title: Epidemiology of pediatric injury in Malawi: burden of disease and implications for prevention.
abstract: OBJECTIVE
  Pediatric 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.
  
  
  METHODS
  Data 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.
  
  
  RESULTS
  Pediatric 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).
  
  
  CONCLUSIONS
  This 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.
authors.affiliation: Department of Surgery, University of North Carolina, Chapel Hill, 27514-7228, USA. michelle_kiser@med.unc.edu
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Kiser
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Samuel
authors.forename: Sean E
authors.initials: SE
authors.lastname: Mclean
authors.forename: Arturo P
authors.initials: AP
authors.lastname: Muyco
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Cairns
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Charles
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008295:Malawi / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D012621:Seasons; D014947:Wounds and Injuries / Q000453:epidemiology*