|Year : 2012 | Volume
| Issue : 1 | Page : 49-52
Physical injury: A profile among the municipal primary school children of Siliguri, Darjeeling District
Kuntala Ray1, Sharmistha Bhattacherjee2, Fasihul Akbar3, Romy Biswas4, Ritam Banerjee5, Manasi Chakraborty6
1 Assistant Professor, Department of Community Medicine, North Bengal Medical College, West Bengal, India
2 Demonstrator, Department of Community Medicine, Institute of Post Graduate Medical Education & Research, Kolkata, India
3 Demonstrator, Department of Community Medicine, Calcutta National Medical College, Kolkata, India
4 Associate Professor, Department of Community Medicine, North Bengal Medical College, West Bengal, India
5 Demonstrator, Department of Biochemistry, Burdwan Medical College, West Bengal, India
6 Professor & Head, Department of Community Medicine, North Bengal Medical College, West Bengal, India
|Date of Web Publication||6-Jun-2012|
Assistant Professor, Department of Community Medicine, North Bengal Medical College, Darjeeling, West Bengal - 734 012
Source of Support: None, Conflict of Interest: None
| Abstract|| |
A cross sectional study was conducted from February - May 2009 with the objectives to find out profile of injuries among municipal primary school children in Siliguri, West Bengal and to identify the related factor associated with injury. 20% of total primary schools under municipal corporation of the town were selected and a pre-designed, pre-tested schedule was used to assess the profile of injury and associated factors. The Chi square test was usedto determine statistical significance at the 0.05 significance level. Out of 956 participants, a significantly higher injury was observed among males (68%). Open wound injuries were commonest (59.6%) occurring mainly at the extremities. Falls were mainly responsible for overall injuries. Injury at home (41.8%) was also found to be more. Mother education, number of siblings and presence of caregiver were significant related factors to injury.
Keywords: Physical injury, Primary school children, Health seeking behaviour
|How to cite this article:|
Ray K, Bhattacherjee S, Akbar F, Biswas R, Banerjee R, Chakraborty M. Physical injury: A profile among the municipal primary school children of Siliguri, Darjeeling District. Indian J Public Health 2012;56:49-52
|How to cite this URL:|
Ray K, Bhattacherjee S, Akbar F, Biswas R, Banerjee R, Chakraborty M. Physical injury: A profile among the municipal primary school children of Siliguri, Darjeeling District. Indian J Public Health [serial online] 2012 [cited 2020 Feb 28];56:49-52. Available from: http://www.ijph.in/text.asp?2012/56/1/49/96972
Children are a restless lot; a rapidly changing life styles and increasing motorization, relative softness of tissue and body parts of children and their psychological characteristics like impulsiveness, curiosity, experimentation, lack of knowledge on judgment of distance / speed, low level of concentration make them vulnerable for injuries. They move from a phase of protected environment and traveling to state of independent travel along with an urge to take risks, which makes them more prone to all types of injury. Worldwide, approximately 5 million persons died as a result of an injury in 2000; - mortality rate of 83.7 per 100000 populations and accounted for 9% of the world's deaths in 2000 and 12% of the world's burden of disease. 
According to a report from the United Nations children's fund, childhood injury declined by 50% in high income countries between 1970-95, unfortunately, several reports from low income countries have shown the opposite trend. South- East Asia (SEA) alone contributes to 31% of world burden and 27% of injury related mortality.  The surveillance system to monitor the occurrence of childhood injuries is poor in India. Though the data from hospital and emergency department are available, they are not an ideal source to study epidemiological features of childhood injuries owing to their poor quality. Therefore, considering the depth of this issue, the present study was conducted to find out the profile of injuries among municipal primary school children; and to identify the related factor associated with injury.
A cross-sectional, epidemiological study was conducted in Siliguri for 4 month from February - May 2009. Among total 34 primary schools, run under Siliguri Municipal Corporation, 20% (7 out of 34) schools were selected randomly, considering feasibility and logistics. All the children studying in class I-IV in those schools were considered as study population.
The injury was operationally defined as any type of unintentional damage to any part of the body, and classified according to exposure and severity as 'superficial wound' (bruise and abrasion), 'open wound' (incised wound and laceration), fracture and burn. The causes of injuries were due to fall, collision with other children, road traffic accident (RTA), during helping at home on the basis of detailed history as described by the mother or by other caregiver. 'Fall' includes fall from a height, from building, during sport etc. The 'occurrence of injury' at any point of time is independent of the previous event, and every event was mutually exclusive and taken as a new event. Information about all injuries, which took place among study subject since last 6 month, was collected. All minor and major injuries, serious enough to be reported by the mother or caregiver, were included.
