P3.H156: Pediatric Population Takes the Hardest Hit: A Descriptive Analysis of Violent Deaths in Ecuador

Background: Understanding causes of death, especially in the case of violent deaths, is crucial for prevention of further deaths and ensuring adequate psychosocial development. In Ecuador, violent deaths have shown an increasing trend consistent with the rise in armed violence nationwide. The most affected group by this are teenagers, who are forcefully recruited by criminal groups in rural regions for illicit activities. In this study, we describe the causes of violent deaths in Ecuadorian pediatric patients in a 10 year period to highlight the need for interventions.

Methods: We reviewed publicly available data for violent deaths from the National Institute of Census and Statistics (INEC) from 2012 to 2022, focusing on Ecuadorian pediatric population, which was stratified into infancy (ages 0 to < 2 years), childhood (ages 2 to < 12 years), adolescence (ages 12 to 18 years). The causes of violent death were categorized based on the International Classification of Diseases (ICD-10) codes X85 to Y09.

Results: This study examined causes of violent death in patients from 2012 to 2022, considering age range, diagnosis, region, and year. Our data showed that the primary cause of violent death was assault by firearm discharge for infants 24% (7 out of 26) and teenagers 62% (536 out of 857). This was followed by assault by a sharp object, which constituted 15.3% (4 out of 26) in infants and 20.18% (173 out of 857) in teenagers. For children, assault by hanging, strangulation, or suffocation was the main cause accounting for 22.3% (44 out of 197), followed by assault by firearm discharge 20.8% (41 out of 197). Nationwide, throughout our chosen timeframe and from ages 0 to 18 years old, 62.8% of violent deaths take place in the coastal region, consistent with its status as the most conflictive region regarding violence and crime. Guayas is the province with the most violent deaths (0.6 per 10.000 habitants). 2022 marked the highest year for violent deaths across all age groups, with alarming results, especially for adolescents, who had a rate of 10.55 violent deaths per 10.000 habitants in adolescents. The other groups showed a ratio of 1.25 per 10.000 habitants in infants and 1.2 per 10.000 in children.

Conclusion: Death by firearms represent the most frequent cause of violent death in infants and teenagers, related to the armed conflict experienced in Ecuador, particularly in the most conflictive regions. Teenage violent death has experienced the most dramatic rise, pointing them as the most vulnerable group, and highlighting the need for preventive and protective measures, and the rest of the pediatric population. Additionally, implementation of measures to address physical and mental health consequences in those who did not die is crucial.