Distribution and circumstances of injuries in squatter settlements of Karachi, Pakistan

This research was conducted to study incidence, distribution, type, causes, severity and circumstances of injuries among people living in squatter settlements in Karachi, Pakistan. Trained interviewers sought a 2 weeks recall for minor injuries for which no health care was sought, 2 months recall for major injuries for which a health provider was consulted and 1 year recall for hospitalization, disability and death from every third household in five squatter settlements in Karachi between May and August 1995. For understanding the injury circumstances 250 in-depth interviews of the injured or the close relatives were also conducted. Among 1182 households, having 9891 residents, 84 minor, 42 major injury episodes, 7 hospitalizations, 0.6 permanent disabilities and 0.3 deaths per 1000 person years were reported. Including all injury episodes, the common types of injury were cutting or piercing (n = 532), falls (n = 382) and burns (n = 235) estimating to 54, 38 and 23 injury episodes per 1000 person years. Injury mainly resulted from a piece of glass (n = 367), falling from height (n = 98) and knife (n = 97) estimating to 37, 10 and 10 injury episodes per 1000 person years, respectively. Fall (n = 32, 3.2/1000 person years) was the major reason for hospitalizations and all permanent disabilities resulted from closed injuries. Medically trained providers were mostly contacted (n = 339, 34/1000 person years), but traditional healers were preferred in bone injury. Injuries are a major cause of morbidity and mortality in Pakistan and the national health and development agenda should include assessment and prevention of injuries.