Trauma is a major cause of morbidity and mortality among children worldwide and accounts for up to 40% of pediatric surgical admissions in low- and middle-income countries (LMICs) [1]. The World Health Organization estimates that 95% of all injury-related pediatric deaths occur in LMICs [2]. In sub-Saharan Africa, road traffic accidents (RTAs), falls, burns, and domestic injuries are consistently reported as the leading mechanisms of pediatric trauma [3][4].

In LMICs, children face heightened vulnerability due to factors such as poor road infrastructure, weak enforcement of safety regulations, and inadequate referral systems. Pediatric trauma mortality in Africa is also elevated because of the absence of prehospital care, limited pediatric trauma expertise, and delayed access to definitive management [5].

Despite children constituting more than half of Cameroon’s population [6], trauma-related data remain scarce. Existing studies originate mainly from single hospitals and often focus on specific injuries [7]. Multicenter data are necessary to inform national prevention and management policies.

This study aimed to determine the prevalence, clinical presentations, and outcomes of pediatric trauma in three major referral hospitals in Cameroon.

We performed a retrospective cross-sectional study from January 2019 to December 2021 in three tertiary hospitals: Douala General Hospital (DGH), Laquintinie Hospital Douala (LHD), and Buea Regional Hospital (BRH). These centers provide pediatric surgical care for the Littoral and South-West regions.

All children aged 0 - 18 years admitted for trauma were included. Ophthalmologic and ENT trauma cases were excluded.

Hospital records were reviewed to extract sociodemographic characteristics, mechanism of injury, clinical presentation, complications, and outcomes. Severe head trauma was defined as GCS ≤ 8. Hemodynamic instability required hypotension/tachycardia for age. Respiratory failure was defined by SpO₂ < 90% or need for oxygen support.

Data were entered into SPSS v25. Descriptive statistics were used. Mortality was stratified by injury type. Categorical variables were analyzed using the Chi-square test and p-value ≤0.05 was considered significant.

Approval was obtained from the University of Buea Faculty of Health Sciences IRB. Hospital authorities granted administrative clearance. Confidentiality was maintained.

Of the 10,539 pediatric admissions recorded during the study period, 537 were trauma related, representing 39.8% of pediatric surgical cases and 5.1% of overall admissions (Table 1). Boys constituted 67.5% of cases (male-to-female ratio: 2:1). The most affected age group was 6 - 12 years (29.5%), followed by 1 - 5 years (27.3%).

Table 1.Sociodemographic characteristics of pediatric trauma patients (N = 537).

Mechanisms of injury were predominantly road traffic accidents (42.4%) and falls (31.2%). Domestic accidents accounted for 11.8%, and assaults for 6.2% (Table 2).

Table 2.Mechanisms of pediatric trauma.

Traumatic lesions were mainly fractures (46.1%) and head injuries (34.5%), representing over 80% of all injuries (Figure 1).

Clinical presentations included limb pain or swelling (49.7%), wounds (28.5%), abdominal pain (20.3%), vomiting (14.9%), and loss of consciousness (9.8%). Complications on arrival occurred in 12.6% of children, primarily anemia and peritonitis (Table 3).

Lesion-specific findings (Table 4):

Fractures: most common among school-aged children; mean hospital stay 10.4 days; mortality 9.1%.Head injuries: highest mortality (54.5%), especially when severe (GCS ≤ 8).Burns: predominantly in younger children; mortality 36.4%.Soft tissue injuries: frequent but with zero recorded mortality.

Figure 1.Distribution of pediatric traumatic lesions (N = 534).

Table 3.Clinical presentations and complications.

Table 4.Most frequent types of traumatic lesions among pediatric patients in three Cameroonian hospitals.

Postoperative complications occurred in 5.7% of managed cases. The most frequent were surgical site infection (37.3%), sepsis (16.2%), and anemia (13.6%) (Table 5). Hypovolemic shock and respiratory distress were less common but clinically significant. Delayed presentation and delayed surgical intervention were strongly associated with complications.

Table 5.Common postoperative complications after management of trauma lesions.

Outcomes (Table 6):

91.5% of children were discharged after treatment.Mortality was 5.2%.Severe head injuries (54.5%) and burns (36.4%) accounted for most deaths.A small proportion left against medical advice (3.3%) or were referred for specialized care (1.1%).

Table 6.Outcomes of pediatric trauma patients.

Pediatric trauma is a leading cause of morbidity and mortality in Cameroon, dominated by road traffic accidents and falls. Boys and school-aged children are most at risk. Mortality remains high, particularly in severe head injuries. Preventive measures, better referral pathways, and improved trauma care capacity are urgently needed.