Paediatric trauma causes, patterns and early intervention at the Muhimbili national hospital emergency department in Dar es Salaam, Tanzania

Trauma remains the leading cause of death and disability in paediatric and adolescent population worldwide, though most of the childhood injury burden rests in low-income and middle-income countries. Many paediatric deaths attributable to trauma are preventable, and morbidity may be greatly reduced by early intervention, but efforts in sub-Saharan Africa are hampered by a lack of regional data to guide interventions. Methods: This was a prospective descriptive cohort study of children under 18 years of age based in the Emergency Department (ED) at Muhimbili National Hospital (MNH) in Dar es Salaam. We used standardized trauma data collection embedded within the clinical chart to assess the mechanism and pattern of injury, and collected follow-up data on interventions performed in the first 24 h after presentation. Results: We enrolled 509 children from August to December 2012, 65.6% male and 34.4% were female. The majority (98.6%) sustained unintentional injuries. 31% of injured children were under the age of 5 years, 28.5% were between 5 and 9 years, and 21.0% were 10–14 years. Motor traffic accident (MTA) was the most common mechanism (40.9%) followed by falls (38.3%) and burns (14.5%). The majority of MTAs (54.3%) were a result of pedestrians struck by vehicles. Fractures and dislocations of upper and lower limbs were the most common injuries (45%) followed by traumatic brain injuries (19%) and burns (14.5%). Only 10% of patients were discharged home from the EMD. Top mechanisms and patterns varied when sub stratified by age quartiles. Conclusion: Childhood injury accounts for a substantial burden of disease at the MNH ED, with MTA being the most common mechanism overall, and with mechanisms and patterns varying by age