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Al‐Mamun M, Alam M, Hossain MJ, Khatun MR, Das PK, Alam F, Islam MR, Ahmed F, Islam MM. Child drowning and associated risk factors: Findings from a qualitative study in Bangladesh. Health Sci Rep 2023; 6:e1380. [PMID: 37396561 PMCID: PMC10308348 DOI: 10.1002/hsr2.1380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/27/2023] [Accepted: 06/16/2023] [Indexed: 07/04/2023] Open
Abstract
Background World Health Organization (WHO) has classified drowning as a major public health problem. The most vulnerable victims of drowning are children from low and middle-income countries. Previously, it was the primary cause of death among children aged between 1 and 17 years in Bangladesh. Aims This study explored the surrounding circumstances and associated factors of child drownings in Bangladesh. Methods A qualitative phenomenological approach has been used to conduct the study. Bangladesh was chosen as the study area, and data were gathered using a semi-structured, open-ended questionnaire. Using convenience and snowball sampling methods, we have collected data from Dhaka and seven additional districts in Bangladesh. We reached a total of 44 individuals, where 22 agreed to participate in an interview (face-to-face and online interviews). The remaining 22 participants were selected in two focus group discussions via the web platform "ZOOM cloud meeting." Results Our investigation revealed several factors associated with child drowning, including a lack of adequate parental supervision and monitoring, geographic locations and environment, seasonal factors, low living standards, peer pressure and risky behaviors, social stigma and prejudices, and natural disasters and calamities. According to our findings, a lower socioeconomic position is linked to a higher risk of nonfatal drowning. Moreover, this research also indicates a substantial nexus between child drowning fatalities and the socioeconomic conditions of the families of the victims. Conclusion The study adds to the existing body of knowledge by underlining the associated factors of child drowning fatalities in Bangladesh, which will aid in developing preventive policies. An essential aspect of any drowning prevention program for Bangladesh should be enhanced for community awareness of safe water rescue and resuscitation practices.
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Affiliation(s)
- Md. Al‐Mamun
- Department of SociologyBangabandhu Sheikh Mujibur Rahman Science and Technology UniversityGopalganjBangladesh
| | - Morshed Alam
- Institute of Education and ResearchJagannath UniversityDhakaBangladesh
| | | | | | - Pranto Kumer Das
- Department of SociologyBangabandhu Sheikh Mujibur Rahman Science and Technology UniversityGopalganjBangladesh
| | | | | | - Foyez Ahmed
- Department of StatisticsComilla UniversityCumillaBangladesh
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Akinkuotu AC, Purcell LN, Varela C, Hayes A, Charles A. Childhood Drownings: An Opportunity for Injury Prevention in a Resource-Limited Setting. J Trop Pediatr 2022; 68:6655718. [PMID: 35925067 DOI: 10.1093/tropej/fmac057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Drowning is a public health problem that is under-reported in Africa. We sought to evaluate the epidemiology and risk factors for drownings in Malawi. METHODS We performed a retrospective review of all pediatric (≤15 years old) patients who presented following a drowning incident to Kamuzu Central Hospital in Lilongwe, Malawi, from 2009-19. Demographics and outcomes were compared between survivors and non-survivors. Logistic multivariate regression analysis was used to identify factors associated with increased odds of mortality. RESULTS There were 156 pediatric drowning victims during the study period. The median age at presentation was 3 (IQR: 2-7 years). Survivors were younger [median age: 2 years (IQR: 2-5) vs. 5 years (IQR: 2-10), p = 0.004], with a higher proportion of drownings occurring at home (85.6% vs. 58.3%, p = 0.001) compared to non-survivors. Patients who had a drowning event at a public space had increased odds of mortality (OR 8.17, 95% CI 2.34-28.6). Patients who were transferred (OR 0.03, 95% CI 0.003-0.25) and had other injuries (OR 0.20, 95% CI 0.06-0.70) had decreased odds of mortality following drowning. CONCLUSION Over half of pediatric drowning victims at a tertiary-care facility in Malawi survived. Drowning survivors were significantly younger, more likely to have drowned at home, and transported by private vehicles and minibus than non-survivors. There is a need for scalable, cost-effective drowning prevention strategies that focus on water safety education and training community members and police officers in basic life support and resuscitation.
