Study On Status And Risk Factors Of Unintentional Injuries Among Students In Primary School In Rural Areas Of Yunnan Province

Background:Injury has been increasingly becoming a serious public health problem either in developed countries or developing countries. Especially children and adolescents have become a high-risk group of injury, and harms caused by injury are much higher than other groups.Objectives:To investigate occurrence and epidemiological characteristics of unintentionally injury among pupils in rural areas, analyze main risk factors for occurrence of unintentioally injury, and provide evidences for intervention programs and relevant policy recommendations in Yunnan Province.Methods:With informed consent,cross-sectional survey and case-control study were used in the study.1) Cross-sectional survey:using multistage strati-fied cluster random sampling method, the fifth and sixth grade students have been enrolled to survey with a self edited questionnaire of accident in nine pr-imary schools in Luliang County, Yunnan Province. It mainly Investigated the situation of accident injury, the level of knowledge and belief, and satisfaction of life in the period from November 30,2014 to December 1,2015.2)Case-control study:from the survey 365 pupils with accidental injury were obtained as the case group and the control group was completely random matched in accordan-ce with the same age, grade, school and household registration. Primary risk factors of unintentional injuries were further analyzed. Qualitative investigation was conducted indepth interviews to relevant staff from local education depart-ment and diseasecontrol department.with individuals.Descriptive analysis,variance analysis,chi-square test and COX regression model were performed using SPSS 17.0 statistical software package.Results:1) Status and epidemiological characteristics of unintentional injuries in primary school students.1) Incidence of unintentional injuries:There were 335 students injured out of 1631 students, the incidence rate of injury was 20.5%; 674 injury cases occurred, of which 427 male students and 247 female students; Boys injury incidence (23.7%) were higher than girls (17%)(x2=11.27, P=0.001); students in urban (26.1%) were higher than that in rural (18.6%) (x2=10.56, P=0.001); commuting students (21.4%) were higher than resident students (15.3%) (x2=4.26, P=0.039); and the left-behind children (25.5%) were higher than the non left-behind children (18.8%) (x2=8.54, P=0.003).2) The epidemiological characteristics of unintentional injuries:there are some seasonal and time distribution, the highest in summer and the lowest in winter, mainly occurred in noon and afternoon; Place distribution mainly found in home, school and on the road;The main types of activities related to their injuries were recreational and sports activities and walking, which mainly caused by their own, students and animals; Injurys among primary school students were mainly unintentional injuries and intentional injury accounted for only 1.2%; The main types of injuries were falls or drops, collision and bite; The injured part was mainly on the upper and lower limbs; The nature of the injury mainly in superficial injury, followed by open wound and dislocation or strain or sprain; The main treatment methods were as follows:the hospital outpatient service, self or other treatment, not treatment, and the need for hospitalization accounted for 9.3%; Economic burden of injury:47.5%of primary school students needed to rest for 1 days or more,62.8%of the medical costs have been generated; Recovery after injury: 12.6%of primary school students’activity with, functional limitation or disabilily.2) Injury KAP level:Average score of risk behaviors was 40.50±10.26. The risk was higher, especially in the animal related behavior, swimming behavior and motor behavior. The average score of injury knowledge was 83.33± 16.67, and the cognitive level was higher, but the correct rate was low for the knowledge of burn and scald, earthquake emergency knowledge, bicycle knowledge and so on.3) Life satisfaction: the average life satisfaction score was 145.2±24.32, the overall satisfaction was in the middle level. "Friends", "school" and "family environment" 3 factors in, injury group were lower than that in non injury group(P<0.05).4) Factors of injury:Risk factors include:left-behind children(OR=2.309,95%(CI):1.290-4.134), dangerous behavior (OR=1.159,95%(CI):1.116-1.204) protective factors:injury knowledge (OR=0.927,95%(CI):0.897-0.958) satisfaction (OR=0.983,95%(CI):0.971-0.994).Conclusions:The overall situation of injury among students is not optimistic, and it has increasingly become a public health and social problem that seriously harms health of pupils.The knowledge of injury is not comprehensive. Injury risk behaviors exist in a higher degree for campus security, but unintentional injuries among pupils have certain characteristics. Regularity, staying, injury risk behaviors, cognitive impairment and life satisfaction are important factors. Thus, it can be carried out, the concrete and feasible intervention strategies for better injury prevention and control and to provide the corresponding processing.Suggestions:Prevention and control of unintentional injuries among pupils is a systematic engineering which involve comprehensive action from governm-ent departments,schools,communities,families,students,and professional institutions. Improving laws and regulations;formation of multisectoral linkage mechanism; integration of resources and advantages of the multilevel subjects and multifom intervention are necessary for carrying out pupils accidental injury prevention and control, monitoring, disposal, and keeping it as routine work.