Browsing by Author "Svanstrom, Leif"

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    Childhood and adolescent injuries in elementary schools in north-western Uganda: extent, risk and associated factors
    (International journal of injury control and safety promotion, 2012) Lawokob, Stephen Emilio Ovugac and Leif Svanstromb; Mutto, Milton; Lawoko, Stephen; Ovuga, Emilio; Svanstrom, Leif
    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 (p¼0.0000). Gender differences in time to event were significant (p¼0.0091). Girls had better survival rates: cumulative prevalence of childhood injury was 36.1%; with significant gender differences (p¼0.007). 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 (p¼0.004). 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.
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    Intentional injuries among Ugandan youth: a trauma registry analysis
    (Injury Prevention, 2010) Mutto, Milton; Lett, Ronald; Lawoko, Stephen; Nansamba, Catherine; Svanstrom, Leif
    To determine intentional injury burden, incident characteristics, and outcomes among Ugandan youth. Methods A cross sectional analysis of trauma registry data from accident and emergency units of five regional referral hospitals was conducted. Data had been prospectively collected from all patients accessing injury care at the five sites between July 2004 and June 2005: youth records were analysed. Results Intentional injuries among youth victims, especially school-age males, are common in all five regions, constituting 7.3% of their injury burden with a male dominance. Intentional youth victimisation mainly occurred at home, on roads, and in public places; incidents were largely due to blunt force, stabs/cuts, and gunshots in general, although variations in causes were evident depending on age. Intentional injuries among the youth victims often manifested as head, neck, and face injuries: 2% were severe and there were 4%case fatalities at 2 weeks. Conclusions and recommendations Intentional injuries among youth victims, especially school-age males, are important contributors of injury burden in all five sites. Homes, roads, and public places are unsafe for Ugandan youth. Although guns were used in all five sites, less lethal mechanisms (blunt force, stabs/cuts, and burns) are the most common with variations between locations. Incidents involving teenage housewives could reflect underlying problem of domestic violence. Community based studies could be highly informative. Youth should be prioritised for prevention of injuries both in and out of school.
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    Unintentional childhood injury patterns, odds, and outcomes in Kampala City: an analysis of surveillance data from the National Pediatric Emergency Unit
    (Journal of injury and violence research, 2011) Mutto, Milton; Lawoko, Stephen; Nansamba, Catherine; Ovuga, Emilio; Svanstrom, Leif
    Unintentional Childhood Injuries pose a major public health challenge in Africa and Uganda. Previous estimates of the problem may have underestimated the childhood problem. We set to determine unintentional childhood injury pattern, odds, and outcomes at the National Paediatric Emergency unit in Kampala city using surveillance data. Methods: Incident proportions, odds and proportional rates were calculated and used to determine unintentional injury patterns across childhood (1-12 years). Results: A total of 556 cases recorded between January and May 2008 were analyzed: majority had been transported to hospital by mothers using mini-buses, private cars, and motorcycles. Median distance from injury location to hospital was 5 km. Homes, roads, and schools were leading injury locations. Males constituted 60% of the cases. Play and daily living activities were commonest injury time activities. Falls, burns and traffic accounted for 70.5% of unintentional childhood injuries. Burns, open wounds, fractures were commonest injury types. Motorcycles, buses and passenger-cars caused most crashes. Play grounds, furniture, stairs and trees were commonest source of falls. Most burn injuries were caused by liquids, fires and hot objects. 43.8% of cases were admitted. 30% were discharged without disability; 10%, were disabled; 1%, died. Injury odds and proportional incidence rates varied with age, place and cause. Poisoning and drowning were rare. Local pediatric injury priorities should include home, road and school safety. Conclusions: Unintentional injuries are common causes of hospital visit by children under 13 years especially boys. Homes, roads and educational facilities are commonest unintentional injury sites. Significant age and gender differences exist in intentional injury causation, characteristics and outcomes. In its current form, our surveillance system seems inefficient in capturing poisoning and drowning. The local prevention priorities could include home, road and school safety; especially dissemination and uptake of proven interventions. Burns should be focus of domestic injury prevention among under-fives. Commercial passenger motorcycles require better regulation and control.