aeaab958a
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Presentation of Pediatric Unintentional Injuries at Rural Hospitals in Rwanda: A Retrospective Study

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