| Objective:Understanding burden status of unintentional injury of children and adolescent aged 0 to 19 by using the systematic review to merge the indexes in English literature published regarding children and adolescents unintentional injury. In addition, their characteristics and differences of the burden of injuries in childdren and adolescents in different countries and regions. Methods:All data were collected from the literature published during 2002~2012 about unintentional injury of children and adolescent aged 0~19 years old. The databases include Pub Med search literature database, OVID medical full-text database, and Science Direct foreign language database. Evaluate sensitivity and bias of published documents were conducted and the injury burden was analized according to gender, regional, geographical, economic level subgroup after extracting information. Results:1. The total incidence of unintentional injury after merged was 10.30%, and 95% CI was 7.37%~14.23%. The incidence on the number was 41.85%(16.02%~73.09%). Among all types of injury, the incidence ranking from high to low was following: falling incidence was 4.80%(1.57%~13.75%), traffic injuries incidence 1.87%(0.71%~4.86%), burns incidence 0.26%(0.06%~1.19%), poisoning incidence 0.16%(0.02%~1.56%), scratch / bite incidence 0.18%(0.02%~1.30%). Among traffic injuries, incidence of pedestrian injuries was 0.48%(0.09%~2.40%), higher than that of motor vehicle injuries which was 0.05%(0.02%~0.12%).2. Except the poisoning and scratch / bite, all injury types have shown the injury incidence of boys was higher than girls(P < 0.05). Unintentional injury incidence in city was higher than that in countryside(P < 0.05). Especially, burns incidence in countryside was higher than that in city(P < 0.05). Incidence of unintentional injury from high to low was ranking as Europe, Asia, and North America. There were significant differences between continents(P < 0.05); Falling incidence was ranked from high to low was Asia, North America, Europe, which there were significant differences between continents(P < 0.05). Burns incidence was ranked from high to low in turn was South America, Africa, Asia, North America, Europe, Oceania, which there were significant differences between continents(P < 0.05). Incidence of unintentional injury and traffic injuries in high-income countries was higher than that in low and middle-income countries(P < 0.05). Incidence of falling, burns, poisoning and scratch / bites in low and middle-income countries was higher than that in high-income countries(P < 0.05).3. The total unintentional injury mortality was 33.7/105(10.8/105~105.4/105). Injury mortality was ranked from high to low in turn: traffic injuries mortality was 11.4/105(3.1/105~41.5/105), drowning mortality 3.4/105(1.5/105~7.5/105), suffocation mortality 2.1/105(0.9/105~5.2/105), burns mortality 1.2/105(0.9/105~1.6/105), falling mortality 0.6/105(0.2/105~1.4/105) and poisoning mortality 0.6/105(0.2/105~1.4/105). Among traffic injury, motor vehicles injury mortality was 20.0/105(6.9/105~57.8/105), which was much higher than that in the pedestrian mortality which was 2.1/105(0.8/105~5.5/105).4. In addition to poisoning and suffocation, the injury mortality for boys was higher than girls(P < 0.05). Unintentional injury mortality from high to low in turn was ranked as Asia, Europe, North America, which was significant differences between continents(P < 0.05). Traffic injury mortality from high to low in turn was ranked as Asia, Europe(P < 0.05). Falling mortality from high to low in turn was ranked as Europe, North America, Asia, which was significant differences between continents(P < 0.05). Burn mortality from high to low in turn was ranked as North America, Oceania, Asia, which was significant differences between continents(P < 0.05). Poisoning mortality in North America was ranked as higher than Europe(P < 0.05). Drowning mortality from high to low in turn was ranked as Asia, Oceania, North America, Europe, which was significant differences between continents(P < 0.05). Asphyxia mortality in Europe was higher than Oceania(P < 0.05).5. The lowest total cost was $15 400.0, highest was $1 423 000 000.0, the lowest per capita total cost was $210.5, the highest was $53 385.9. The shortest per capita hospitalization days of burns was 1.7d, longest was 19.9d, the shortest total hospitalization days was 164.9d, longest was 27 050.0d; The shortest per capita hospitalization days of traffic injuries was 2.9d, the longest was 6.0d, the shortest total hospitalization days was 272.6d, the longest was 667.0d. The shortest absence days from school caused by unintentional injury per capita was 1.8d, the longest was 21.1d, the shortest total absence days was 30.6d, the longest was 4 268.3d.6. Traffic injury was the most common unintentional injury types, which caused disability adjusted life years and years of potential life lost. Conclusions:1. The highest incidence was falling, the highest mortality rates was the traffic injuries.2. Boys was high-risk population, whose incidence and mortality were all higher than girls in all kinds of injuries. In the view of injury prevention and control, more attention should be paid to boys.3. Unintentional injury incidence in urban area was higher than it in countryside; burn incidence in countryside was higher than it in urban. Due to there were different high unintentional injury types in different regions, prevention should be taken based on local conditions.4. The order of the injury incidence and mortality in different region was not completely consistent, suggesting that the prevention and control of different regional unintentional injury types, not only to reduce the incidence, at the same time, more attention must be paid to the injury types which was high mortality.5. Incidence of traffic injuries in high income countries was higher than that in low and middle-income countries and the other unintentional injuries incidence in low and middle-income countries were all higher than high income countries. The results showed that prevention and control work in different area with their economic levels should be considered by their circumstance.6. It is not allowed to ignore that injury expenses, hospitalization days, days absent due to injury, disability adjusted life years and years of potential life lost in a certain extent reflect the burden of unintentional injury. |
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