Childhood trauma in Owerri (south eastern) Nigeria

Abstract

Background: Childhood trauma is becoming a significant source of morbidity in many developing countries. Understanding the peculiar features of trauma in these areas is invaluable to the development of better preventive and treatment program. We aim to study the pattern and outcome of childhood trauma in southeastern Nigeria.

Methods: Evaluation of 1,642 children managed for trauma at the Federal Medical Centre, Owerri southeast Nigeria from January 1, 1999 to December 31st 2004.

Results: Nine hundred and forty-one children (57.3%) were boys and 701 (42.7%) were girls with a mean age of 8.7 years (range 3 months-15 years). Road traffic accidents (46.7%), falls (17.1%) and assaults (16.1%) were the commonest cause of trauma. The aetiology of trauma differed significantly in the different ages (P < 0.05). Laceration (61.1%), bruises (45.0%) and fractures (21.4%) comprised the predominant type of injury encountered among the children with 997 (60.7%) having multiple injuries. The mean time to hospital presentation was 2.7 days (range 30 minutes to 17 days). Eight hundred and one (48.8%) required admission while 841 (51.2%) were discharged from the emergency unit. Laparotomy (5.3%) and skin grafting (5.0%) were the main operative procedures. There were 41 deaths (2.5%), with 27 (65.9%) of these from severe head injury, 9 (21.9%) from chest injury, 3 (7.3%) from penetrating abdominal injury and 2 (4.9%) from burns. Twenty-nine (70.7%) of the deaths occurred within 96 hours of injury.

Conclusion: There is appreciable variety of childhood trauma in our environment. Delay in presentation is a problem. Mortality can be minimized by preventive measures and improvement of emergency medical services.