Epidemiology of pediatric injury in Malawi: Burden of disease and implications for prevention

AbstractPurposePediatric injuries pose a significant health burden in sub-Saharan Africa, though historic data are too scarce to appreciate the extent of the problem. The purpose of this study is to utilize a comprehensive database to describe the epidemiology of pediatric injuries at a tertiary hospital in Malawi.MethodsData were prospectively collected on patients presenting to the emergency department for treatment of injuries from 2008 to 2010 (n = 23,625). The subset of pediatric patients (n = 7233) underwent cross-sectional analysis to examine demographics, injury environment, timing and mechanisms.ResultsPediatric patients, (0–16 years) comprised 30.6% of all trauma patients. Mean age was 7.2 years. Falls were the most common injury (43%), followed by burns (11.1%), pedestrian road traffic injuries (9.7%), foreign bodies (7.5%), and assaults (7.2%). Statistically significant differences in injury pattern were observed between gender, age groups and season. After logistic regression, predictors of fall included male gender, home setting, and rainy season, whereas predictors of burn included female gender, age 0–5 yrs, home setting, and cold season. Predictors of pedestrian injury included age 6–10 yrs, female, and roadside setting. Predictors of foreign body ingestion included age 0–5 yrs, female gender, home setting, and daytime, and predictors of assault include male gender, age 11–16 yrs, nighttime hours. All predictors were statistically significant (p < 0.05).ConclusionsThis study revealed patterns of injury based upon age, gender, location, and season. Our results may prove useful to stakeholders in injury prevention for designing, evaluating, and implementing programs to improve public safety in children in Malawi and similar resource poor nations

An observational study addressing the anatomic basis of mesosigmoidopexy as a rational treatment of non-gangrenous sigmoid volvulus

Sigmoid volvulus is a common cause of bowel obstruction.We describe mesosigmoidopexy, an accepted surgical technique for the management of non-gangrenous sigmoid volvulus, and provide anatomic correlations supporting the therapy. Mesosigmoidopexy should be considered as a rational alternative to resection and anastomosis when operating on non-gangrenous sigmoid volvulus

Hospital-based injury data in Malawi: strategies for data collection and feasibility of trauma scoring tools

Injury is a major cause of morbidity and mortality in developing countries. Utilizing a partnership between Kamuzu Central Hospital (KCH) and the University of North Carolina Departments of Surgery, we describe an approach to injury surveillance, examine the utility of trauma scoring systems, and outline steps necessary before such scoring systems can be reliably instituted in a resource-constrained setting

Epidemiology of Injuries at a Tertiary Care Center in Malawi

Injury surveillance is an ongoing process required for primary, secondary, and tertiary injury prevention. In Malawi, hospital-based injury data are not available

Ward Round - Paediatric bowel obstruction: A surprising and rare cause of a common problem

A four year old boy presented to Kamuzu Central Hospital for evaluation of five days of progressive nausea, vomiting, and obstipation. History was obtained from the child and mother. For several months prior to presentation he suffered from abdominal discomfort and distension, without diarrhoea, constipation, fevers, chills, or weight loss

An observational study addressing the anatomic basis of mesosigmoidopexy as a rational treatment of non-gangrenous sigmoid volvulus

Sigmoid volvulus is a common cause of bowel obstruction.We describe mesosigmoidopexy, an accepted surgical technique for the management of non-gangrenous sigmoid volvulus, and provide anatomic correlations supporting the therapy. Mesosigmoidopexy should be considered as a rational alternative to resection and anastomosis when operating on non-gangrenous sigmoid volvulus