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Affiliation(s)
- Adesola C Akinkuotu
- Department of Surgery, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura N Purcell
- Department of Surgery, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Carlos Varela
- Department of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi
| | - Andrea Hayes
- Department of Surgery, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anthony Charles
- Department of Surgery, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Ashraf L, Agrawal P, Rahman A, Bhuiyan MAA, Salam SS, Li Q, Bachani AM. Caregivers’ Compliance and Perception of Daycare Centers—A Community-Based Childhood Drowning Prevention Intervention Implemented in Rural Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159537. [PMID: 35954900 PMCID: PMC9368301 DOI: 10.3390/ijerph19159537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/29/2022] [Accepted: 07/31/2022] [Indexed: 11/28/2022]
Abstract
Drowning was one of the most prevalent causes of death worldwide for children under five in 2020. Drowning was the second leading cause of death for children under five in Bangladesh, while 58% of all deaths in the 1–5 years old age group resulted from drowning. Adult supervision helps prevent child drowning in rural areas where water bodies are easily accessible and located very close to homes. This paper aims to assess caregivers’ compliance and perception of community daycare centers in rural Bangladesh, piloted as a child drowning prevention intervention. In this longitudinal study, each child enrolled in the daycare intervention was visited and data on compliance and satisfaction with the daycare were collected. Descriptive statistics on daycare attendance, patterns of supervision, and caregivers’ perceptions about daycare were reported. When inquired about daycare attendance (n = 226,552), a total of 77.4% of children (n = 175,321) were found to attend daycare. The distance from homes and an adult’s unavailability to take the child to daycare were the most common reasons for not attending or discontinuing enrollment. The majority of children (76.4%) were supervised by their mothers during daycare closures. A total of 67.7% of respondents perceived daycare to be a safe place, where children also developed cognitive (51.7%) and social skills (50.6%). There were no incidences of drowning among children while attending daycare. Rural families were found to be compliant with the daycare and professed it to be a safe place protecting children from drowning and other injuries, while allowing them to focus on household chores or income-generating activities. These findings indicate a potential for the expansion of this intervention in rural Bangladesh and similar settings.
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Affiliation(s)
- Lamisa Ashraf
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA; (L.A.); (P.A.); (Q.L.)
| | - Priyanka Agrawal
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA; (L.A.); (P.A.); (Q.L.)
| | - Aminur Rahman
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), House # B-120, Road # 07, New DOHS, Mohakhali, Dhaka 1206, Bangladesh; (A.R.); (M.A.A.B.)
| | - Md. Al Amin Bhuiyan
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), House # B-120, Road # 07, New DOHS, Mohakhali, Dhaka 1206, Bangladesh; (A.R.); (M.A.A.B.)
| | - Shumona Sharmin Salam
- International Center for Diarrheal Disease Research, Bangladesh, 68, Shaheed Tajuddin Ahmed Sarani Mohakhali, Dhaka 1212, Bangladesh;
| | - Qingfeng Li
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA; (L.A.); (P.A.); (Q.L.)
| | - Abdulgafoor M. Bachani
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA; (L.A.); (P.A.); (Q.L.)
- Correspondence:
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Bhuiyan MAA, Agrawal P, Alonge O, Alam Z, Ashraf L, Wadhwaniya S, Talab MA, Li Q, Bachani AM, Rahman F, Rahman A. Compliance to playpen usages to enhance parental supervision of under-five children in rural community of Bangladesh. PLoS One 2022; 17:e0264902. [PMID: 35533177 PMCID: PMC9084520 DOI: 10.1371/journal.pone.0264902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 02/21/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction In Bangladesh, injury is one of the leading causes of death and morbidity in children. All children under 5 years of age are at high risk for drowning though the risks are highest when children first learn to walk and crawl while they do not understand the danger of water. The Centre for Injury Prevention and Research, Bangladesh (CIPRB) in collaboration with Johns Hopkins International Injury Research Unit (JH-IIRU) has been implementing two drowning prevention interventions, providing playpens and community day care centres (anchal), or both in three rural sub-districts of Bangladesh under Saving of Lives from Drowning (SoLiD) project in Bangladesh. In CIPRB intervention areas, wooden playpens were distributed among the children nine months to three years at household (HH) level. Objective The aim of this study was to explore and understand the acceptability and perceptions of parents towards playpen and its relevance for drowning and injury related mortality and morbidity prevention. Methods Anchal mothers (‘anchal maa’ in Bangla) distributed 30,553 playpens and collected compliance information at the HH level using a structured questionnaire. 1600 trained anchal maas collected data via face to face interviews from May 2014 to November 2015. Playpen compliance visits were conducted periodically on the second and seventh days and every two months after delivering the playpen. Data were entered using standard data entry formats and analyzed using SPSS software version 23. Results Parents reported that playpen is a safe place and protects children from drowning and other injuries. During compliance data collection, anchal maa founds that 71.8% of all children were using playpen and 93.7% (of 71.8%) children were playing inside the playpen while mothers were busy with their household chores like cooking, washing dishes and clothes, taking care of their poultry and domestic animals etc. 95.7% parents reported playpen is being used for keeping the child safe. On an average, the children were placed two to six times per day in a playpen. 99.1% of the children who reported using a playpen did not get any injuries (falls, cuts and bruises) while using the playpen. Satisfaction level with the playpen intervention among mothers was 90.5%. Some respondents suggested improving the playpen utilization by providing toys, adding wheels for ease of mobility, and increasing the height. Conclusion The playpens were found to be well accepted and utilized for the children, especially when mothers were busy with their household chores.
