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S N Forjuoh

Publications and source records attributed to S N Forjuoh.

At least 37 records · Page 2Linked to original sources
PubMed1997

Estimation of age specific incidence rates of childhood burns from a prevalence survey of burn scars.

OBJECTIVES: This paper describes two methods of estimating the age specific incidence rates of childhood burns from a prevalence survey of burn scars. METHODS: A prevalence survey of burn scars was carried out in 1992 on 15,742 Ghanaian children aged 5 years or less. Nine hundred and fifty five (6.1%) of these children had scars from burn, and for 630 (66%) of these children, additional information about the burn incident, including the child's age at the time of the burn, was obtained from the mother two to three months later. Thirty four per cent of mothers of children with burn scars were not interviewed due to absence, relocation, or inaccessibility. Age specific incidence rates of burns were estimated for eight age groups using two methods. In method I, the number of incident cases of burns for each age group were estimated from the burn scars by subtracting the estimated contribution of scars from burns that had occurred at earlier ages. In method II, the estimate was based on the mother's recall of the age of the child at the time of the burn. RESULTS: Slightly different results were obtained with the two methods, and problems were noted with both methods. CONCLUSION: We recommend the use of these methods for estimating age specific incidence rates from retrospective population surveys for health conditions which result in long term residual markers.

Age Distribution↗
PubMed1996

Burn repetitions in Ghanaian children: prevalence, epidemiological characteristics and socioenvironmental factors.

This paper reports the prevalence, epidemiological characteristics and socioenvironmental-factors for burn repetitions in Ghanaian children newborn to 5 years old using a population-based survey. Mothers of children identified in a survey with burn scars were interviewed to obtain information on each child's demographics and the burn event, among others. Burn repeaters were compared with non-repeaters (children burned just once). Of 630 children identified with burns, 20 (3.2 per cent) had been burned twice. This statistic is significantly lower than expected from the known burn prevalence of 6.1 per cent in the region (P < 0.01). Burn repeaters included nine (45 per cent) children aged 24-35 months, 11 (55 per cent) males, and 9 (45 per cent) rural residents. The mean time interval between repeat burns was 9.6 months. While different mechanisms caused the two burns in 14 children, six were burned by the same mechanism. None of the demographic and socioenvironmental variables examined was significantly associated with burn repetition. It is concluded that since burn repetitions are low and share similar epidemiological characteristics with first-time burns, prevention efforts need not address repeat burns separately from burns in general.

Age Distribution↗
PubMed1996

Injury surveillance: a statewide survey of emergency department data collection practices.

STUDY OBJECTIVE: To assess current emergency department data collection practices in Pennsylvania and determine whether existing data sources can be used as part of a statewide injury surveillance system. METHODS: Separate survey questionnaires requesting information on current ED patient data collection practices and attitudes were mailed to all directors of medical records, billing, and EDs in Pennsylvania (N = 212). RESULTS: Of the medical records department respondents, 92% indicated that ED registration data are retained in a computerized information system; 94% of respondents from billing departments reported that their ED patient registration system is integrated with an ED billing system. A total of 36% of EDs surveyed use a computerized ED patient logbook, and another 27% plan to begin a computerized log within 2 years. Dictation and transcription services that permit electronic retrieval of text are being used by 26% of EDs for patient medical records. CONCLUSION: Many elements for building a statewide ED injury surveillance system are in place in Pennsylvania, but they are as yet incomplete. Future studies should examine the feasibility of integrating existing ED data systems into statewide injury surveillance systems.

Data Collection↗
PubMed1996

A review of successful transport and home injury interventions to guide developing countries.

