Epidemiology of injuries in children under five years old in Qazvin, Iran

Document Type: Original Article

Authors

1 Nursing Dept., Qazvin University of Medical Sciences, Qazvin, I.R. Iran

2 Center of Non-Communicable Diseases Control, Qazvin University of Medical Sciences, Qazvin, I.R. Iran

Abstract

Background and aims: In Iran, according to the available data on health statistics, injuries are the as the common cause of death in different age groups after chronic heart diseases. The aim of this study was to present detailed information on eight common injuries.
Methods: This study is an analysis on existing data (secondary study on recorded data) in Health Informatics System (HIS) available in Qazvin Health Management Office (QHMO), Iran. Permission to use these data was provided by researchers and the Health Research Ethics Board at the Qazvin University of Medical Sciences and also approved this analysis. Eight categories of injuries were derived from HIS and analyzed in SPSS software.
Results: The total registered injuries in the whole population of Qazvin province was 22,821 (30% in females) from March 2014 to March 2015. From this, 1688 (7.3%) occurred in children under five years old. The rate of falling, violence, traffic and burns related injuries were in the top. About 69% of total injuries were in urban, and near 13% in villages.
Conclusion: Children are the main victims of adults’ car crashes. Most of the children’s injuries take place at homes and roads. Some educational programs in order to increase children’s safety are in progress. There is not a good system to evaluate these interventions’ outcomes, and as such doing more study in this field is needed.

Keywords

Main Subjects


INTRODUCTION

 In Iran, according to the available data on health statistics, injuries are the common cause of death in different age groups after chronic heart diseases. Injuries account for more than 60% of all injury deaths in children younger than 19 years.1 Various factors influence children’s injuries like as; age, gender, behavior, and environmental agents, meanwhile age and sex are the most important agents suffering the patterns of injuries. Injuries are the major causes of childhood’s mortality and morbidity in the United States, too.1-3 Injuries represent one of the most important public health problems facing both developing and industrialized countries today.4 A one-year study in an Iranian province, revealed that about 5% of injured children in urban and sub-urban areas referred to emergency departments were pedal cyclists, of whom, 55% had head injuries.5 Due to the lack of responsible agency and funding, the data capture systems in Iran are inadequate, and few studies have investigated the epidemiological patterns of injuries in children under five years old.1,6,7 There was no age-specific study done in Iran.4,8,9 Qazvin is in central region of Iran. In spite of the higher prevalence of some injuries (Traffic accidents; Motorbike specifically) in Qazvin than the other provinces of Iran, little researches have been conducted to aim all the injuries in a specific age group. The aim of this study was to present detailed information on 8 common injuries (Falling, Violence and attack, Traffic injuries, Burns, Poisoning, Wild animals’ attacks and snakebites, Electrocution and Drowning) in children under the age of
5 years.

 

METHODS

This study is an analysis on existing data (secondary study on recorded data) in Health Informatics System (HIS) available in Qazvin Health Management Office (QHMO), Iran. Permission to use these data was provided by researchers and the Health Research Ethics Board at the Qazvin University of Medical Sciences also approved this analysis. Eight categories of injuries were derived from HIS and analyzed in SPSS software.

 

RESULTS

Total registered injuries in whole population of Qazvin province were 22,821 (30% in females) from March 2014 to March 2015. From this, 1688 (7.3%) occurred in children under five years old. Distributions of injury are shown in Table 1 and Figure 1.

 

 

Table 1: Distribution of injuries type in children under 5 years

Type of injuries

Girls

Boys

Total

n

%

n

%

n

%

Falling

155

24

220

0.21

375

22.2

Violence and attack

121

18.7

214

20.5

335

20.0

Traffic injuries

101

15.6

150

14.5

251

15.0

Burns

53

8.1

98

9.5

151

9.0

Poisoning

18

2.8

18

1.7

36

2.1

Wild animals attack and snakebites

2

0.3

2

0.19

4

0.23

Electrocution

3

0.4

5

0.48

8

0.5

Drowning

0

0.0

2

0.19

2

0.11

Others (unspecified)

194

30

332

32

426

25.2

Total

647

100

1041

100

1688

100

 

Figure 1: Gender-based distribution of injuries in Qazvin population

 

 

The rate of falling, violence, traffic and burns related injuries were in the top. There was no detailed information about these, except for the traffic injuries. Types of traffic injuries are shown in Figure 2.