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Affiliation(s)
- Md. Al-Amin Bhuiyan
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Mohakhali, Dhaka, Bangladesh
- * E-mail: ,
| | - Priyanka Agrawal
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Olakunle Alonge
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Zobaer Alam
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Mohakhali, Dhaka, Bangladesh
| | - Lamisa Ashraf
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Shirin Wadhwaniya
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Md. Abu Talab
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Mohakhali, Dhaka, Bangladesh
| | - Qingfeng Li
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Abdulgafoor M. Bachani
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Fazlur Rahman
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Mohakhali, Dhaka, Bangladesh
| | - Aminur Rahman
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Mohakhali, Dhaka, Bangladesh
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Alfonso YN, Hyder AA, Alonge O, Salam SS, Baset K, Rahman A, Hoque DME, Islam MI, Rahman F, El-Arifeen S, Bishai D. Cost-effectiveness analysis of a large-scale crèche intervention to prevent child drowning in rural Bangladesh. Inj Epidemiol 2021; 8:61. [PMID: 34715946 PMCID: PMC8555188 DOI: 10.1186/s40621-021-00351-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 08/31/2021] [Indexed: 11/25/2022] Open
Abstract
Background Drowning is the leading cause of death among children 12–59 months old in rural Bangladesh. This study evaluated the cost-effectiveness of a large-scale crèche (daycare) intervention in preventing child drowning. Methods The cost of the crèches intervention was evaluated using an ingredients-based approach and monthly expenditure data collected prospectively throughout the study period from two agencies implementing the intervention in different study areas. The estimate of the effectiveness of the crèches intervention was based on a previous study. The study evaluated the cost-effectiveness from both a program and societal perspective. Results From the program perspective the annual operating cost of a crèche was $416.35 (95% CI: $221 to $576), the annual cost per child was $16 (95% CI: $8 to $23), and the incremental-cost-effectiveness ratio (ICER) per life saved with the crèches was $17,008 (95% CI: $8817 to $24,619). From the societal perspective (including parents time valued) the ICER per life saved was − $166,833 (95% CI: − $197,421 to − $141,341)—meaning crèches generated net economic benefits per child enrolled. Based on the ICER per disability-adjusted-life years averted from the societal perspective (excluding parents time), $1978, the crèche intervention was cost-effective even when the societal economic benefits were ignored. Conclusions Based on the evidence, the crèche intervention has great potential for generating net societal economic gains by reducing child drowning at a program cost that is reasonable. Supplementary Information The online version contains supplementary material available at 10.1186/s40621-021-00351-9.
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Affiliation(s)
- Y Natalia Alfonso
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Adnan A Hyder
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Olakunle Alonge
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Kamran Baset
- Center for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Aminur Rahman
- Center for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Dewan Md Emdadul Hoque
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Md Irteja Islam
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Fazlur Rahman
- Center for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Shams El-Arifeen
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - David Bishai
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Gupta M, Bhaumik S, Roy S, Panda RK, Peden M, Jagnoor J. Determining child drowning mortality in the Sundarbans, India: applying the community knowledge approach. Inj Prev 2021; 27:413-418. [PMID: 32943493 DOI: 10.1136/injuryprev-2020-043911] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/25/2020] [Accepted: 08/29/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND The Sundarbans in India is a rural, forested region where children are exposed to a high risk of drowning due to its waterlogged geography. Current data collection systems capture few drowning deaths in this region. METHODS A community-based survey was conducted in the Sundarbans to determine the drowning mortality rate for children aged 1 to 4 years and 5 to 9 years. A community knowledge approach was used. Meetings were held with community residents and key informants to identify drowning deaths in the population. Identified deaths were verified by the child's household through a structured survey, inquiring on the circumstances around the drowning death. RESULTS The drowning mortality rate for children aged 1 to 4 years was 243.8 per 100 000 children and for 5 to 9 years was 38.8 per 100 000 children. 58.0% of deaths were among children aged 1 to 2 years. No differences in rates between boys and girls were found. Most children drowned in ponds within 50 metres of their homes. Children were usually unaccompanied with their primary caretaker engaged in household work. A minority of children were treated by formal health providers. CONCLUSIONS Drowning is a major cause of death among children in the Sundarbans, particularly those aged 1 to 4 years. Interventions keeping children in safe spaces away from water are urgently required. The results illustrate how routine data collection systems grossly underestimate drowning deaths, emphasising the importance of community-based surveys in capturing these deaths in rural low- and middle-income country contexts. The community knowledge approach provides a low-resource, validated methodology for this purpose.
