Lower incidence of unintentional injury with older age in children in China? A meta-analysis

Abstract

Objective: The aim of this study was to identify the relationship between children’s age and the incidence of unintentional injuries, and giving some basic data on the guidance for the prevention of unintentional injuries in children aged 0 to 18 years in China.

Methods: The literatures on the incidence of unintentional injury in children included in China from 2008 to 2018 were analyzed by meta-analysis method. The data were retrieved according to the guidance of Cochrane Systematic review. A meta-analysis was carried out on homogeneous studies, and then subgroup analysis was conducted according to age group. Publication bias was also evaluated. Stata software (version 15.0) and SPSS software (version 18.0) were used to analyze the gathered information.

Results: A total of 3,303 related pieces of literature were reviewed. Of the 37 that met the inclusion criteria. The meta-analysis showed that total sample size were 77,023, and the pooled incidence of unintentional injury is 20%, 95%CI (17%-23%), (p <.001). Subgroup analysis showed the following results: the incidence are 15%, 23%, 20% and 20% for aged in “0-2”, “3-5”, “6-11”, “12-18” subgroups, respectively. However, the trend of decreased incidence of unintentional injury with older age in children was not significant.

Conclusion: The pooled incidence of unintentional injuries in children is high. Based on accessible literature, the incidence between different age subgroup were not statistically significant. We should pay attention to the incidence of unintentional injuries in children of all age subgroups.

Keywords

Children / Meta-analysis / Unintentional injuries

References

[1] Sminkey L. World report on child injury prevention. Injury prevention: Journal of the International Society for Child and Adolescent Injury Prevention. 2008; 14(1): 69. PMid:18245322. https://doi.org/10.1136/ip.2007.018143

[2] Xu T, Gong L, Wang H, et al. Epidemiology of unintentional injuries among children under six years old in floating and residential population in four communities in Beijing: a comparative study. Maternal and Child Health Journal. 2014; 18(4): 911-919. PMid:23793489. https://doi.org/10.1007/s10995-013-1318-6

[3] Alptekin F, Uskun E, Kisioglu AN, et al. Unintentional non-fatal home-related injuries in Central Anatolia, Turkey: frequencies, characteristics, and outcomes. Injury. 2008; 39(5): 535-546. PMid:17582412. https://doi.org/10.1016/j.injury.2007.02.042

[4] Halfon N, Hochstein M. Life course health development: an integrated framework for developing health, policy, and research. The Milbank Quarterly. 2002; 80(3): 433-479. https://doi.org/10.1111/1468-0009.00019

[5] Su B, Yu J. Meta-analysis of the Unintentional Death of Children Aged 0 to 5 Years in China Between 1995 and 2015. Pediatric Emergency Care. 2017; 0(0): 1-6. PMid:28221278.

[6] Tang K, Jian L, Qin Z, et al. Characteristics of burn patients at a major burn center in Shanghai. Burns: Journal of the International Society for Burn Injuries. 2006; 32(8): 1037-1043. PMid:17011133. https://doi.org/10.1016/j.burns.2006.03.021

[7] WHO Guidelines Approved by the Guidelines Review Committee. In: Peden M, Oyegbite K, Ozanne-Smith J, Hyder AA, Branche C, Rahman A, et al., editors. World Report on Child Injury Prevention. Geneva: World Health Organization; 2008.

[8] Ren YQ, Cui Y, Zhang YC, et al. Epidemiological of unintentional injuries in children: analysis of 192 cases treated in pediatric in yensive care unit. China Journal of Emergency Resuscitation and Disaster Medicine. 2015; 10(2): 104-107.

[9] Wei YH, Wang DH, Jing QL, et al. Epidemiological analysis of primary students unintentional injury in Guangzhou area. Journal of Medical Pest Control. 2014; 30(07): 711-714.

[10] Loney PL, Chambers LW, Bennett KJ, et al. Critical appraisal of the health research literature: prevalence or incidence of a health problem. Chronic Diseases in Canada. 1998; 19(4): 170-176. PMid:10029513.

[11] Liu Y. Prevention of Infant Accidental Injury. Chinese Practical Journal of Rural Doctor. 2014; 21(1): 22-24.