Injury is recognized as an increasing public health problem in developing countries. Extensive research on injury control has been conducted in the U.S. and other industrialized countries in the past several decades, but research is still in its infancy in developing countries. In this paper, successful interventions for transport and home injuries are reviewed in the context of the developing country setting. The aim is to evaluate injury interventions developed in the industrialized countries and identify those likely to be usable in developing countries. The evaluation criteria used include the efficacy of the interventions, as well as their affordability, feasibility and sustainability. The review demonstrates that while several interventions are available in the field of injury prevention for developing countries to import, caution should be taken in doing this. The use of automobile safety seat belts, bicyclist and motorcyclist helmets, speed limits, laws banning the sale of alcohol at lorry parks, pedestrian crossing signs, adequate roadway lighting, separation of pedestrians from vehicles, conspicuity-enhancement measures, simple safety equipment, and poison prevention packaging should be seriously considered by developing countries to reduce the morbidity and mortality from transport and home injuries. Since injury prevention may often require a blend of several interventions due to the multifactorial nature of the causes of injury, interventions that appear to be most effective are those with multidimensional strategies including education, legislation and environmental modification. This review should serve as a useful guide to injury control efforts in developing countries which must grapple with limited resources and low levels of education.

Accidents, Home↗
PubMed1996

Firearm ownership and storage practices in Pennsylvania homes.

OBJECTIVE: To determine the household prevalence of firearms in Pennsylvania, and describe the storage practices for these weapons. DESIGN: A statewide telephone survey of 3,620 Pennsylvania adults selected from households by random digit dialing in 1994. MAIN OUTCOME MEASURES: Firearm ownership and storage practices were computed by household characteristics using logistic regression. RESULTS: The prevalence of firearm ownership was 37% (95% confidence interval = 35.4 to 38.6). Ownership of firearms was significantly higher for white residents, households with annual income of $20,000 or more, those in rural counties, and those with children and adolescents. Of the households with firearms, 23% contained a single firearm, the majority of which were handguns (40%) or rifles (40%); 76% had two or more firearms, with 57% reporting one handgun or more and 83% reporting one rifle or more. Storage of firearms in 72% of households involved two or more of these barriers: (1) taken apart; (2) trigger lock applied; (3) kept in a locked place; (4) unloaded; (5) no other ammunition; (6) locked ammunition; 6% stored at least one of their firearms with none of these barriers. The strongest predictor of storing a firearm with fewer than two protective barriers was households with no children or adolescents. CONCLUSIONS: Firearms are present in a large number of Pennsylvania homes. Many of these homes also contain children. To reduce the potential risks of firearms, optimal methods of storage of firearms in the home need to be determined.

Adult↗
PubMed1996

Burn-related physical impairments and disabilities in Ghanaian children: prevalence and risk factors.

The prevalence, and risk factors for childhood burn-related physical impairments and disabilities in Ghana were determined with data from mothers of burned children. Of 650 identified burns 113 (174%) resulted in physical impairments, 5 (1%) resulted in physical disabilities. After multivariate adjustment, the odds of developing burn-related physical impairments were increased by burns with protracted healing (odds ratio [OR] = 5.80), burns to the head/neck (OR = 344), burns involving skin removal (OR = 3.04), and wound infection (OR = 2.03) and decreased by first aid (OR = 0.51) and maternal education (OR = 0.54). Education on the proper care of burns may prevent burn-related physical impairments. The results also underscore the link between maternal education and child morbidity.

Age Distribution↗
PubMed1995

Pattern of intentional burns to children in Ghana.

Intentional (inflicted) injury to children through burns has been studied and mentioned extensively in the literature, although much less so in developing countries. A community-based survey of children aged 0-5 years in the Ashanti Region of Ghana found that of 650 childhood burns, 35 (5.4%) were purposefully inflicted. The perpetrators were mostly friends (43%) and siblings (37%) of the victims, and traditional healers (6%) who inflicted these burns to children who were comatose after convulsions. Intentional burns were more likely to be inflicted by flame (OR = 3.87, 95% CI = 1.52-10.0), and contact with a hot object (OR = 1.66, 95% CI = .62-4.44) than through scalding, the most common cause of burns in this region. Other patterns of intentional burns included the absence of any adult, burns covering < 3-5% of body surface area, and increased rate of wound infection. These findings contrast with the pattern of intentional burns seen in other countries, notably developed ones. Even though these inflicted burns were minor, it is important that doctors working in this setting become aware of their presence and that traditional healers and the general public be educated about the appropriate treatment for childhood convulsions.