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Affiliation(s)
- Medhavi Gupta
- George Institute for Global Health, Newtown, New South Wales, Australia
| | - Soumyadeep Bhaumik
- Injury Division, The George Institute for Global Health India, New Delhi, India
| | - Sujoy Roy
- The Child In Need Institute, Pailan, West Bengal, India
| | | | | | - Jagnoor Jagnoor
- Injury Division, The George Institute for Global Health India, New Delhi, India
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Gupta M, Rahman A, Dutta NC, Saha AK, Zwi A, Ivers RQ, Jagnoor J. Implementing a crèche-based community drowning programme in rural Bangladesh: a process evaluation. Inj Prev 2021; 28:23-31. [DOI: 10.1136/injuryprev-2020-044066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 11/03/2022]
Abstract
BackgroundLiving and environmental conditions in rural Bangladesh expose children to drowning. The Anchal programme protects children through crèche-based supervision in an enclosed space run by locally recruited carers. It is unclear under what conditions the programme best operates to maximise protection. We conducted a process evaluation of Anchal to determine enabling factors and challenges to implementation.MethodsQuantitative programme data were analysed to calculate metrics including child participation and fidelity of implementation to defined processes. Qualitative data collection with programme participants and implementers provided insights into barriers and enablers of implementation. Analysis was guided by the UK Medical Research Council’s process evaluation framework.ResultsAnchal operated 400 centres with an average of 22.2 children enrolled, as per target. However, daily attendance averaged lower than the 80% target. Children aged 1–2 years old, who are most at risk of drowning, were least likely to enrol and attend regularly due to low engagement with activities and parental concerns for safety. Greater distances and lower educational attainment in some regions reduced attendance and increased carer attrition.ConclusionsThe Anchal programme met most programme delivery targets. However, programme success could be improved through increasing supervision, providing communication training for implementing staff, designing programmes for children aged 1–2 years old, encouraging community ownership and providing child pick-up services. These contextual solutions can be adapted to similar programmes operating through grassroots-level engagement and recruitment of community health workers, to maximise their effectiveness and sustainability.
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Hossain MJ, Hossain MS, Bhuiyan AA, Rahman AF, Mashrelky SR, Rahman A. Medical care-seeking behaviours among drowning casualties: Results from a national survey conducted in Bangladesh. J Taibah Univ Med Sci 2020; 15:374-379. [PMID: 33132809 PMCID: PMC7564935 DOI: 10.1016/j.jtumed.2020.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/19/2020] [Accepted: 07/21/2020] [Indexed: 11/28/2022] Open
Abstract
Objective Despite the high magnitude of drowning, medical care-seeking behaviours among drowning casualties remain unexplored in Bangladesh. This study aimed to explore this behaviour among drowning casualties in Bangladesh. Methods A population-based cross-sectional study was conducted using a multi-stage cluster sampling method. Data were collected using a structured questionnaire from 299,216 rural and urban residents. Results From the survey, we found 191 drowning cases: 40.84% (n = 78) were fatal and 59.16% (n = 113) were non-fatal. Among the drowning cases, 71.2% (n = 136) were referred to healthcare providers, while 62.8% (n = 120) received medical care from different health service providers. Further analysis showed that 66.6% (n = 116) of children and 26.6% (n = 4) of adults sought healthcare. As many as 78.9% (n = 120/152) of rural residents sought healthcare, as compared to 61.5% (n = 24/39) of urban residents. Among all drowning casualties, 31.7% (n = 38) received healthcare from a qualified healthcare provider, whereas 68.3% (n = 82) received it from non-qual]ified healthcare providers. About 59 (49%) casualties received care from a pharmacy and 34 (28%) from a recognised hospital. The hospital admission rate for drowning was 11.7%. About 14 (11.7%) drowning casualties were brought to hospitals in motorised or non-motorised vehicles. As many as 97 (80.8%) patients sought healthcare attention and managed to survive. Conclusion A significant number of drowning casualties sought medical care from qualified and non-qualified healthcare providers. In Bangladesh, it is necessary to develop guidelines for providing medical care for drowning casualties.
