Incidence of childhood injuries and modifiable household risk factors in rural Ghana: a multistage, cluster-randomised, population-based, household survey.
OBJECTIVE
We aimed to describe the incidence of childhood household injuries and prevalence of modifiable household risk factors in rural Ghana to inform prevention initiatives.


SETTING
357 randomly selected households in rural Ghana.


PARTICIPANTS
Caregivers of children aged <5 years.


PRIMARY AND SECONDARY OUTCOME MEASURES
Childhood injuries that occurred within 6 months and 200 metres of the home that resulted in missed school/work, hospitalisation and/or death. Sampling weights were applied, injuries were described and multilevel regression was used to identify risk factors.


RESULTS
Caregivers from 357 households had a mean age of 35 years (SD 12.8) and often supervised ≥2 children (51%). Households typically used biomass fuels (84%) on a cookstove outside the home (79%). Cookstoves were commonly <1 metre of the ground (95%). Weighted incidence of childhood injury was 542 per 1000 child-years. Falls (37%), lacerations (24%), burns (12%) and violence (12%) were common mechanisms. There were differences in mechanism across age groups (p<0.01), but no gender differences (p=0.25). Presence of older children in the home (OR 0.15, 95% CI 0.09 to 0.24; adjusted OR (aOR) 0.26, 95% CI 0.13 to 0.54) and cooking outside the home (OR 0.28, 95% CI 0.19 to 0.42; aOR 0.25, 95% CI 0.13 to 0.49) were protective against injury, but other common modifiable risk factors (eg, stove height, fuel type, secured cabinets) were not.


CONCLUSIONS
Childhood injuries occurred frequently in rural Ghana. Several common modifiable household risk factors were not associated with an increase in household injuries. Presence of older children was a protective factor, suggesting that efforts to improve supervision of younger children might be effective prevention strategies.
['Gyedu|Adam|A|', 'Stewart|Barclay T|BT|0000-0002-8099-9218', 'Otupiri|Easmon|E|', 'Mehta|Kajal|K|', 'Donkor|Peter|P|', 'Mock|Charles|C|']
D000293:Adolescent D000328:Adult D002648:Child D005191:Family Characteristics D005869:Ghana D006801:Humans D015994:Incidence D012307:Risk Factors D012424:Rural Population
accident & emergency medicine epidemiology non-accidental injury preventive medicine