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 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 5  |  Issue : 4  |  Page : 215-219

Prevalence and pattern of domestic injuries in rural area of Tamil Nadu


1 Department of Community Medicine, Chennai Medical College Hospital and Research Centre, Tiruchirappalli, Tamil Nadu, India
2 Department of Community Medicine, Government Theni Medical College, Theni, Tamil Nadu, India

Date of Web Publication15-Nov-2016

Correspondence Address:
Dr. Hemalatha Kumarasamy
Department of Community Medicine, Chennai Medical College Hospital and Research Centre, Tiruchirappalli - 621 105, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-344X.194084

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  Abstract 

Background: Domestic injuries contribute a major proportion in the prevalence of injuries. Although domestic injuries lead to significant morbidity and mortality, most of these injuries are under recognized. Methodology: Community-based cross-sectional study was conducted among 200 households. A structured questionnaire was used to collect information on the injuries that occurred in previous 6 months, and the results were analyzed using SPSS version 20. Results: The prevalence of domestic injury was 4.8% among 839 individuals interviewed. The majority of the injuries occurred among males, and all injuries were unintentional in nature. Forty-two percent of the injuries occurred in hand which was the most common site. More than 50% of the injuries occurred due to handling of sharps, and 62.5% of injuries were mild in nature. No domestic injury-related deaths had occurred. Conclusions: Majority of the domestic injuries occurred due to handling of sharps. Careful handling of sharps, preventing handling of sharps by children would help reducing the occurrence of domestic injuries in this community.

Keywords: Domestic injury, pattern, prevention, rural community


How to cite this article:
Kumarasamy H, Prabhakar V R. Prevalence and pattern of domestic injuries in rural area of Tamil Nadu. Int J Health Allied Sci 2016;5:215-9

How to cite this URL:
Kumarasamy H, Prabhakar V R. Prevalence and pattern of domestic injuries in rural area of Tamil Nadu. Int J Health Allied Sci [serial online] 2016 [cited 2021 Sep 27];5:215-9. Available from: https://www.ijhas.in/text.asp?2016/5/4/215/194084


  Introduction Top


Injuries have a significant impact on the disease burden worldwide. Globally injury accounts for 10% of disability-adjusted life years (DALYs) lost and by 2020 this is expected to increase to 20%.[1] In India, injuries are the second most common cause of death after 5 years of age. Injury not only affects the physical health of the affected individual but also leads to psychological problems due to the resulting disabilities.[2] Injuries account for 16% of total disease burden in India in terms of DALYs.[3]

Domestic accidents contribute a major proportion in the prevalence of injuries than others.[4],[5] Domestic accident includes an accident that takes place at home and/or its immediate surrounding and not the accidents that occur due to traffic, vehicle, or sports.[6] Most of the domestic injuries are minor injuries in nature[7],[8] which may not require medical attention or minimal health care intervention. Hospital-based studies focus only on the cases which necessitate medical attention and hence will not reflect the nature of domestic accidents occurring in the community. This cross-sectional study focused on the occurrence of domestic injuries at the community level and the knowledge of rural population regarding prevention of domestic injuries which will give the real pattern of injuries and would help reducing its occurrence by creating awareness programs.

Objectives

  • To study the prevalence and pattern of domestic injuries in rural population
  • To find the factors determining domestic injuries
  • To assess their knowledge on risk factors, preventive measures, and first aid for domestic injuries.



  Methodology Top


A community-based cross-sectional study was conducted for 3 months from January to March 2015 in the Rural Health Training Centre (RHTC) service area of Chennai Medical College Hospital and Research Centre (CMCH & RC), Tiruchirappalli. CMCH & RC is a rural-based medical college and RHTC is located 20 km from the college. RHTC has ten villages under its service area which is divided into four sectors. Calculated sample size was 196 households taking prevalence as 9.6%,[9] average household size as 3.9 and design effect of 2. The sample size was calculated using the formula from guidelines for conducting community surveys on injuries and violence by the World Health Organization.[10] Two-stage cluster sampling with probability proportion to size (PPS) was used to select the households from the ten villages in RHTC service area. Cluster size was decided to be twenty and ten clusters were needed to cover the calculated sample size and hence the sample came to 200. Ten clusters were selected from the ten villages in RHTC area using PPS.

