Falls among children in the developing world: A gap in child health burden estimations?

Aim: To estimate the incidence and mortality rates for unintentional fall injuries in children under 5 years of age in three developing regions of the world. Methods: This is a systematic review of literature on unintentional childhood fall injuries. A computerized PUBMED search of literature published between 1980 and 2006 was conducted and a manual search of journals was also completed. Results: Over 140 000 injuries to children under 19 years were reported in 56 studies (21 from Asia, 20 from Africa and 15 from South America); on an average 36% of injuries (52 575) were due to falls. The median incidence is estimated at 137.5 fall injuries per 100 000 children. The incidence of falls specific to the under-5 age group was reported in 16 studies with a median incidence of 40.6 falls per 100 000. The overall average incidence rate for childhood falls is highest in South America at 1315 followed by Asia at 1036 and Africa at 786 per 100 000, respectively. Average mortality rates were highest for Asia at 27 followed by Africa at 13.2 per 100 000, respectively. Conclusion: This review demonstrates that the burden of falls on children has not been well documented, and is most likely under-reported. With the large and growing population of children in developing countries, the public health implications of the observed results are tremendous. Appropriate prevention relies on accurate statistics.