Citation

Carlson LC, Lafta R, Al-Shatari S, Stewart BT, Burnham G, Kushner AL. Surgery 2016; 160(2): 493-500.

Affiliation

Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Surgeons OverSeas (SOS), New York, NY. Electronic address: akushne1@jhu.edu.

Copyright

(Copyright © 2016, Elsevier Publishing)

DOI

10.1016/j.surg.2016.03.022

PMID

27155907

Abstract

BACKGROUND: Injury disproportionately affects low- and middle-income countries, and in Iraq, this risk has been compounded by conflict and insecurity since the Coalition invasion in 2003. Children in such settings are particularly vulnerable; yet, the epidemiology of pediatric injury during conflict has not been previously described. This study aimed to characterize the pattern and outcomes of pediatric injury in Baghdad, Iraq from 2003-2014.

METHODS: We conducted a cluster-randomized, cross-sectional, community-based survey in Baghdad in 2014 to determine the epidemiology and impact of injuries since 2003. This study details the injury patterns and outcomes among children (ie, <18 years of age) as well as care sought and provided.

RESULTS: A total of 900 households, which represented 5,148 persons, were surveyed. There were 152 pediatric injuries from 2003-2014 (28% of all injuries). The incidence of childhood injury during the study period was 6.5 per 1,000 life years. The most common cause of injury was fall (52 injuries; 34% of pediatric injuries) followed by road traffic crash (32; 22%). Fifteen percent of pediatric injuries were directly related to conflict (22 injuries). There were 10 reported deaths (7% of pediatric injuries).

CONCLUSION: Although falls and road traffic crashes were the most common causes of childhood injury, conflict was directly responsible for 1 in 6 injuries. The number of pediatric injuries that resulted in death far exceeded that of low- and middle-income countries unaffected by conflict. These findings reflect the importance of pediatric injury prevention, protection of vulnerable populations, and essential trauma care during conflict.

Copyright © 2016 Elsevier Inc. All rights reserved.

Language: en