Incidence of childhood injuries and modifiable household risk factors in rural Ghana: a multistage, cluster-randomised, population-based, household survey. Issue 7 (23rd July 2021)

• Record Type: Journal Article
• Authors: Gyedu, Adam; Stewart, Barclay T; Otupiri, Easmon; Mehta, Kajal; Donkor, Peter; Mock, Charles
• Is Part Of: BMJ open. Volume 11:Issue 7(2021)
• Publication Date: 2021-07-23
• Subjects: non-accidental injury -- epidemiology -- preventive medicine -- accident & emergency medicine; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2020-039243
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objective: We aimed to describe the incidence of childhood household injuries and prevalence of modifiable household risk factors in rural Ghana to inform prevention initiatives. Setting: 357 randomly selected households in rural Ghana. Participants: Caregivers of children aged <5 years. Primary and secondary outcome measures: Childhood injuries that occurred within 6 months and 200 metres of the home that resulted in missed school/work, hospitalisation and/or death. Sampling weights were applied, injuries were described and multilevel regression was used to identify risk factors. Results: Caregivers from 357 households had a mean age of 35 years (SD 12.8) and often supervised ≥2 children (51%). Households typically used biomass fuels (84%) on a cookstove outside the home (79%). Cookstoves were commonly <1 metre of the ground (95%). Weighted incidence of childhood injury was 542 per 1000 child-years. Falls (37%), lacerations (24%), burns (12%) and violence (12%) were common mechanisms. There were differences in mechanism across age groups (p<0.01), but no gender differences (p=0.25). Presence of older children in the home (OR 0.15, 95% CI 0.09 to 0.24; adjusted OR (aOR) 0.26, 95% CI 0.13 to 0.54) and cooking outside the home (OR 0.28, 95% CI 0.19 to 0.42; aOR 0.25, 95% CI 0.13 to 0.49) were protective against injury, but other common modifiable risk factors (eg, stove height, fuel type, secured cabinets) were not. Conclusions: Childhood injuries occurred frequently in rural Ghana. Several common modifiable household risk factors were not associated with an increase in household injuries. Presence of older children was a protective factor, suggesting that efforts to improve supervision of younger children might be effective prevention strategies.