title: Childhood and adolescent injuries in elementary schools in north-western Uganda: extent, risk and associated factors.
abstract: Childhood injuries remain understudied in Uganda. The objective of this study was to determine the extent, nature and determinants of school-related childhood injury risk in north-western Uganda. A cohort of 1000 grade fives from 13 elementary schools was followed-up for one term. Survival and multi-level modelling techniques compared the risk rates across gender, schools and locations. Childhood injuries are common in north-western Uganda. Most of them occur during travel, breaks, practical classes and gardening, while walking, playing, learning and digging. Most injuries result from collisions with objects, sports and falls. Two-thirds of children receive first aid and hospital care. Times to injury were 72.1 and 192.9 person days (p = 0.0000). Gender differences in time to event were significant (p = 0.0091). Girls had better survival rates: cumulative prevalence of childhood injury was 36.1%; with significant gender differences (p = 0.007). Injury rate was 12.3/1000 person days, with a hazard ratio of 1.4. Compared to girls, boys had a 37% higher injury rate (p = 0.004). Rates varied among schools. Associated factors include sex and school. Rural-urban location and school differences do influence childhood injury risk. Childhood injuries are common: the risk is high, gender- and school-specific. Determinants include gender and school. Location and school contexts influence injury risk.
authors.affiliation: Pincer Group International Ltd, PO Box 72455, Kampala, 256, Uganda. mmutto@pincergroup.org
authors.forename: Milton
authors.initials: M
authors.lastname: Mutto
authors.forename: Stephen
authors.initials: S
authors.lastname: Lawoko
authors.forename: Emilio
authors.initials: E
authors.lastname: Ovuga
authors.forename: Leif
authors.initials: L
authors.lastname: Svanstrom
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D012424:Rural Population; D012574:Schools / Q000706:statistics & numerical data*; D017678:Sex Distribution; D016019:Survival Analysis; D014454:Uganda / Q000453:epidemiology; D014505:Urban Population; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology