Part I How childrenare injured 1.Introduction Injury is a major killer of children and adolescents throughout the world,responsible for over 875 000 deaths in children and young people under the age of 18 years each year(1).Tens of millions more require hospital care for non-fatal injuries,many of whom are left with some form of disability,which all too often has lifelong consequences. The burden of injury is unequal in that it falls most heavily on the poor,that is to say,the burden is greatest Child and adolescent injury deaths on children and adolescents in the poorer countries of Injury deathsa Injury death rate the world and within any given country,on those from (of all (per100000 low-income families.Overall,more than 95%of all injury deaths) population) deaths in children and adolescents occur in low-and High-income countries 41 7.7 middle-income countries.Although the child injury death Low-and middle-income rate is much lower among children and adolescents countries 13 37.2 from high-income countries,injuries are still a major cause of death,accounting for about 40%of all child aData refer to persons aged 1-14 years. Source:WHO Global Burden of Disease project,2002,version 5 and adolescent deaths in these countries (see facing table). Disconcertingly,as data collection systems improve,it has become increasingly LEADING CAUSES OF obvious that both the absolute numbers and rates of child and adolescent injury and OLESCEUS AED ONE death are rising in the low-and middle-income countries,in tandem with growing levels TO 15 YEARS,2002,by rank of urbanization and motorization.The combination of increasing incidence and recent successes in reducing other causes of death,particularly infectious disease,means Lower respiratory infections that the significance of injury is growing such that it now figures prominently among the Childhood cluster diseases list of leading causes of death in children and adolescents(see chart). Diarrhoeal diseases These trends can,however,be reversed.The experience of many high-income HIV/AIDS countries shows that through careful analysis and appropriate action,child and Malaria adolescent injuries can be prevented.Among the member countries of the Organisation Road traffic可juries for Economic Co-operation and Development(OECD),for example,the number of Drowning injury deaths among children under the age of 15 years fell by half between 1970 and Perinatal conditions 1995(2).This reduction has been attributed to a combination of research,data system development,the introduction of specific prevention measures,changes in the local Protein-energy malnutrition environment,legislation,public education,improvements in the level and quality of Congential anomalies 10 emergency assistance and trauma care,and project evaluation.Regrettably,until Fire-related burns 11 relatively recently,little or no attention has been paid to the issue of injuries in the low- Tuberculosis and middle-income countries.The lack of awareness and understanding of the problem Meningitis and given the particular circumstances that these countries face-has meant that appropriate interventions for injury prevention have not been implemented to the same Leukaemia extent as they have been in the high-income countries. Poisonings 1





























































































           
                                                                           
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