Elsevier

Public Health

Volume 120, Issue 7, July 2006, Pages 641-649
Public Health

Original Research
Unintentional injuries among school adolescents in Kathmandu, Nepal: A descriptive study

https://doi.org/10.1016/j.puhe.2006.01.012Get rights and content

Summary

Objective

To describe detailed mechanisms and activities at the time of unintentional injuries among adolescents in Kathmandu, Nepal.

Methods

A school-based study was conducted on 1557 students in grades 6–8 across 14 schools, using a self-administered questionnaire during August–September 2003. Mechanisms and activities were coded using the Nordic Medico Statistical Committee's classification.

Findings

Falls (65%) and cuts (63%) were the most common injuries, followed by transport-related injuries (36%) and burns (22%). In urban areas, falls (59%) were the most common injuries, followed by transport-related injuries (50%); in semi-urban areas, falls (66%) and cuts (65%) were the most common injuries, followed by transport-related injuries (34%). At the time of falls, boys were generally engaged in sports while girls were engaged in walking on streets or on stairs in houses, in both areas. Falls from trees among boys and falls from roofs among girls were also common in semi-urban areas. Cut injuries while processing food were common among boys and girls in both areas, whereas agricultural work was also a source of injury in semi-urban areas. Pedestrian injuries were common during transport among boys and girls in both areas; boys in semi-urban areas were almost equally likely to be injured during cycling. Burn injuries while cooking and serving food were more common among girls in semi-urban areas.

Conclusion

Falls, cuts, transport-related injuries, and burn injuries were quite prevalent among adolescents in Kathmandu. The reported injury mechanisms and activities posing injury risks have implications for future interventions.

Introduction

Unintentional injuries are the leading causes of the death and disease burden globally, with a disproportionate number occurring in developing countries.1 These countries accounted for more than 95% of global deaths from unintentional injuries among children aged 5–14 years and 93% among young people aged 15–29.1 Despite such a situation, previous research in developing countries has been largely limited to hospital-based information, which provides information on severe injuries2, 3, 4, 5, 6 without considering accessibility, affordability, or preference for health services. People seldom receive hospital care for their injuries due to lack of money7 and consult with traditional healers and pharmacists based on their preference, even in places where hospital treatment is available.8, 9

A few community-based studies, taking account of the large numbers of injuries not reported in hospitals, have reported that falls, cuts, transport-related, and burn injuries are common;10, 11, 12, 13 but did not elaborate more precisely on the circumstances under, which these injuries occurred. We investigated the detailed mechanisms and activities at the time of common unintentional injuries among adolescents in Kathmandu. Such information is useful in designing specific prevention interventions.

Section snippets

Study site

We conducted a school-based cross-sectional study on students of 14 schools located in urban and semi-urban areas of Kathmandu (2001 population 1,081,845) and Lalitpur (2001 population 337,785) districts in the Kathmandu valley. Three of the 75 districts in Nepal are located in the Kathmandu valley. The survey was conducted between August 31 and September 15, 2003, as part of an on-going school health program of World Vision Nepal, an international non-governmental organization that has been

Results

The mean age of the 1557 participants was 13.8 years (Standard deviation [SD]=1.3) (Table 1). Most of their families owned a television and resided in semi-urban areas. The majority of their fathers were literate and engaged in informal work. The majority of their mothers were illiterate and housewives.

The socio-demographic characteristics of urban and semi-urban participants were similar except in the case of the mothers' education and occupations. The proportion of mothers who were illiterate

Discussion

Our study indicated differences in mechanisms or activities at the time of injury incidents on the basis of gender and area using the NOMESCO classification of external causes of injury, which previous community-based studies could not completely investigate.

Boys were more likely to receive fall injuries while playing or walking, whereas for girls injuries occurred more often while walking on the street or on indoor stairs than while playing. This is possibly because boys are culturally

Acknowledgements

This study was conducted as part of the activities of World Vision. International Nepal. We gratefully acknowledge Trihadi Saptoadi, National director and kurian James, operation manager of World Vision International Nepal, for their support and co-operation to conduct this study. We would like to thank Ram Babu Koirala and ASHA Nepal staff, for their fieldwork arrangement and data collection. The authors wish to thank the project staff, schoolteachers, study participants and their parents for

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