Prevalence and factors associated with injuries among children aged 12 years and below admitted to hospitals in Nyeri County, Kenya

Purpose: Injury and violence is a major killer of children throughout the world, responsible for about 950 000 deaths annually, in children and young people under the age of 18 years. The World Health Organization identifies burns, falls, road traffic injuries (RTIs), poisoning and drowning as the major causes of injuries in children. In Kenya, injuries are the 5th leading cause of morbidity among patients attending health facilities while in Nyeri County; they are the 3rd leading cause of mortality among those attending health facilities. The objective of this study was to determine the prevalence, characteristics and factors associated with injuries among children aged 12 years and below admitted in hospitals in Nyeri County.Methodology: A cross-sectional study was conducted from June 2013 to August 2013.Systematic random sampling was used to enrol patients based on hospital monthly inpatient workload. Information on socio-demographic characteristics, clinical characteristics, length of hospital stay, and outcome was collected from parents/guardians using interviewer administered questionnaires. For the patients presenting with injuries, further information on cause and circumstances surrounding the injury was collected. Medical records of all the patients were reviewed to verify clinical and socio-demographic data. Univariate, bivariate and multivariate analyses were performed.Results: Of the 415 patients enrolled into the study, 108 (26%) presented with injuries, with a median age of 39 months (range: 7-144), males being the majority at 67(62%). The leading causes of injuries were burns 41(38%), falls 38(35%), cuts 13(12%) and poisoning 9(8%). Eighty-six (80%) of the injuries occurred at home, 70(65%) during play and 67(62%) in the absence of an adult/care taker. Independent risk factors associated with injuries were; parents spending < 6 hours with the child in a day [AOR=2.6; 95% CI (1.5-4.3)]; age >5years [AOR=2.6; 95% CI (1.4-4.9)]; low SES [AOR=2.5; 95% CI (1.3-4.7)] and previous history of injury [AOR=4.0; 95% CI (1.6-10.1)]. Prevalence of injuries is high among males and patients above 5 years of age. Burns, falls, cuts and poisoning were the leading causes of injuries. Policy recommendation:Based on the result findings, the study recommended that there was need for the facilities and the county to intensify data collection and analysis for action. Local prevention programs should focus on home environment as this is where most of injuries occur. It was further recommended that there was a need to establish an injury surveillance system and repository for injuries, which ideally will be utilized at all the hospitals in the County. The surveillance system could then be used to enhance injury data collection, establish prevention and treatment strategies, and measure outcome.