[12] Ablewhite J, McDaid L, Hawkins A, et al. Approaches used by parents to keep their children safe at home: a qualitative study to explore the perspectives of parents with children aged under five years. BMC Public Health. 2015; 29(15): 983. PMid:26419449. https://doi.org/10.1186/s12889-015-2252-x

[13] Schwebel DC, Gaines J. Pediatric unintentional injury: behavioral risk factors and implications for prevention. Journal of Developmental and Behavioral Pediatrics: JDBP. 2007; 28(3): 245-254. PMid:17565295. https://doi.org/10.1097/01.DBP.0000268561.80204.2a

[14] Zen CJ, Luo Q. Retrospective investigation on factors influencing accidental injury to city students. Chinese Journal of Healthy Birth & Child Care. 2008; 14(1): 35-38.

[15] Yang HJ, Liu J, Zhang YH. Analysis and prevention of accidental injury in children. Chinese Jounral of Hospital Statistic. 2008; 15(3): 249-250.

[16] Han NH. Epidemiological investigation on accidental injury of Children in Chancheng District of Foshan City. Chinese Journal of Misdiagnosis. 2008; 8(4): 1000-1001.

[17] Guo YL, Wang MB, Chen YY. Epidemiological Investigation of Children Accidental Injuries in Yantai City. Occupy and Health. 2008; 24(1): 55-56.

[18] Liu FY. Epidemiological investigation on Children’s accidental injury in Youjiang District of Baise City. Acta Medicinae Sinica. 2009; 22(1): 64-65.

[19] He GL, Liu Y, Wu XJ, et al. Investigation on the unexpected injury in children age 1 to 14 years in Zhenjiang. Modern Preventive Medicine. 2009; 36(16): 3012-3013, 3016.

[20] Li L. Analysis of temperament and behavior characteristics in preschool children who were unintentional injured in urban of Jinan. Chinese Journal of Child Health Care. 2009; 17(4): 396-397.

[21] Shen M, Yang S, Han J, et al. Non-fatal injury rates among the “left-behind children” of rural China. Injury prevention: journal of the International Society for Child and Adolescent Injury Prevention. 2009; 15(4): 244-247. PMid:19651997. https://doi.org/10.1136/ip.2008.019869

[22] Li SH, Yu YY, Tang ZR, et al. Cross-sectional Study on Injury Among Rural Children in Pucheng. Chinese Journal of School Health. 2009; 30(12): 1118-1120.

[23] Chen D. Investigation on accident injury of Primary School students in Xinzhuang Town Minhang District and Analysis of its harm factors. World Health Digest Medical Periodical. 2011; 8(22): 133-136.

[24] Zhang C, Sun LH, Zeng LX, et al. Investigation on the unintentional injuries among rural children in Shaanxi province. Zhong Hua Liu Xing Bing Xue Za Zhi. 2011; 32(12): 1221-1223. PMid:22336604.

[25] Wang P, Wei L, Tan XY, et al. Analysis of Epidemiological feature of unintentional injuries in Primary and Middle School students of Liuzhou. Modern Preventive Medicine. 2011; 38(3): 401-403,408.

[26] Xu T, Zhang R, Liang Y, et al. Epidemiological study on unintentional injuries among migrant children under six years old in four communities in Beijing. Chinese Journal of Healthy Birth & Child Care. 2011; 19(8): 704-706.

[27] Jiang W, Huang HX, Wei JL, et al. Epidemiological investigation on unintentional injuries of left-behind children in rural area of Nanning. Maternal & Child Health Care of China. 2011; 26(4): 563-565.

[28] Jiang W, Pan CH, Liu W, et al. Epidemiological study on accidental injuries among preschool children in Nanning. Chinese Journal of Child Health Care. 2011; 19(1): 24-26.

[29] Chen Y, Zhu ZP, Wu YC, et al. Surveillance of injury in primary and middle school students in Guangming New District of Shenzhen City. Chinese Journal of School Doctor. 2011; 25(9): 670-672.

[30] Pan FZ. Investigation and Analysis on accidental injury of Preschool Children in Kindergarten. Zhejiang Journal of Traumatic Surgery. 2012; 17(4): 526-527.

[31] Li GC, Yang GM. Investigation and Analysis on accidental injury of Children under six years of age in Jiucun Village, Sanxiang, Luquan County. Medicine and Pharmacy of Yunnan. 2013; 34(1): 60-61.

