• Catherine J Bradshaw, Ashwath S Bandi, Zahid Muktar, Muhammad A Hasan, Tanvir K Chowdhury, Tahmina Banu, Mesay Hailemariam, Florence Ngu, David Croaker, Rouma Bankolé, Tunde Sholadoye, Oluwole Olaomi, Emmanuel Ameh, Antonio Di Cesare, Ernesto Leva, Yona Ringo, Lukman Abdur-Rahman, Ramy Salama, Essam Elhalaby, Helen Perera, Christopher Parsons, Stewart Cleeve, Alp Numanoglu, Sebastian Van As, Shilpa Sharma, and Kokila Lakhoo.
• Department of Paediatric Surgery, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford, OX3 9DU, UK. catherinebradshaw@doctors.net.uk.
• World J Surg. 2018 Jun 1; 42 (6): 1885-1894.

ObjectivesTrauma is a significant cause of morbidity and mortality worldwide. The literature on paediatric trauma epidemiology in low- and middle-income countries (LMICs) is limited. This study aims to gather epidemiological data on paediatric trauma.MethodsThis is a multicentre prospective cohort study of paediatric trauma admissions, over 1 month, from 15 paediatric surgery centres in 11 countries. Epidemiology, mechanism of injury, injuries sustained, management, morbidity and mortality data were recorded. Statistical analysis compared LMICs and high-income countries (HICs).ResultsThere were 1377 paediatric trauma admissions over 31 days; 1295 admissions across ten LMIC centres and 84 admissions across five HIC centres. Median number of admissions per centre was 15 in HICs and 43 in LMICs. Mean age was 7 years, and 62% were boys. Common mechanisms included road traffic accidents (41%), falls (41%) and interpersonal violence (11%). Frequent injuries were lacerations, fractures, head injuries and burns. Intra-abdominal and intra-thoracic injuries accounted for 3 and 2% of injuries. The mechanisms and injuries sustained differed significantly between HICs and LMICs. Median length of stay was 1 day and 19% required an operative intervention; this did not differ significantly between HICs and LMICs. No mortality and morbidity was reported from HICs. In LMICs, in-hospital morbidity was 4.0% and mortality was 0.8%.ConclusionThe spectrum of paediatric trauma varies significantly, with different injury mechanisms and patterns in LMICs. Healthcare structure, access to paediatric surgery and trauma prevention strategies may account for these differences. Trauma registries are needed in LMICs for future research and to inform local policy.

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