After obtaining informed written consent a pretested, semi-structured interviewer-administered questionnaire was used to obtain information about the domestic injuries. For the purpose of this study, injury was defined as any bodily injury that occurred due to an external cause, resulting from sudden exposure to energy which includes mechanical, chemical, thermal, and electrical generated by agent-host interaction. Both intentional and unintentional injuries were included in this study. Ethical clearance was obtained from the Institute Ethical Committee.

Injuries that occurred within a period of past 6 months were included in the study and a recall period of 5 years was used for domestic injury-related death in the family. This recall period was selected based on a study done in Andhra Pradesh.[11] Information regarding domestic injury was collected from all members of the family; one additional visit was made if one or more family member was not available during the first visit. Adult member of the family provided information regarding injuries that occurred in children. The questionnaire included information about the sociodemographic details, cause of injury, type of injury, number of events, treatment seeking behavior, knowledge on risk factors and prevention and first aid practiced for common domestic injuries. Adults members aged more than 20 years were interviewed to get the information about the knowledge on risk factors and prevention and first aid practiced for common domestic injuries. Data were analyzed using Statistical Package for Social Sciences version 20.0.


  Results Top


Sociodemographic details of the study participants

A total of 839 persons from 200 households were included in the study. Mean age was 32.43 years. 51.8% of the study population was males and the rest was females (48.2%). Per capita income of the study population ranges from Rs. 310 to Rs. 12,513 and the mean per capita income was Rs. 2514. Majority of the families interviewed belong to Class III (30%) followed by Class IV (27.5%) based on Prasad's socioeconomic status classification.[12] [Table 1] shows the sociodemographic details.
Table 1: Sociodemographic details of the study population


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Prevalence, pattern, and factors related to injuries

A total of 40 individuals reported domestic injuries during the recall period of 6 months. Thus, the prevalence was 4.8%. 52.5% of the injured persons were males and 47.5% of them were females. The gender difference of injury occurrence was not statistically significant (P - 0.93). All injuries were unintentional/accidental in nature. None of the interviewed individuals reported intentional injuries. Forty percent of the injuries occurred among children aged <10 years. Most common site injured was hand (42%) followed by leg (20%) and injury to upper extremities (48%) was common than lower extremities (30%) [Table 2].
Table 2: Distribution of injuries based on age, gender, and site of injury


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Majority (61.25) of the injuries was incised, or lacerated wounds, and one elderly individual had fracture of femur due to accidental fall. Most of the injuries occurred during afternoon (50%) [Table 3]. Most of the injuries occurred due to the handling of sharp objects (55%) followed by falls (20%) [Table 4]. Twenty-five individuals (62.5%) suffered mild injury without any disability and loss of days of work or school. A total of 15 injured persons had a temporary disability. One individual had temporary disablement for more than 1 month because of fracture due to fall [Table 5]. Moreover, the rest 14 (35%) had a temporary disability for less than a week ranging from 2 to 5 days. Loss of work was 2, 3, 5 days, and 6 months for 6, 5, 3, and 1 injured person, respectively. The mean days of loss of work for injured persons was 5.5 days.
Table 3: Distribution of injuries based on its type and time of occurrence


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Table 4: Distribution of injuries based on mode of occurrence


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Table 5: Distribution of injuries based on severity


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Self-treatment was done for 10 (25%) injured individuals and hospital visit was required for remaining 30 (75%). Hospitalization was done for one individual who had fracture and all other hospital visits were in the form of outpatient treatment and observation. For individuals who were temporarily physically challenged, one of their family members had to take care of them. The caregivers were not able to do their household work and also were not able to go for their job. The mean days of loss of work were 1.65 days. Three families had to borrow money to meet the health care expenses.