[32] Jia GZ, Song LD, Xu TH, et al. Study on epidemiological characteristics and influencing factors of unintentional injuries among rural children in Dongming county, Hezecity. Chinese Journal of Child Health Care. 2014; 22(4): 423-426.

[33] Shao QJ, Sun X. Investigation and analysis of accidental injuries among junior middle school and children in some counties of Henan Province. Hanan Medical Research. 2014; 23(9): 144-147.

[34] Shi XQ, Qi YH, Shi D, et al. Features and risk factors of nonfatal injury among the rural children: a survey of seven schools in a mountain area in Southwest China. PloS One. 2014; 9(7): e102099.

[35] Qiu XY, Yu JF, Zheng Q. Study on family environment of unintentional family injuries among infants in Wenzhou city. Maternal & Child Health Care of China. 2014; 29(7): 1039-1042.

[36] Xiang B, Ding YP, Zhu CC, et al. Analysis on epidemiological characteristics of injuries among school-age girls in rural areas of Hanchan. Modern Preventive Medicine. 2015; 31(10): 1327-1329.

[37] Dang FM, Gong XM, Hu PC, et al. Epidemiological characteristics and risk factors for unintentional injury among primary and junior middle school students in rural areas of Liling, Hunan Province, China. Practical Preventive Medicine. 2015; 22(11): 1336-1338.

[38] Zhang GZ, Ma JF, Yao XM. Research of Risk Factors for Accidental Injuries in Preschool Children of Urumqi City. China Health Industry. 2015; (4): 7-8.

[39] Liu HL, Yang L, Feng Q, et al. Epidemiological characteristics and risk factors of the unintentional injuries among migrant children aged 3-6 years old in Guangzhou. Chinese Journal of Child Health Car. 2015; 23(4): 419-421.

[40] Mao P, He W, Cao HM, et al. Study of epidemiological features on unintentional injuries of left-behind rural preschoolers in Hunan Province. China Journal of Modern Medicine. 2015; 25(9): 77-80.

[41] Yang YL, Xue L, Cui LH, et al. Investigation and analysis of accidental injury of 3-6 years old rural children in Zibo County. Chinese Journal of Child Health Care. 2014; 32(1): 93-95.

[42] Zhang Y, Zeng Y, Peng Y. An investigation on injury and parents’ knowledge, belief and behavior of the 6-year-old Children in Yuzhong District of Chongqing. Journal of Chronic Diseases. 2015; (3): 281-286.

[43] Peng ZH, Wang H, Shi YP, et al. Study on prevalence and household-environmental factors of child injury in kindergartens of Shenzhen city. Maternal & Child Health Care of China. 2015; 30(36): 6569-6571.

[44] Xiao DQ, Wei QW, Zhang CH, et al. Investigation on the status of injuries among 2564 migrant children aged 2-16 years old. Chinese Journal of Disease Control & Prevention. 2016; 20(7): 675-678.

[45] Cao FM, Zhang X, Yu YM, et al. Investigation and Analysis on the status of accidental injury and related knowledge and belief in boarding Middle School students. Chinese Journal of School Doctor. 2016; 30(9): 652-653.

[46] Sheng JH. Study on accident injury and risk factors of Primary School students in Luliang County, Yunnan Province [Master]: Kunming Medical University. 2016; 3(4): 125-127.

[47] Huang Y, Li XM, Tang M, et al. Influencing Factors of Unintentional Injuries among the Left-behind Children in a Poverty County in Yunnan Province. Journal of Kunming Medical University. 2016; 37(12): 37-40.

[48] Zhu J, Long LH, Cao SH, et al. Epidemiological study on unintentional injuries in children aged 0-6 years in Shaoguan District. China Modern Medicine. 2017; 24(29): 137-139.

[49] Li FJ, Wu YX, Yang YL, et al. Epidemiological investigation of accidental injuries among pupils in Zibo City. Chinese Journal of School Doctor. 2018; 32(1): 39-41.

[50] He FN, Xie WJ, Wu JC, et al. Incidence and influencing factors of accidental injuries in preschool children in Jiujiang. South China Journal of Preventive Medicine. 2018; 44(1): 7-11.