Burns↗
PubMed1995

Childhood burns in Ghana: epidemiological characteristics and home-based treatment.

The objectives of this research were to study the epidemiological characteristics and home-based treatment of childhood burns in the Ashanti Region of Ghana. Children aged 0-5 years with a burn history were identified through a community-based, multisite survey. A standard questionnaire was administered to mothers of 630 of these children to elicit information on their sociodemographic characteristics and the circumstances of the burn event. Ninety-two per cent of the burns occurred in the home, particularly in the kitchen (51 per cent) and the house yard (36 per cent), with most of them happening in the late morning and around the evening meal. The main causes of the burns were scalds (45 per cent), contact with a hot object (34 per cent) and flame (20 per cent). 'Cool' water was applied to the burned area in 30 per cent of cases. Otherwise, treatment with a traditional preparation was the most popular first-aid choice. Since a considerable proportion of burns happened between meals when children 'play with fire' in the house yard, the provision of alternative play activities and community play areas may reduce the incidence of burns to these children. Secondly, we recommend that education on first-aid management of burns be intensified, with special emphasis on alternatives to the use of traditional preparations.

Age Distribution↗
PubMed1995

Prevalence and age-specific incidence of burns in Ghanaian children.

The incidence of burns in developing countries is not precisely known due to unavailability or incompleteness of death registration and disease reporting. In this study, we determined prevalence and age-specific incidence of burns in children 0-5 years in the Ashanti region of Ghana using burn scars as proxy. We used a community-based, multi-site survey to identify children who had scars as evidence of previous burns. A scar prevalence of 6 per cent was found. No sex differences were found. However, significant differences were found among age groups, with children aged 18-23 months having the highest incidence (57.4 per 1000 person-years). There was evidence of focal occurrence of childhood burns in certain districts, and a higher prevalence in rural areas. We conclude that childhood burns are a significant health problem in Ghana, especially among rural residents and the very young, and recommend that interventions be developed to control them.

Age Factors↗
PubMed1995

Determinants of modern health care use by families after a childhood burn in Ghana.

OBJECTIVES: This study examined determinants of modern health care use by families after their child aged 0-5 years sustained a burn injury in the Ashanti Region of Ghana. METHODS: A community based survey of children aged 0-5 years was conducted in 50 enumeration areas in the region. Mothers of all children with scars as evidence of a burn were selected for a follow up interview using a standard questionnaire two to three months later. Determinants of health care use were investigated through a multivariate logistic regression using interview responses from mothers of 617 children for whom report on some treatment was given. RESULTS: Overall, 48% of the burned children were taken to a modern health facility for treatment. Of those taken to a modern health facility, 68% were sent within 24 hours of the burn event. Factors with large adjusted odds ratios for modern health care use included wound infection, burns covering 6% or more of the body surface, and third degree burns. Compared with scalds, children with contact and flame burns were less likely to be taken to a health facility, as were burns to rural children, and those given first aid treatment at home. CONCLUSIONS: It is concluded that families, particularly rural residents, should be educated about appropriate health care seeking practices after a burn.

Adult↗
PubMed1995

Risk factors for childhood burns: a case-control study of Ghanaian children.

