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    ABSTRACT: During the fi rst week of 2009 a number of children were treated in the Trauma Unit at the Red Cross War Memorial Children's Hospital in Cape Town. A 2-year-old girl visiting from the province fell in front of a bus while her mother was being robbed of a cell phone in one of the suburbs. The bus could not avoid the little girl, crushed her and killed her. A 6-yearold girl travelling back from the city to her home with her family was severely injured when someone threw a brick at the front windscreen of the car, breaking it and instantly killing the driver, after which the car left the road and all the passengers were seriously injured. Three children were electrocuted when their homes, which were disconnected by the municipality because of nonpayment, and were illegally rewired, leaving live wires exposed and killing the children. Another 6-year-old girl was hit by a stray bullet in a gang fight. Although all these deaths are quite different in nature, a similar pattern is recognizable. Adults, in active chase for their own gratifi cation are injuring children lethally in the process. It is unlikely that in any of these cases the children were directly targeted, however, they died while adults were pursuing their own criminal interests. A study performed a few years ago at the Red Cross Children's Hospital indicated that of all children presenting with head injuries after abuse, almost 50% of them were injured when adults were fi ghting with each other.
    World Journal of Pediatrics 11/2010; 6(4):293-5. DOI:10.1007/s12519-010-0229-5 · 1.05 Impact Factor
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    ABSTRACT: Childhood trauma is one of the major health problems in the world. Although pediatric trauma is a global phenomenon in low- and middle-income countries, sub-Saharan countries are disproportionally affected. We reviewed the available literature relevant to pediatric trauma in Africa using the MEDLINE database, local libraries, and personal contacts. A critical review of all cited sources was performed with an emphasis on the progress made over the past decades as well as the ongoing challenges in the prevention and management of childhood trauma. After discussing the epidemiology and spectrum of pediatric trauma, we focus on the way forward to reduce the burden of childhood injuries and improve the management and outcome of injured children in Africa.
    Seminars in Pediatric Surgery 05/2012; 21(2):111-5. DOI:10.1053/j.sempedsurg.2012.01.003 · 2.22 Impact Factor
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    ABSTRACT: IntroductionThoracic injuries continue to be a leading cause of childhood trauma, despite the government's efforts to curb the scourge of this problem. Our review focuses on the incidence, etiology, and management of thoracic trauma in the pediatric population with reference to the recent experience at our institution in a developing country. Methods For the literature review, the National Library of Medicine's PubMed database was searched for the following terms: pediatric, chest trauma, hemothorax, hemopneumothorax, pneumothorax, diaphragmatic, esophageal, and mediastinal injury. For the hospital data analysis, data of all 378 pediatric patients treated with thoracic injuries under the age of 13 years from 2008 to 2012 (a 5-year period), at the Red Cross War Memorial Children's Hospital, were retrospectively analyzed. ResultsThe male to female ratio was 2.1:1 (255 males and 123 females). The mean age was 6.92.3 years. Blunt chest trauma was responsible for chest injuries in 90.5%, while penetrating trauma caused 9.5% of the injuries. Road traffic crashes were the mean cause (48.9%) with pedestrian injuries in 72.4% and passenger injuries in 27.6%, respectively. Sports injuries were the cause in 4% and falls from a height in 22%. Most injuries occurred at home: inside one's own home (5%), outside one's own home (52%); inside someone else's home (44%); outside someone else's home (2%). Public space injuries occurred at schools or creches in 77%, pavement or roads in 6%, and were not specified in 17%. Overall 74% presented with injuries of the thoracic cage; rib fractures occurred in 13%, chest wall contusions in 40%, and abrasions in 31%. Respiratory system injuries occurred in 22%; hemothoraces in 23%, pneumothoraces in 45%, and hemopneumothoraces in 29%. Cardiovascular injuries occurred in 16% of cases with vascular injuries in five patients (two firearms injuries and three motor vehicle crashes). Management was nonoperative in 79.4%, tube thoracotomy in 17.2%, and open surgery in 3.4%. The mortality rate was 1.3%, all contributed by firearm-related injuries and polytrauma. Conclusion Thoracic trauma has remained a significant cause of morbidity and mortality in the pediatric population. Concerted effort from governments, civil societies, and the medical profession are needed to address this challenge.
    European Journal of Pediatric Surgery 12/2013; 23(6). DOI:10.1055/s-0033-1363160 · 0.99 Impact Factor