Approval from Ethics Committee of North Bengal Medical College and permission of concerned school authorities were obtained. The school authorities were intimated about the date and time of the visit and were requested to ensure the presence of the parents at the time of the survey. All the children accompanying their parents or caregiver were included in this study; therefore, the total study population was 956. The case definition of injury was discussed in details with the participants to ensure uniform reporting. Children who had suffered from any intentional injuries or who were absent at the time of visit were excluded from the study. Only self-reported unintentional injury was taken into consideration.
A second visit was done to decrease absentees. Relevant information about the type, site, cause of each episode of injury were entered in a pre-tested, pre-designed, semi-structured schedule, along with other related information like number of sibling, education of the mother/caregiver etc. Treatment cards and absentee statement of school register were cross-checked. For each event, the initial medical help sought, was taken into consideration. 'First aid' includes folk medicine, home treatment with antiseptic, medicine purchased over the counter, and 'treatment at health facilities' includes both public and private institutions. Association between occurrence of injury and related factors were examined using the Chi-square test.
Total number of children participated in this study were 956 out of 1165. They were between 5-12 years of age; and response rate was 82%. There were 590 (61.7%) girls and 366 (38.3%) boys, with the mean age of all the children 7.18 ± 1.48 yrs. Among the 956 students, 564 injury events were identified according to case definition. The prevalence of unintentional injury among the study population was 58.9%. It was higher in boys (68%) than in girls (53%). Highest prevalence of injury was observed in 11-12 yrs age group.
The commonest type of injury was open wound, which accounted for 59.6% of all injuries. Extremities were the most common site to be injured (55.3%). More than one site was affected in only 2.7% of the injuries. More than 41% of the students experienced injuries at home, followed by 31.6% on road. While considering the cause of injury, it was found that fall (39.5%) was responsible for most of the cases, followed by collision; both of these occurred mostly during sports and other playing activities [Table 1].
Mothers' education, number of siblings and absence of caregiver at the time of injuries were found to be significantly related to injury [Table 2].
|Table 2: Factors associated with occurrence of injuries in the study population N = 956|
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It was revealed that 44.5% of injuries were managed by first-aid care. The commonest place of first-aid was either at home or at traditional practitioners (36.9%) and 7.6% were managed at school. Registered medical practitioner and hospitals managed 55.5% of the cases.
In the present study, injury rate was highest among the children aged more than 10 years, which was similar to the finding of Vazirinejad et al. and Sibamani et al., The overall occurrence of injury was higher in boys than  in girls that are consistent with the findings of Singapore injury statistics and Kamel et al. This might be due to more risk taking behavior among the boys along with their age.
In this study, among the different types of injuries, open wound injuries were found to be the commonest [Table 1]. This finding corroborated with the study, conducted on global childhood unintentional injury surveillance in 4 cities, in developing countries.  In the present study, extremities were found to be the most common site of injury. On the contrary, according to a study conducted in Australia, the most frequent site of injury was head.  This may be due to difference in classification.
'Fall' was the most common cause of injury in our study, which is similar to the findings of Kamel et. al. 'Fall' followed by collision with other children, which was found in this study, was consistent with the findings in the study by Vazirinejad et al. Almost 42% of injuries occurred inside the home, which was similar to the finding of a study in Damascus.  Childhood injury incidence depended on socio-demographic factors. The effect of the socio-demographic factors varied between injury mechanisms and products involved in the injury. Presence of caregiver did not prevent the occurrence of injury, which suggests the need of educating the caregiver for close supervision of child at home. This present study showed that the risk ratio of 0.73 for children with literate mothers compared to those who were illiterate and 0.95 (1.4-1.6) for children in families with the lowest vs. highest income, which was consistent with the finding of Laursen et al.  In this study, the occurrence of injury in presence of caregiver was less in contrary to the results of the above study. This might be due to the fact that this present study included injuries occurring both places, at home and outside. As the injuries are common in the daily lives of thousands of school children, a proactive attitude coupled with intensive research on the causes, prevention, and better on-site management would impact immensely on the health status of school-goers.
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[Table 1], [Table 2]