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Affiliation(s)
- Mohammad J Hossain
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Md S Hossain
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Al-Amin Bhuiyan
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Akm F Rahman
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Saidur R Mashrelky
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Aminur Rahman
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
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Alonge O, Bishai D, Wadhwaniya S, Agrawal P, Rahman A, Dewan Hoque EM, Baset KU, Salam SS, Bhuiyan AA, Islam MI, Talab A, Rahman QSU, Rahman F, El-Arifeen S, Hyder AA. Large-scale evaluation of interventions designed to reduce childhood Drownings in rural Bangladesh: a before and after cohort study. Inj Epidemiol 2020; 7:17. [PMID: 32389128 PMCID: PMC7212604 DOI: 10.1186/s40621-020-00245-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 04/14/2020] [Indexed: 11/29/2022] Open
Abstract
Background This paper estimates the impact on childhood drowning rates of community-based introduction of crèches or playpens or both in rural Bangladesh for children aged 0–47 months. Methods A baseline census of the whole population of 270,387 households in 51 unions, 451 villages from 7 rural sub-districts in Bangladesh was conducted in 2013. The baseline census determined retrospective, age-specific, and cumulative drowning incidence rates (IR) experienced in the target households in the 12 months prior to the intervention. Beginning in late 2013, creches for drowning prevention were established across the study area. Acceptance into creches was provided and written assent to attend a creche was obtained for all children aged 9–47 months in all participating unions. Playpens were provided to 45,460 of these children, of which 5981 children received only the playpens. All children were followed-up until their 48-month birthday or administrative censoring (fixed timepoint to stop observing the drowning deaths), after a two-year implementation period (2014–2016). Drowning IR were estimated for children and compared to corresponding baseline rates from 2012. Age-specific drowning IR under different “as treated” categories (playpen-only, creche-only, and playpen-plus-creche) were compared to the baseline rates experienced by the categorized households prior to intervention. Results A total of 3205 creches (average of 7 creches per village) were established, and 116,054 children aged 9–47 months were exposed to the intervention packages. Aggregated drowning IRs between age 0 and 47 were estimated per 100,000 population per year at 86.73 (95% CI: 69.67–107.97) and 43.03 (95% CI: 35.55–52.10) in the baseline and post implementation period, respectively. Risk ratios were 0.40 (95% CI: 0.28–0.57) overall, and 0.34 (95% CI: 0.13–0.90), 0.09 (95% CI: 0.02–0.36), and 0.04 (95% CI: 0.002–0.60) in children under the creche-only, aged, 1, 2, and 3 years old respectively. Inexplicably, drowning rates were statistically significantly higher post-intervention in children 0-11 months. There was no mortality reduction with playpen use (alone or in combination), and this group may actually have had a higher risk of drowning. Conclusions Creches are effective for preventing childhood drowning in rural Bangladesh for children above age 1-year, and should be considered for further scale-up.
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Affiliation(s)
- Olakunle Alonge
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
| | - David Bishai
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.,Department of Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Shirin Wadhwaniya
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Priyanka Agrawal
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Aminur Rahman
- Center for Injury Prevention Research, Dhaka, Bangladesh
| | - Emdad Md Dewan Hoque
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | | | - Shumona Sharmin Salam
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | | | - Md Irteja Islam
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | - Abu Talab
- Center for Injury Prevention Research, Dhaka, Bangladesh
| | - Qazi Sadeq-Ur Rahman
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | - Fazlur Rahman
- Center for Injury Prevention Research, Dhaka, Bangladesh
| | - Shams El-Arifeen
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | - Adnan A Hyder
- Milken Institute School of Public Health, George Washington University, Washington DC, USA
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Mohammed Z, Aledhaim A, AbdelSalam EM, El-Setouhy M, El-Shinawi M, Hirshon JM. Factors associated with injuries among preschool children in Egypt: demographic and health survey results, 2014. BMC Public Health 2020; 20:595. [PMID: 32357864 PMCID: PMC7193349 DOI: 10.1186/s12889-020-08658-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 04/06/2020] [Indexed: 11/22/2022] Open
Abstract
Background Childhood injuries are a significant and growing global public health problem, often with high morbidity and, at times, mortality. A large proportion of injuries in preschool children occur in or around the home. We aimed to identify socioeconomic and demographic factors associated with preschool children injuries in Egypt. Methods Secondary data analysis were done for the Egyptian Demographic and Health Surveys (EDHS), 2014. Potential associated factors were measured from data on child welfare and questions on the prevalence of accidents and injuries of preschool children. These data were linked to the children demographic data, maternal age at marriage, working status of the mother, and questions on childcare arrangements. Results Out of the 634 injured children, 520 (83.4%) children required medical care for their injuries. The most common reported injury was an open wound 288 (45.5%), followed by fractures 237 (35.7%), burns 124 (19.7%), electrical shock 12 (1.9%) and other unknown types of injury 15 (2.4%). There was a positive correlation between injury and child’s age, household wealth, mother’s age at marriage, and unsupervised children or children left in the care of a minor. Conclusion Leaving children unsupervised or in the presence of other young children is significantly associated with the occurrence of child injuries.