 

 

 

Figure 2: Type of traffic injuries in children under 5 years old

 

 

As shown in this figure, car injuries have the most prevalence related to other traffic injuries. Home and the roads were the most common places for these injuries as shown in Table 2. About 69% of total injuries were in urban, and nearly 13% in villages (Table 3).

 

 

Table 2: Distribution of injuries’ places in children under 5 years

Scene of injuries

Girls

Boys

Total

n

%

n

%

n

%

Home

294

45.0

434

41.5

728

43.0

Roads

111

17.0

183

17.5

294

17.4

Public recreational places

8

1.2

17

1.6

25

1.5

Kindergarten

1

0.15

1

0.09

2

0.11

Others (unspecified)

233

36.0

639

61.3

872

51.6

Total

647

100

1041

100

1688

100

 

Table 3: Geographical points of injuries in children under 5 years

Geographical points

Girls

Boys

Total

n

%

n

%

n

%

Urban

444

68.5

724

69.5

1168

69.0

Villages

83

12.3

139

13.3

222

13.0

Others (unspecified)

119

18.3

176

17.0

301

18.0

Total

647

100

1041

100

1688

100

 

 

DISCUSSION

 

Based on the last census in 2011, Iran’s population was over than 75 million (nearly six millions were under five years old), and about 1,201,565 are living in Qazvin province (little more than 80,000 are under five years old).7 The most causes of injuries in this study were falling, violence, traffic injuries and burns with prevalence rate, 22.2%, 20.0%, 15.0%, respectively. Unfortunately, there is no reliable data about falling and violence distribution, but national and international figures shows that traffic injuries in Iran are higher than the rate estimated for the Eastern Mediterranean countries.5 The rate of road accidents in Iran is twenty times more than the world’s average. In Iran, among all unintentional fatal injuries inflicted on children under five, traffic-related fatalities are the leading cause of death.10 Although some interventions like as legislation, education, and the roads safety enhancement, have been handled.6,8 It is noteworthy that, none of these interventions have been focused on children. Basically, children under five years old are a common high risk population, and some of the traffic injuries reduction intervention must be done on this group. The high rate of falling, violence and traffic injuries in children under five years, suggests a hidden neglect or abuse against children.4,5,8 However, it seems necessary to make some specific interventions to reduce these injuries. Some of these interventions should be oriented toward parents or child’s guardians. Road traffic crashes are predictable and can be prevented. Many countries have achieved sharp reductions in the number of crashes and the frequency and severity of traffic-related injuries by addressing key issues. Interventions that have been proven to be effective include those that deal with: speeding, seat belt, child restraints, helmet, road design and infrastructure, and emergency services.10

Traffic injuries are categorized into pedestrians, car accidents and motorbikes. Each year, road traffic crashes kill nearly 28,000 people in Iran, and injure or disable 300,000 more. Traffic fatalities cost Iran’s economy six billion US dollar every year, which amounts to more than 5% of the country’s Gross National Product.3,10 This study revealed that car accident injuries are obviously more that the other two (Figure 2), so children are the main victims of adults’ car crashes. Most of the children’s injuries take place at homes and on roads (Table 2). It is because of the parental neglect and unsafe environments. Now, some educational programs with respect to increasing children’s safety are in process. There is not a good system to evaluate these interventions’ outcomes, yet doing more study in this field is needed.

 

CONCLUSION

Children are the main victims of adults’ car crashes. Most of the children’s injuries take place at homes and roads. Some educational programs in order to increase children’s safety are in progress. There is not a good system to evaluate these interventions’ outcomes, and as such doing more study in this field is needed.

 

CONFLICT OF INTEREST

The authors declared no conflicts of interest.

 

ACKNOWLEDGEMENT

We would like to thank all individuals who cooperated in this research and helped us to fill out the study. Design and analysis of data, Critical revision of the manuscript and statistical analysis: Kazem Hosseinzadeh. Data interpretation and drafting of the manuscript: Raheleh Sadegh.

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