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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/15156

Title: Comparison of childhood household injuries and risk factors between urban and rural communities in Ghana: A cluster-randomized, population-based, survey to inform injury prevention research and programming
Authors: Stewart, Barclay
Gyedu, Adam
Otupiri, Easmon
Nakua, Emmanuel
Boakye, Godfred
Mehta, Kajal
Donkor, Peter
Mock, Charles
Keywords: Injury
Issue Date: Apr-2021
Publisher: Injury 52 (2021) 1757–1765
Citation: Injury 52 (2021) 1757–1765
Abstract: Background: Childhood household injuries incur a major proportion of the global disease burden, par- ticularly in low- and middle-income countries (LMICs). However, household injury hazards are differen- tially distributed across developed environments. Therefore, we aimed to compare incidence of childhood household injuries and prevalence of risk factors between communities in urban and rural Ghana to in- form prevention initiatives. Methods: Data from urban and a rural cluster-randomized, population-based surveys of caregivers of children < 5 years in Ghana were combined. In both studies, caregivers were interviewed about childhood injuries that occurred within the past 6 months and 200 meters of the home that resulted in missed school/work, hospitalization, and/or death. Sampling weights were applied, injuries and incidence rate ratios (IRRs) were described, and multi-level regression was used to identify and compare risk factors. Results: We sampled 200 urban and 357 rural households that represented 20,575 children in Asawase and 14,032 children in Amakom, Ghana, respectively. There were 143 and 351 injuries in our urban and rural samples, which equated to 594 and 542 injuries per 1,0 0 0 child-years, respectively (IRR 1.09, 95%CI 1.05-1.14). Toddler-aged children had the highest odds of injury both urban and rural communities (OR 3.77 vs 3.17, 95%CI 1.34-10.55 vs 1.86-5.42 compared to infants, respectively). Urban children were more commonly injured by falling (IRR 1.50, 95%CI 1.41-1.60), but less commonly injured by flame/hot sub- stances (IRR 0.51, 95%CI 0.44-0.59), violence (IRR 0.41, 95%CI 0.36-0.48), or motor vehicle (IRR 0.50, 95%CI 0.39-0.63). Rural households that cooked outside of the home (OR 0.36, 95%CI 0.22-0.60) and that also supervised older children (OR 0.33, 95%CI 0.17-0.62) had lower odds of childhood injuries than those that did not. Conclusions: Childhood injuries were similarly common in both urban and rural Ghana, but with differ- ent patterns of mechanisms and risk factors that must be taken into account when planning prevention strategies. However, the data suggest that several interventions could be effective, including: community- based, multi-strategy initiatives (e.g., home hazard reduction, provision of safety equipment, establishing community creches); traffic calming interventions in rural community clusters; and passive injury surveil- lance systems that collect data to inform violence and broader prevention strategies
Description: This article is published by Injury is also available at https://doi.org/10.1016/j.injury.2021.04.050
URI: 10.1016/j.injury.2021.04.050
Appears in Collections:College of Health Sciences

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