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Affiliation(s)
- Zeinab Mohammed
- Public Health and Community Medicine Department, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt. .,Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Ali Aledhaim
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Maged El-Setouhy
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia.,Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed El-Shinawi
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.,Department of General Surgery, Ain Shams University, Cairo, Egypt
| | - Jon Mark Hirshon
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.,Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
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11
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Hamilton K, Peden AE, Smith S, Hagger MS. Predicting pool safety habits and intentions of Australian parents and carers for their young children. JOURNAL OF SAFETY RESEARCH 2019; 71:285-294. [PMID: 31862040 DOI: 10.1016/j.jsr.2019.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 08/08/2019] [Accepted: 09/28/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Children under five years are most at risk of experiencing fatal and nonfatal drowning. The highest proportion of drowning incidents occur in private swimming pools. Lapses in adult supervision and failures in pool barriers are leading contributory factors for pool drowning in this age group. METHODS We investigated the role of the theory of planned behavior social cognitions (attitude, subjective norm, and perceived behavioral control) as well as perceived barriers, planning, role construction, and anticipated regret on parents' and carers' intentions and habits toward two pool safety behaviors: restricting access and supervising children around private swimming pools. The study adopted a cross-sectional correlational design. Participants (N = 509) comprised Australian parents or caregivers with children aged under five years and access to a swimming pool at their residence. Participants completed a battery of self-report measures of social cognitive variables with respect to the swimming pool safety behaviors for their children. RESULTS Path analytic models controlling for past behavior indicated that subjective norm, planning, anticipated regret, and role construction were important predictors of habit, and subjective norm was a consistent predictor of intentions, for both behaviors. Planning predicted intentions in the restricting access sample, while attitudes, barriers, and role construction also predicted intentions in the supervising sample. Both models controlled for past behavior. CONCLUSION Current findings indicate the importance of psychological factors for restricting access and supervising behaviors, with normative factors prominent for both reasoned (intentions) and non-conscious (habits) behavioral antecedents. It seems factors guiding restricting access, which likely require regular enactment of routine behaviors (e.g., ensuring gate is not propped open, pool fence meets standards), may be governed by more habitual than intentional processes.
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Affiliation(s)
- Kyra Hamilton
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia; Health Psychology and Behavioural Medicine Research Group, School of Psychology, Faculty of Health Sciences, Curtin University, Perth, Australia.
| | - Amy E Peden
- Royal Life Saving Society - Australia, Sydney, Australia; School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Stephanie Smith
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Martin S Hagger
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia; Psychological Sciences, University of California, Merced, USA; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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12
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Xu H, Zhu X, Zhou Z, Xu Y, Zhu Y, Lin L, Huang J, Meng R. An exploratory model for the non-fatal drowning risks in children in Guangdong, China. BMC Public Health 2019; 19:599. [PMID: 31101032 PMCID: PMC6525405 DOI: 10.1186/s12889-019-6944-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 05/07/2019] [Indexed: 11/10/2022] Open
Abstract
Background Drowning is a leading cause of accidental death in children under 14 years of age in Guangdong, China. We developed a statistical model to classify the risk of drowning among children based on the risk factors. Methods A multiple-stage cluster random sampling was employed to select the students in Grades 3 to 9 in two townships in Qingyuan, Guangdong. Questionnaire was a self-reported measure consisting of general information, knowledge, attitudes and activities. A univariate logistic regression model was used to preliminarily select the independent variables at a P value of 0.1 for multivariable model. Three-quarters of the participants were randomly selected as a training sample to establish the model, and the remaining were treated as a testing sample to validate the model. Results A total of 8390 children were included in this study, about 12.18% (1013) experienced drowning during the past one year. In the univariate logistic regression model, introvert personality, unclear distributions of water areas on the way to school, and bad relationships with their classmates and families were positively associated with drowning. However, females, older age and lower swimming skills were negatively associated with drowning. After employing the prediction model with these factors to estimate drowning risk of the students in the testing samples, the results of Hosmer-Lemeshow tests showed non-significant differences between the predictive results and actual risk (χ2 = 5.97, P = 0.65). Conclusions Male, younger children, higher swimming skills, bad relationship with their classmates and families, introvert personality and unclear distributions of water areas on the way to school were important risk factors of non-fatal drowning among children. The prediction model based on these variables has an acceptable predictive ability.
