title: Gunshot injuries in infants and children in KwaZulu-Natal--an emerging epidemic?
abstract: OBJECTIVE
  To determine the pattern of firearm injuries in children under the age of 13 years admitted to a paediatric surgical unit in KwaZulu-Natal and to assess the impact of such injuries on hospital resources.
  
  
  METHODS
  Retrospective review of the Department of Paediatric Surgery and hospital databases for all gunshot admissions, 1983-1995 inclusive.
  
  
  METHODS
  King Edward VIII Hospital, Durban.
  
  
  METHODS
  Children aged 12 years and under admitted to the care of the Department of Paediatric Surgery for management of gunshot injuries.
  
  
  METHODS
  Data retrieved included demographic details, circumstances of injury, duration of hospital stay, management and outcome in terms of mortality and long-term morbidity.
  
  
  RESULTS
  One hundred and six patients were identified, of whom 96 were available for review. There has been a rapid escalation of numbers presenting. During 1994-1995, an additional 38 children with gunshot injuries were admitted to other units within Durban academic hospitals. The mean age of injury in patients admitted to the Department of Paediatric Surgery was 6.4 years and the abdomen was the most frequently injured area. Multiple injuries were common. The in-hospital mortality rate was 10.4%. Major morbidity, including paraplegia, hemiplegia, amputation and major peripheral nerve deficit, was seen in 11.4%. Duration of bed occupancy in the general surgical ward reached 247 days in 1995.
  
  
  CONCLUSIONS
  There is an increasing incidence of gunshot injuries in this region. Of children surviving to reach hospital, 10% die and 11% are left with lifelong major morbidity. Most victims are innocent bystanders and too young to be considered active participants. Prevention will require sociopolitical stability and the disarming of the community.
authors.affiliation: Department of Paediatric Surgery, University of Natal, Durban.
authors.forename: G P
authors.initials: GP
authors.lastname: Hadley
authors.forename: M
authors.initials: M
authors.lastname: Mars
mesh_terms: D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012737:Sex Factors; D013019:South Africa / Q000453:epidemiology; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000191:economics / Q000453:epidemiology* / Q000601:surgery