Accidents involving dogs are very common, especially in the case of children. In addition to acute injuries, aggression by dogs can cause fractures, infections, scars and psychological trauma. Pediatrician Michelle Marchi de Medeiros analyzed all visits to children aged 0 to 14 years who were victims of attacks by dogs carried out at the Children's Referral Emergency Unit of the Hospital de Clínicas (HC) at Unicamp, from January 2010 to December 2019. .
According to the study, 1.012 services of this type were identified in the period analyzed. Male children were more affected (65,2% of cases) than female children (34,8%) in accidents involving dogs. Injuries occurred most frequently in the age group of 7 to 14 years, in a total of 498 patients (49,2%), followed by the age groups of 4 to 6 years, with 268 patients (26,5%), and children from 0 to 3 years, with 246 patients (24,3%). The majority of injuries were located on the head or neck (37,4%).
According to Andrea Fraga, research supervisor, dog accidents represent a major public health problem in developing countries.
"These data are useful for developing preventive measures aimed at each age group in pediatrics, including offering guidance to parents, dog owners and older children and developing public policies seeking to control the animal population abandoned on the streets and encouraging the conscious ownership of animals. domestic animals”, recommends Fraga.
The information included in the study was collected from the service records of the Campinas Toxicological Information and Assistance Center (Ciatox), responsible for applying anti-rabies immunobiologicals to victims of dog bites.
"This is one of the only studies that evaluates the differences between dog accidents in different age groups in the pediatric area in Brazil. Without a doubt, there are many bites by dogs that do not reach the emergency units of tertiary hospitals”, warns Medeiros.
Attacks
The cause of most dog attacks, across all age groups, was accidental (64,9%). The breed of the dog was included in 49,4% of the service records. A total of 26 breeds were documented. Mixed breed animals (SRD) were the most common (36,2%), followed by pit bull (3,6%), German shepherd (1,4%) and poodle (1,3%).
The accidents were caused by healthy dogs (55,3%) and domiciled dogs (44,5%). In 394 cases (38,9%), the dogs were non-domiciled and in 143 (14,1%), they were semi-domiciled. As for a small percentage of occurrences, the origin of the dog was not described (2,5%). The majority of accidents happened outdoors (68,2%). In 31,5% of cases, the attacks took place in the child's own home and, in 0,5% of cases, the location of the accident was not described.
Injuries located in the head and neck were the most prevalent (37,4%) according to the study, followed by injuries in the upper limbs (34%), lower limbs (27,9%), trunk (9,4%) and mucous membranes (1,4%). Head and neck injuries occurred more frequently in younger children (61,4%). Injuries to the upper and lower limbs were described more frequently in the age group of 7 to 14 years (36,5% and 42,6%, respectively). In the age group of 4 to 6 years, injuries to the head and neck were described in 47,4% cases and, in the age group of 7 to 14 years, in 20,1% cases.
Upper limb injuries were present in 76 children (30,9%) aged 0 to 3 years and in 86 children (32,1%) aged 4 to 6 years. Injuries located in the lower limbs were reported in 8,5% of children aged 0 to 3 years and in 18,3% of children aged 4 to 6 years.
"We found that younger children suffer more localized injuries to the head and neck, caused by accidents that occur with dogs in regular contact, within the home, due to causes, depending on the child's interaction with the animal. As age increases, the number of injuries located in the upper and lower limbs, such as arms and legs, in accidental attacks in external environments increases”, says Medeiros.
Regarding the type of exposure, regardless of the location of the wound, bites were the most frequent, being reported in more than 78% of cases in all segments of the body, followed by scratching and licking.
Regarding the type of injury, deep injuries were described in more than 84% of cases in different segments of the body. Tearing injuries were most frequently reported in the head and neck, in a total of 29 cases (7,7%), followed by 14 cases (5%) in the lower limbs and 7 cases (2%) in the upper limbs.
"Older children suffer more injuries from unobservable dogs. This implies the need to use immunobiologicals to prevent rabies, generating costs for health services in Campinas”, comments the pediatrician at Unicamp HC.
Published article
The research was conducted within the Postgraduate Program in Child and Adolescent Health at the Faculty of Medical Sciences (FCM) at Unicamp. In addition to Fraga, Professor Ricardo Mendes Pereira co-supervised the work. Both belong to the FCM Pediatrics Department.
The master's thesis also resulted in the scientific article “Epidemiological profile of dog accidents in children under 14 years of age treated at the Pediatric Referred Emergency Unit of a tertiary hospital in Campinas”.
The article was published in the magazine Frontiers in Pediatrics.
This article featured the analysis and interpretation of data, writing and reviewing Fernando Augusto Lima Marson and Leonardo Souza Marques, both from Laboratory of Medical Genetics and Human Genetics in the Health Sciences area of the São Francisco University, in addition to Medeiros, Fraga and Andressa Oliveira Peixoto, the latter also a member of the Department of Pediatrics at FCM.