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Affiliation(s)
- Haofeng Xu
- Guangdong Provincial Center for Disease Control and Prevention, Institute of Control and Prevention for Chronic Non-infective Disease, Guangzhou, China
| | - Xuhao Zhu
- Qingyuan City Center for Disease Control and Prevention, Qingyuan, 511515, China
| | - Zhishan Zhou
- Qingxin District Center for Disease Control and Prevention, Qingyuan, 511000, China
| | - Yanjun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Institute of Control and Prevention for Chronic Non-infective Disease, Guangzhou, China
| | - Yongjian Zhu
- Qingxin District Center for Disease Control and Prevention, Qingyuan, 511000, China
| | - Lifeng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Center Director's office, Guangzhou, China
| | - Jinying Huang
- Qingyuan City Center for Disease Control and Prevention, Qingyuan, 511515, China
| | - Ruilin Meng
- Guangdong Provincial Center for Disease Control and Prevention, Institute of Control and Prevention for Chronic Non-infective Disease, Guangzhou, China.
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13
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Peden AE, Barnsley PD, Queiroga AC. The association between school holidays and unintentional fatal drowning among children and adolescents aged 5-17 years. J Paediatr Child Health 2019; 55:533-538. [PMID: 30298959 DOI: 10.1111/jpc.14235] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/16/2018] [Accepted: 08/28/2018] [Indexed: 11/30/2022]
Abstract
AIM Children aged 5-17 years in Australia have one of the lowest unintentional fatal drowning rates. One possible explanation is the protective effect of formal schooling, reducing leisure time for exposure to water hazards. We examine differences in frequency and circumstances of drowning deaths in this age group between school holidays and school days in Australia. METHODS A total population survey (2005-2014) of unintentional fatal drownings was extracted from the (Australian) Royal Life Saving National Fatal Drowning Database. Date of drowning incident and state of residence were used to determine if the drowning occurred during school days or school holidays (including public holidays). RESULTS A total of 188 5-17 year-olds drowned during the study period. We found a statistically significant difference between drowning incidence during school holidays and school days, with relative risk (RR) of drowning on a holiday 2.40 times higher (confidence interval (CI): 1.82-3.18) than on a school day. This risk was similar for males (RR = 2.41; CI: 1.75-3.33) and females (RR = 2.38; CI: 1.33-4.27) but differs between children 5-9 years (RR = 3.05; CI: 1.98-4.72) and adolescents 10-17 years of age (RR = 2.02; CI: 1.38-2.93). CONCLUSIONS Drowning rates among 5-17 year-olds are more than twice as high during holidays than on school days. Impact of school holidays was the strongest among younger children, visitors to the drowning location and in pools and inland waterways. Results were robust to alternative specifications excluding weekends and treating them as holidays. Prevention strategies may include counselling parents and care providers of the increased risk ahead of school holidays, education on drowning risk in the school curriculum and extra holidays for parents and care givers.
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Affiliation(s)
- Amy E Peden
- Royal Life Saving Society - Australia, Sydney, New South Wales, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Paul D Barnsley
- Royal Life Saving Society - Australia, Sydney, New South Wales, Australia
| | - Ana C Queiroga
- Royal Life Saving Society - Australia, Sydney, New South Wales, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.,EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
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14
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Ning P, Chen B, Cheng P, Yang Y, Schwebel DC, Yu R, Deng J, Li S, Hu G. Effectiveness of an app-based intervention for unintentional injury among caregivers of preschoolers: protocol for a cluster randomized controlled trial. BMC Public Health 2018; 18:865. [PMID: 29996813 PMCID: PMC6042388 DOI: 10.1186/s12889-018-5790-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 07/03/2018] [Indexed: 11/28/2022] Open
Abstract
Background Each year, over 15,000 preschoolers die from unintentional injuries in China. Many interventions proven to work in other nations have not been implemented nationwide in China. The rapid popularity of smartphones offers an opportunity to overcome this limitation and disseminate evidence-based interventions to the large population of China. This study aims to assess the effectiveness of an app-based intervention for caregivers of preschoolers to prevent unintentional injury among young Chinese children. Method A single-blinded, 6-month, parallel-group cluster randomized controlled trial with 1:1 allocation ratio will be conducted in Changsha, China. In total, 2626 caregivers of preschoolers ages 3–6 years old who own a smartphone will be recruited from 20 preschools. Clusters will be randomized at the preschool level and allocated to either the control group (routine education plus app-based parenting education excluding unintentional injury prevention) or the intervention group (routine education plus app-based parenting education including unintentional injury prevention). The app-based injury prevention program was developed based on the Theory of Planned Behavior, the Haddon Matrix, the Mobile Learning framework, and a needs assessment. Data collection will be conducted at baseline, 3-month, and 6-month follow-up via app-based survey plus printed questionnaire survey. The primary outcome measure is