Unintentional Injuries Requiring Medical Attention in Low-Income and Middle-Income Countries: Evidence from Nationally Representative surveys in 12 Countries.

Abstract

Background: Despite a high burden of injuries in low-income and middle-income countries (LMICs), a lack of empirical evidence on mechanism, location, and distribution of unintentional injuries requiring medical attention (hereafter injuries) hinders informed health system policy development.

Methods: Using individual-level data from nationally representative surveys conducted in LMICs between 2014-2019, we describe the weighted annual prevalence of non-fatal injuries, their mechanisms, environments in which they occur, and characteristics of people injured, in individuals aged 15-64 years. Multivariable logistic regression models were estimated to evaluate associations of injuries with individual-level characteristics.

Results: We included data on 47,747 participants from 12 LMICs in four WHO regions. The weighted prevalence of non-fatal injuries in the past year was 6.8% (95% CI: 6.3%-7.2%); men suffered a greater prevalence of injuries than women (8.3% [95% CI 7.6%-9.0%] vs. 5.4% [95% CI 5.0%-5.9%], respectively). In the multivariable logistic regression, the odds of having any injury were lower among females and married people and higher among individuals with some primary education. Prevalence of non-road traffic collision injuries was almost threefold that of road traffic collision (RTC) injuries: 5.6% (5.2%-6.0%) vs. 1.7% (1.5%-2.0%). When considering non-RTC injuries, falls were the most common mechanism (47.0%, 95% CI 44.0%-50.1%), and homes were the most common location (38.1%, 95% CI 34.9%-41.4%), followed by road (17.9%, 95% CI 15.7%-20.4%), and workplace (17.4%, 95% CI 15.2%-19.8%). The largest proportion (23.2%, [95% CI 20.6%-25.9%]) of non-RTC injuries happened to women at home.

Conclusion: Non-RTC injuries, in particular falls, predominate in this population. This highlights a neglected side of injuries, many of which happen at home to women, whereas global attention tends to focus on RTCs. Data on all mechanisms of injuries and care-seeking behaviour after injuries are required for health system planning.