Article Text

Original research
Child transport injuries and deaths in Lebanon: a multicentre retrospective study
  1. Samar Al-Hajj1,
  2. Sebouh Arjinian2,
  3. Zahraa Hamadeh2,
  4. Elie Al-Zaghrini3,
  5. Khalil El Asmar4
  1. 1Health Management and Policy Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
  2. 2American University of Beirut, Beirut, Lebanon
  3. 3Emergency Medicine Department, Faculty of Medicine, Lebanese American University, Beirut, Lebanon
  4. 4Epidemiology and Population Health Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
  1. Correspondence to Dr Samar Al-Hajj; sh137{at}


Introduction Road traffic injury (RTI) constitutes the leading cause of deaths and disabilities for individuals aged 5–29 years globally. Lebanon suffers from a high toll of transport mortality and morbidity, though accurate and reliable RTI data are limited. The aim of this study is to assess the prevalence and the characteristics of child transport injuries and deaths in Lebanon and to determine their outcomes and associated risk factors.

Methods We conducted a multicentre retrospective study to analyse data on transport injuries and deaths for children aged 0–17 years over a 3-year period (2015–2017). Data were captured from multiple sources, including police reports and the emergency departments of 30 hospitals across the country . We performed logistic regression models to examine the effects and test the association of multiple simultaneous factors on the child injury outcome and severity.

Results A total of 3,033 cases of child transport injuries and 237 fatalities were collected. The majority of the cases were males (73%) (mean (SD) age=11 (±5) years). Transport victims were Lebanese (66.5%) and Syrian refugees (27.9%). The most commonly reported factor contributing to child’s RTI was a child riding in high-speed vehicles (25%) and the most affected body regions were upper and lower extremities (29.9%), followed by head injuries (26.1%). Pedestrians had higher odds of sustaining fatal injuries compared to four-wheel vehicle occupants (OR=1.6; 95% CI: 1.17 to 2.27). Older age groups of 6–14 years (OR=0.51; 95% CI: 0.79 to 0.69) and 15–17 years (OR=0.41; 95% CI: 0.30 to 0.61) had lower odds of dying from transport injuries compared to the younger age group of 0–5 years.

Conclusion Child transport injury is a major public health problem in Lebanon. Findings from this study urge policy-makers and health professionals to implement evidence-based child transport safety policies and behaviour change programs to reduce child transport injuries and deaths.

  • Child Transport Injury
  • Road Traffic Injury
  • Lebanon
  • multicenter retrospective

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  • SA and KEA contributed equally.

  • Contributors SA-H has contributed to the conception, overseeing data collection, cleaning and analysis process, as well as writing, reviewing and editing the manuscript. SA has contributed to the data collection, manuscript writing and data analysis process. ZH has contributed to the data collection, data cleaning process and supported with the initial writing. EA-Z has contributed to the data collection at emergency rooms and initial writing of the manuscript. KEA has contributed to the data analysis and review of methodology and results sections. All authors have read the manuscript and agreed that the work is ready for submission and accept responsibility for its contents.

  • Funding This research was funded by Save the Children International (CON-B-2018-020). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

  • Map disclaimer The depiction of boundaries on this map does not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. This map is provided without any warranty of any kind, either express or implied.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study ethical approval was obtained from the institutional review board of the American University of Beirut (BIO-2018-0459) and from the ethical committee of each participating hospital.

    This manuscript reflects original work that has not previously been published in whole or in part and is not under consideration elsewhere. The authors have read the manuscript and have agreed that the work is ready for submission and accept responsibility for its contents. The authors of this paper have complied with all ethical standards and do not have any conflicts of interest to disclose at the time of submission.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Data compiled from this study will be shared publicly. Hyperlink to the archived dataset will be accessible upon manuscript publication.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.