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Timely access to appropriate care may improve pediatric injury outcomes. Using a pediatric injury registry, the study assessed morbidity and mortality in 849 patients aged under 18 in Northern Tanzania by referral status, location, distance, and time to definitive care. Patients treated at facilities before KCMC had higher morbidity, while longer time to definitive care at KCMC increased mortality, identifying targets for faster pediatric-specific care.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-effects-of-time-and-distance-to-definitive-care-on-morbidity-and-mortality-in-pediatric-injury-patients-in-northern-tanzania/416953/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-effects-of-time-and-distance-to-definitive-care-on-morbidity-and-mortality-in-pediatric-injury-patients-in-northern-tanzania/416953.png","ImageObject",300,407,{"name":92,"@type":93},"Indoniesian Boy","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What question does the study address about pediatric injuries?","Question",{"text":112,"@type":113},"It evaluates how time and distance to definitive care relate to morbidity and mortality in pediatric injury patients in Northern Tanzania, using referral status, location, and travel metrics.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How does treatment before KCMC affect outcomes?",{"text":117,"@type":113},"Patients treated at a health care facility prior to KCMC had higher morbidity than those who presented directly to KCMC.",{"name":119,"@type":110,"acceptedAnswer":120},"What factor was significantly associated with mortality?",{"text":121,"@type":113},"Mortality increased with longer time to definitive care at KCMC, including a higher chance of mortality for patients who took longer than 48 hours to reach definitive care.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},416953,1790867193,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962090760608,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Journal of Tropical Pediatrics, 2026, 72 (1), fmaf053 [https://doi.org/10.1093/tropej/fmaf053](https://doi.org/10.1093/tropej/fmaf053)[ ](https://doi.org/10.1093/tropej/fmaf053)Original Paper  \nThe effects of time and distance to definitive care on morbidity and mortality in pediatric injury patients in  \nNorthern Tanzania  \nShannon Brady1, 􀀃 , Francis Sakita2,3, Marissa Taddie4, James A. VanDerslice4, Getrude Nkini5, Arthi Kozhumam6, Joao Ricardo Nickenig Vissoci7,8, Catherine Staton7,8, Blandina T. Mmbaga2,3,9,‡, Elizabeth Keating1,‡  \n1Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Utah, Salt Lake City, UT, 84112, USA  \n2Kilimanjaro Christian Medical Centre, Moshi, Tanzania  \n3Kilimanjaro Christian Medical University College, Moshi, Tanzania  \n4Department of Family and Preventative Medicine, University of Utah, Salt Lake City, UT, 84112, USA 5Duke–Kilimanjaro Christian Medicine Centre Collaboration, Moshi, Tanzania 6Northwestern University Feinberg School of Medicine, Medical Scientist Training Program, Chicago, IL, 60611, USA 7Department of Emergency Medicine, Duke University Medical Center, Durham, NC, 27710, USA 8Duke Global Health Institute, Duke University, Durham, NC, 27710, USA  \n9Kilimanjaro Clinical Research Institute, Moshi, Tanzania  \n􀀃 Corresponding author: Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Utah, Salt Lake City, UT, 84112, USA.  \nE-mail: [Shannon.Brady@hsc.utah.edu](Shannon.Brady@hsc.utah.edu).  \n‡¼ equal contribution.  \nABSTRACT  \nInjury is the leading cause of death for youth aged 5–24 years with the majority of deaths occurring in low- and middle-income countries (LMICs). Interventions directed at reaching appropriate care faster have the potential to improve pediatric injury-related outcomes in LMICs. Using a pediatric injury registry, we examined the rates of morbidity and mortality of pediatric injury patients in Northern Tanzania based on referral status, location, distance, and time to definitive care. We included 849 patients aged \u003C18 years. Patients treated at a health care facility prior to KCMC had higher morbidity that those who presented direct to KCMC. There was no significant association between distance of first care site to KCMC and mortality or morbidity, however there was a statistically significant increase in mortality with longer time to definitive care at KCMC. We found that pediatric injury patients treated at first care sites prior to KCMC had higher morbidity. Additionally, the chance of mortality was statistically higher in pediatric injury patients who took longer than 48 hours to reach definitive careat KCMC. This study identifies facilities with longer median times and allows for future targeted interventions to improve pediatric readiness and raising awareness of the importance of timely pediatric specific injury care.  \nKEYWORDS: Tanzania; Geographic Information System; Child; Child Mortality; Time-to-Treatment; Injury  \n© The Author(s) [2026]. Published by Oxford University Press.  \nThis is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence ([https://creativecommons](https://creativecommons). org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact [reprints@oup.com](reprints@oup.com) for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [journals.permissions@oup.com](journals.permissions@oup.com).  \n2 􀀏 Brady et al.  \nINTRODUCTION  \nInjury related morbidity and mortality in low- and middle-income countries (LMICs) is a major global public health crisis—injuries account for ","cbCaieu0ntanfC9v","https://ap.wps.com/l/cbCaieu0ntanfC9v","pdf",1744747,11,"English","# Introduction\n## Global burden of pediatric injury\n## Time-critical care and delays\n## Geospatial analyses and GIS in LMICs","[{\"question\":\"What question does the study address about pediatric injuries?\",\"answer\":\"It evaluates how time and distance to definitive care relate to morbidity and mortality in pediatric injury patients in Northern Tanzania, using referral status, location, and travel metrics.\"},{\"question\":\"How does treatment before KCMC affect outcomes?\",\"answer\":\"Patients treated at a health care facility prior to KCMC had higher morbidity than those who presented directly to KCMC.\"},{\"question\":\"What factor was significantly associated with mortality?\",\"answer\":\"Mortality increased with longer time to definitive care at KCMC, including a higher chance of mortality for patients who took longer than 48 hours to reach definitive care.\"}]","The effects of time and distance to definitive care on morbidity and mortality in pediatric injury patients in Northern Tanzania | PDF",1790607392,28]