Knowledge on risk factors, prevention, and practice of first aid for common domestic injuries

Adult members of the households alone were interviewed to assess the knowledge on risk factors, prevention, and practice of first aid measures. Hence, the sample size was 594. Majority (89.7%) of the respondents said that carelessness leads to domestic injuries. Rest of the respondents said that domestic injuries occurred due to unclean house (4.7%), slippery surface (1.5%), not switching off gas (1.5%), stress (1.5%), and using sharps (1%) [Figure 1]. Seventy-two percent of the respondents considered careful handling of sharps/instruments and other heavy objects as an important preventive measure. Avoiding conflict (1.7%), preventing children from playing with sharps (2.9%), concentration in work (8.8%), keeping house clean (7.6%), switching off gas (5.5%), and practicing yoga (1.5%) to reduce stress were considered as other measures to prevent domestic injuries. When a person had cut injury, burns, and animal bite 52.5%, 53%, and 61% of the respondents respectively said that he has to be taken to a health care facility without any first aid at the site of occurrence of injury. Washing with cold water (42.4%), applying ointment (12.6%), wrapping with blanket (13.6%), and applying ink (1.5%) were also practiced as first aid measures for burns. Applying pressure with cloth (25.7%), washing with water (14.6%), applying ointment (4%), turmeric powder (1.5%), and talcum powder (1.5%) have been under practice for cut injury-related first aid measure. Tying above or over the bite wound with a cloth (12.1%), washing with water (19.3%), application of ointment (7%), and vaccination (3%) were practiced as first aid for animal bites.
Figure 1: Knowledge about risk factors for domestic injuries

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  Discussion Top


A total of 839 individuals participated in the present study. Among the participants, forty individuals reported the occurrence of domestic injuries during the study recall period which constituted 4.8% of the study population and hence the prevalence of domestic injury in the current study was 4.8%. Some studies have reported higher prevalence rates[9],[13] and also lower prevalence rates.[11],[14],[15] This may be due to the difference in the recall period. The present study used a recall period of 6 months and the studies reported higher prevalence used a recall period of 1 year. Prevalence of domestic injuries from other studies ranges from 1.7% to 9.6%.[9],[11],[13],[14],[15] The prevalence of domestic injuries in this study falls within this range. Majority of the injuries (52.55) were among males. Similar findings had been reported by a study done in Imphal[16] and many studies reported more domestic accidents among females.[7],[9],[11],[13],[14] Majority (57.5%) of the injuries occurred due to sharps which was concordant with the reports by two other studies done in India.[11],[17] This is contrary to the reports by few other Indian studies where falls contributed to a major proportion of injuries.[7],[9],[14],[18] Fifty percent of the injuries occurred during afternoon which was close to the report by another study.[13] Majority (62.5%) of the individuals suffered mild injury which was similar to another study.[7] This could be because of the low mechanical force from the objects which has caused injury. Although the majority of the individuals had mild injury, 75% of the injured persons sought medical care. Two other studies have also identified that almost 70-80% of the injured persons had some form of medical treatment.[14],[15] Health care seeking for injury was high compared to another study done in Mysore.[13] This could be because of the high accessibility to health services and difference in the level of awareness in the community. No domestic injury-related deaths had occurred in the study population during the study. A similar report was given by several others.[7],[9],[14],[16] Loss of wages for injured person and the caregiver would impose an indirect effect on the economic condition of the family. Seventy-two percent of the respondents were aware that careful handling of objects and instruments is an important preventive measure. Avoiding conflict, maintenance of cleanliness, reducing stress were also considered as preventive measures for injuries by the respondents.


  Conclusion Top


Handling of sharp instruments was the factor which has lead to majority of the injuries among the participants. Though two-third of the injuries were mild in nature the injuries has resulted in a significant medical expenses and wage loss for the family which had indirect effect on family economy. Reducing the injuries by careful use of the objects would help curbing the occurrence of injuries and their associated problems.

