ROAD TRAFFIC INJURIES AMONGST PAEDIATRIC PATIENTS PRESENTING AT THE MUHIMBILI ORTHOPAEDIC INSTITUTE, TANZANIA

Abstract

Background: Motor traffic injuries are very common worldwide and account for a major cause of morbidity and mortality among patients including children. In Africa, road fatality rates account for 24.1 deaths per 100,000 population. Studies have shown that a quarter (25.3%) involved children in a study done in Uganda.
The objective of this study was to determine the pattern of injuries and their management among pediatric patients involved in motor traffic crashes attended at Muhimbili orthopedic institute.
Material and methods: A descriptive cross-sectional study was done at Muhimbili Orthopedic Institute from August 2018 to April 2019. The study included all road traffic injuries among children below 18 years. Participants were enrolled at the emergency medicine department and standard structured questionnaire was used to collect information. Variables included age, sex, residence, type of collision, day and time of injury, injury setting, protective gear usage, and type of motor vehicle. The filled in questionnaires were checked for quality, coded and then analyzed. Frequency distributions were used to describe categorical variables and mean and standard deviation for continuous variables. Kruskal Wallis and Mann Whitney tests were used to test the association between the duration of hospital stay and socio-demographics as well as other characteristics of victims. Post-hoc tests were performed using
Dunn’s pairwise comparisons to determine groups which had significantly
different duration of hospital stay in each factor. Bonferroni adjustment was applied to correct the p-value for multiple tests by multiplying the p-value by the number of tests performed. P-value of <0.05 was considered significant.
Results: A total of 186 patients were included in this study. The Mean age was 9.7 years and 55.9% of them were males. Motorcycles were responsible for almost three fifth of the road traffic crashes. Overall, 72.6% of them were involved in motor traffic crash as pedestrians. Two thirds of the pediatric patients arrived at the Emergency Department within 24 hours post-injury and 64.5% of them were brought by ambulance. Head and musculoskeletal injuries (extremities) were the most frequent body region injured accounting for 55.4 % and 23.7 % respectively.
Conclusion: Motorcycle accidents are still a significant problem as once again this was shown to be the most common cause of pediatric trauma. Majority of the pediatric trauma involved them as pedestrians. Head and extremity injuries were the most common injuries seen.