From the College of Nursing and Department of Community Medicine*, Post Graduate Institute of Medical Education and Research, Chandigarh 160 012, India.

Reprint requests: Dr. Amarjeet Singh, Additional Professor, Community Medicine, P.G.I.M.E.R., Chandigarh 160 012, India.

Manuscript received: September 14, 1999;
Initial review completed: October 13, 1999;
Revision accepted: December 21, 1999

Injuries are world wide health problem in terms of high morbidity and mortality. However, most of the research of childhood injuries in India and abroad has focussed on major and fatal injuries. Non-fatal minor injuries have not been adequately studied(1). Minor injuries are quite common in children because of the range and extent of their activities which expose them to such episodes. It is vital to understand the epidemiology of minor injuries for development of an educational campaign for prevention and proper management of minor injuries. In view of this the present study was conducted to estimate the prevalence and pattern of minor injuries among underfive children of Dadu Majra Colony, Chandigarh.

This survey was conducted by a nursing student (CT) in Dadu Majra Colony, Chandi-garh, the field practice area of College of Nursing, PGI, Chandigarh during January to February, 1997. A sample size of 217 was estimated for the study at 95% level of confidence and 5% level of error. The study was confined to underfive (0-5 year) children. House was taken as the sampling unit. Systematic random sampling was done covering every 10th house out of 2400 houses. Survey of 220 houses yielded the desired sample size. Mothers of the children were asked about history of minor injury (superficial abrasions/contusions) at present or during preceding 15 days. A brief physical examina-tion was also done. A pretested/pilot tested interview schedule was used for the study. Chi-square test and x2 (trend) was used for statistical analysis.

Overall 147 (66.8%) underfives had minor injury during the specified period. The calculated age-specific prevalence rates are shown in Table I. The maximum prevalence was noted in age group 49-60 months. Prevalence of minor injury was the highest among children of illiterate mothers as compared to literate ones (p <0.01). Signifi-cantly more of children from nuclear families (73%) had injury than in joint families (60%) (p <0.05).

Table II shows the site and type of minor injuries. The most common site of injury was head and trunk. Head and trunk had maximum of scratch injuries (53%) followed by abrasion (28%).Upper limb and fingers had maximum of scratch and cut injuries (27% each). Lower limb and toes had maximum of abrasions (67%). Contusions were maximum on head and trunk (p <0.001).

Overall maximum injuries took place at home (62.6%). Majority of injuries were self sustained (60%) and while playing (60.5%). In 33 (22.4%) cases (out of 147) no treatment was taken for minor injuries. Home treatment was taken for 102 (69.4%) cases. A doctor was consulted in 12 (8.1%) cases only. Local wound treatment included washing the wound with water, application of turmeric, mustard oil and facial creams (Table III).

Table I__Age and Sex wise Prevalence of Injury

Figures in parentheses are percentages.

– x² 48.66 d.f. = 5, p <0.001 (for age specific prevalence).

Table II__Site and Type of Injury

* Others include crush, puncture and laceration injuries.

Figures in parentheses indicate percentages of total except under the column total in which they represent percentages of 147.

Present study revealed a prevalence rate of 67% for minor injuries among underfives. Other authors have reported a prevalence of 14.2% (4-9 years age)(2) and, 15.3% (6 month to 6 year age(3). The higher prevalence in our study might have been because of the inclusion of recall (15 days) period. A trend of increasing prevalence of injuries was seen with increasing age particularly among boys. As children grow their range of activities increases. They tend to explore the environment. Many of their activities are potentially dangerous as they can not recognize the possible hazards. With increasing age they learn to stand and walk. They spend more time without their parents around.

In consonance with earlier reports(3,4), maximum injuries were sustained at home in the present study. This is possibly because of the reason that much of the time of underfives is spent at home. Playing is an important activity of a child’s life. In consonance with earlier experience(2), we also found that majority of injuries were sustained while playing.

Fingers were reported(1) as the most common site of minor injuries. In the present study, however, head and trunk were documented as the most common site of injury. A higher prevalence of injuries in nuclear families as compared to joint families may be due to the fact that in nuclear families, the mother is able to spare lesser time for care of the toddler. The injury rate was higher among children of working mothers. The reason could be the lack of supervision during mothers’ working hours. Scheidt et al.(5) stated that the injury occurrence increased when mothers’ education level was higher. In contrast to this, Mittal et al.(4) and the present study observed that as the education level of mothers increased, injury among their children decreased. The findings of the present study indicated the need for a health education program alongwith a training on first aid for the women of child bearing age in this area.

Contributors: CT collected the data, analyzed it and participated in writing the article. IW helped in planning, analyzing and writing the project report. AS planned the study, analyzed the data and drafted the paper; he will act as the guarantor.

Funding: None.

Competing interests: None stated.

1. Singh AJ, Kaur A. Knowledge and practices of urban and rural high school children regarding minor injuries. Indian J Public Health 1995; 39: 23-25.

2. Tandon JN, Kalra A, Kalra K, Sahu SC, Nigam CB, Quereshi GV. Profile of accidents in children. Indian Pediatr 1993; 30: 765-768.

3. Kopjar B, Wickizer T. How safe are day care centres? Day care versus home injuries among children in Norway. Pediatrics 1996; 91: 43-47.

4. Mittal BN, Indrayan A, Sengupta RK, Bagchi SC. Epidemiological triad in domestic accidents. Indian J Med. Res 1975; 63: 1344-1351.

5. Scheidt PC, Harel Y, Trumble AC, Jones DH, Overpeck MD, Bijur P. The epidemiology of non-fatal injuries among US children and youth. Am J Public Health 1995; 85: 932-938.