Acknowledgment

We would like to thank the participants of the study for their cooperation.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
The Top 10 Causes of Death. Available from: http://www.who.int/mediacentre/factsheets/fs310/en/. [Last accessed on 2015 Aug 03].  Back to cited text no. 1
    
2.
Gururaj G. Injuries in India: A National Perspective. National Commission on Macroeconomics and Health. Background Papers. Burden of Disease in India. New Delhi: Ministry of Health and Family Welfare, Government of India; 2005.  Back to cited text no. 2
    
3.
Patel V, Chatterji S, Chisholm D, Ebrahim S, Gopalakrishna G, Mathers C. Chronic diseases and injuries in India. Lancet 2011;377:413-28.  Back to cited text no. 3
    
4.
Zaidi SH, Khan Z, Khalique N. Injury pattern in children: A population based study. Indian J Community Health 2013;25:45-51.  Back to cited text no. 4
    
5.
Rahman F, Andersson R, Svanström L. Medical help seeking behaviour of injury patients in a community in Bangladesh. Public Health 1998;112:31-5.  Back to cited text no. 5
    
6.
Park K. Preventive and social medicine. Accidents and injuries. 23 th ed. Jabalpur: M/S Banarasi Das; 2015. p. 409.  Back to cited text no. 6
    
7.
Aggarwal R, Singh G, Aditya K. Pattern of domestic injuries in a rural area of India. Internet J Health 2009;11:1-5.  Back to cited text no. 7
    
8.
Tripura K, Das R, Datta SS, Bhattacharjee P, Singh B. Prevalence and management of domestic injuries among under five children in a peri-urban area of Agartala, Tripura. Health Agenda 2015;3:1-5.  Back to cited text no. 8
    
9.
Ramesh Masthi NR, Kishore SG, Gangaboriah. Prevalence of domestic accidents in the rural field practice area of a medical college in Bangalore, Karnataka. Indian J Public Health 2012;56:235-7.  Back to cited text no. 9
    
10.
WHO. Guidelines for Conducting Community Surveys on Injuries and Violence. Geneva: World Health Organization; 2004.  Back to cited text no. 10
    
11.
Kommula VM, Kusneniwar GN. A study of domestic accidents in the rural area of South India. Int J Curr Microbiol Appl Sci 2015;4:764-7.  Back to cited text no. 11
    
12.
Dudala SR, Reddy KA, Prabhu GR. Prasad′s socio-economic status classification - An update for 2014. Int J Res Health Sci 2014;2:875-8.  Back to cited text no. 12
    
13.
Sudhir, Krishna D, Channabasappa AN, Dhar M. Prevalence of domestic accidents in rural India: A cross sectional study. Sch J Appl Med Sci 2014;2:657-9.  Back to cited text no. 13
    
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Bhanderi DJ, Choudhary S. A study of occurrence of domestic accidents in semi-urban community. Indian J Community Med 2008;33:104-6.  Back to cited text no. 14
[PUBMED]  Medknow Journal  
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Patel MG, Darshan KM, Girija PK, Purani SK, Nagar SS. A study on occurrence of indoor accidents in field practice area of UHTC in Surendranagar. Healthline 2013;4:32-7.  Back to cited text no. 15
    
16.
Hmingthanzuala, Devi HS, Singh TG. Domestic accidents in an Urban Health Training Centre. Ind Med Gaz 2011;145:476-80.  Back to cited text no. 16
    
17.
Sirohi S, Pandey D, Dixit S, Jain C, Deshmankar B, Raja RS. Domestic accidents: An emerging threat to community. Int J Med Sci Public Health 2015;4:1202-5.  Back to cited text no. 17
    
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Chaurasia R, Shukul M. Home is it the safest place? J Soc Sci 2006;12:171-6.  Back to cited text no. 18
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]


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