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Fatal Head Injuries in Children Under the Age of 5 Years in Pretoria

du Toit-Prinsloo, Lorraine MBChB; DipForMed(SA)Path; FCForPath(SA); MMed(Path)(Forens); Saayman, Gert MBChB; MMed(Med)(Forens); FCForPath

The American Journal of Forensic Medicine and Pathology: September 2014 - Volume 35 - Issue 3 - p 212–217
doi: 10.1097/PAF.0000000000000113
Original Articles

The incidence of fatal injuries in children has been reported to be highest among children aged 1 to 4 years. Major causes of head injury include road traffic accidents, falls, and intentional or inflicted injury (such as nonaccidental injury syndrome). This study reviewed the profile of children (under 5 years of age) who had been admitted to a large urban medicolegal mortuary (in Pretoria, the capital city of South Africa), after having suffered fatal head injuries. This study was conducted over a 5-year period (from January 2004 through December 2008), and a total of 107 cases were identified for inclusion. These cases constituted nearly a fifth of admissions in this age group. The male-to-female ratio was 56%:44%, and the peak age of injury was less than 1 year. Most head injuries were sustained in road traffic accidents (70%) followed by falls (10%) and other types of blunt force injuries (9%). Only 1 case of nonaccidental injury syndrome (child abuse) was found. The great majority of deaths were deemed to have been accidental in nature (91%) with 6 (6%) homicides. Urgent review pertaining to the use of child restraint devices and the safety of pedestrians is required, and the institution of childhood injury registers could aid in reducing childhood fatalities in South Africa.

From the Department of Forensic Medicine, University of Pretoria, Pretoria, Gauteng, South Africa.

Manuscript received April 30, 2014; accepted June 9, 2014.

The authors report no conflicts of interest.

Reprints: Lorraine du Toit-Prinsloo, MBChB; DipForMed(SA)Path; FCForPath(SA); MMed(Path)(Forens), Department of Forensic Medicine, University of Pretoria, Private Bag X323, Arcadia, 0007, Pretoria, Gauteng, South Africa. E-mail:

© 2014 by Lippincott Williams & Wilkins.