STUDY OBJECTIVE: To study risk factors for childhood burns in order to identify possible preventive strategies. DESIGN: Case-control design with pair matching of controls to cases in relation to age, sex, and area of residence. The cases and controls were identified by a community based, multisite survey. The effects of host and socioenvironmental variables reported by mothers were investigated in a multivariate analysis using conditional logistic regression. SETTING: A developing country setting the Ashanti Region in Ghana. PARTICIPANTS: These comprised 610 cases aged 0-5 years who had been burned (as evidenced by a visible scar) and 610 controls with no burn history. MAIN RESULTS: The presence of a pre-existing impairment in a child was the strongest risk factor in this population (OR = 6.71; 95% CI 2.78, 16.16). Other significant risk factor included: sibling death from a burn (OR = 4.41; 95% CI 1.16, 16.68); history of burn in a sibling (OR = 1.79; 95% CI 1.24, 2.58); and storage of a flammable substance in the home (OR = 1.51; 95% CI 1.03; 2.21). Maternal education had a protective effect against childhood burns, although this effect was not strong (OR = 0.76; 95% CI 0.55, 1.05). CONCLUSIONS: Community programmes to ensure adequate child supervision and general child wellbeing, particularly for those with impairments, as well as parental education about burns are recommended, to reduce childhood burns in this region of Ghana. The public should bed advised against storing flammable substances in the home.

Burns↗
PubMed1993

Case-fatality rates by body part affected and trends in hospitalized burns in Maryland, 1981-90.

This study was undertaken (i) to determine in-hospital case-fatality rates (CFRs) by severity using body part(s) affected as a proxy, and (ii) to examine the trends in hospitalized burns regarding CFRs. The study used the Health Service Cost Review Commission non-confidential Maryland hospital discharge data for the years 1981-90. CFRs were computed as percentages of hospitalized burns that died. Chi-square tests were used to assess homogeneity for categorical variables and to examine linear trends. The CFR for hospitalized burns was 2.9 per cent. CFR was highest among the elderly (13.1 per cent) and for burns affecting multiple specified sites (7.4 per cent), and lowest among children (1.1 per cent) and for upper limb burns (0.22 per cent). Burn CFR increased overall by 59 per cent for 1981-90, with a decreasing rate only in children. However, after controlling for age and degree of burn no significant change in trend in CFRs over the 10-year period was evident. The findings demonstrate that while child burn fatality seems to have declined, the elderly continue to have high CFR for burns regardless of the body part affected, and that the CFRs for hospitalized burns remained constant between 1981 and 1990 in Maryland despite considerable advances in treatment.

Adolescent↗
PubMed1993

Injury surveillance: should it be a concern to developing countries?

Injuries have now become a recognizable public health problem in developing countries. However, no definite policies regarding their surveillance and control are yet available in most of these countries. This paper, using Ghana as a prototype, examines the need for policy and action which has been accentuated in recent times by public outcry. The paper also provides some recommendations to solve this problem: the urgent need to initiate programs such as needs assessment, the establishment of a surveillance system for injuries at various levels of health services, creation of public awareness and provision of health education, and the institution of simple first-aid measures. Specific policies regarding injuries from motor vehicle accidents and fires are also given.

Developing Countries↗
PubMedDate not supplied

Identifying homes with inadequate smoke detector protection from residential fires in Pennsylvania.

With data from the Center for Disease Control's Behavioral Risk Factor Surveillance System, we estimated the prevalence of homes with inadequate smoke detector protection from residential fires in Pennsylvania and identified the characteristics of these homes in an effort to identify useful prevention strategies for Pennsylvania and other regions with similar characteristics. Homes with inadequate smoke detector protection from residential fires were defined on three levels. Eight percent (95% CL = 6.8, 8.6) of homes lacked any installed smoke detectors, 14% (95% CL = 12.8, 15) lacked smoke detectors installed on the same floor where they slept, and 28% (95% CL = 26.6, 29.6) were found to engage in unsafe smoke detector practices. The strong predictors of unsafe smoke detector practices determined from logistic regression included black, non-Hispanic homes (OR = 1.53), homes with annual household income of less than +20,000 (OR = 1.29), and those with no children younger than 5 years old (OR = 1.55). These findings should assist policy makers in planning residential fire prevention programs for Pennsylvania, which has yet to meet the Healthy People 2000 objective regarding fire prevention.

Accidents, Home↗