unintentional injury incidence among preschoolers in the past 3 months. Secondary outcome measures include economic losses due to unintentional injury in the past 3 months, the Incremental Cost-Effectiveness Ratios (ICERs), and parent’s attitudes and behaviors concerning supervision to prevent preschooler unintentional injury in the past week. An intention-to-treat approach will be used to evaluate outcome measures. Chi-square tests will examine differences for outcome measures between groups at each time point and generalized estimation equations (GEE) will test the overall effectiveness of the app-based intervention. Missing outcome data will be imputed using the Expectation Maximization algorithm (EM). Discussion This trial will examine evidence concerning the effectiveness of an innovative app-based intervention for caregivers of Chinese preschoolers. If effective, the app-based intervention could offer an effective population-based intervention option to cost-effectively promote unintentional injury prevention in countries and regions where injury control is under-supported. Trial registration ChiCTR-IOR-17010438. Registered 15 January 2017. Electronic supplementary material The online version of this article (10.1186/s12889-018-5790-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Peishan Ning
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Bo Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Peixia Cheng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Yang Yang
- Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Renhe Yu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Jing Deng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Shukun Li
- Information and Network Center, Central South University, Changsha, Hunan, China
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, 410078, Hunan, China.
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15
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Ozanne-Smith J, Li Q. A social change perspective on injury prevention in China. Inj Prev 2018; 24:i25-i31. [PMID: 29730599 DOI: 10.1136/injuryprev-2017-042712] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 03/19/2018] [Accepted: 03/28/2018] [Indexed: 11/04/2022]
Abstract
INTRODUCTION China has undergone massive social change over the past four decades. Since national estimates became available in 1987, the overall fatal injury rate has decreased. This paper investigates targeted interventions and sociodemographic factors that may have contributed to fatal injury rate changes particularly for road traffic fatality (RTF), suicide and drowning. AIMS (1) To review the recent epidemiology of injury in China.(2)To investigate factors influencing trends in overall and specific cause injury mortality rates. METHODS Published injury mortality statistics and related literature were reviewed. Factors potentially influencing trends were investigated in the context of rapid development based on literature reviews of targeted interventions, macrolevel and microlevel contextual factors and changes specific to RTF, suicide and drowning. RESULTS Overall estimated national injury mortality rates in China decreased between 1987 and 2015, despite a rapid rise in RTF. Suicide and drowning rates decreased significantly and falls displaced drowning among the leading causes. The higher female to male suicide ratio reversed. Differences were observed in frequencies and proportions of deaths by major cause by age group and over time. DISCUSSION Economic and structural development and related social change in this period include: urbanisation, changes in demographics, life choices (eg, internal migration), education, poverty alleviation, health insurance and relevant regulations/legislation. These factors potentially explain much of the change in fatal injury rates in China. Data limitations persist. Increased investment in data and research would provide realistic opportunities for accelerated progress in implementing effective targeted interventions to further reduce China's injury burden.
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Affiliation(s)
- Joan Ozanne-Smith
- Department of Forensic Medicine, Monash University, Victorian Institute of Forensic Medicine, Melbourne, Victoria, Australia
| | - Qingfeng Li
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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16
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Lukaszyk C, Ivers RQ, Jagnoor J. Systematic review of drowning in India: assessment of burden and risk. Inj Prev 2018; 24:451-458. [PMID: 29330198 DOI: 10.1136/injuryprev-2017-042622] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 12/05/2017] [Accepted: 12/15/2017] [Indexed: 11/03/2022]
Abstract
AIM To examine the burden and risk factors for fatal and non-fatal drowning in India. METHODS Relevant literature was identified through a systematic search of 19 electronic databases and 19 national and global, institutional, organisational and government sources of injury data. Search terms used pertained to drowning, injury, trauma, morbidity and mortality in India. RESULTS A total of 16 research articles and five data sources were included in the review. Three national data sources provided counts of drowning deaths, reporting a range of 1348-62 569 drowning deaths per year. A further three national data sources provided information on drowning-related morbidity; however, each source presented different outcome measures making comparison difficult. Ten research studies investigated risk factors associated with drowning in India. Key risk factors reported were male gender, young age (0-5 years) and individuals residing in the North-Eastern part of the country who have high exposure to water sources within community settings. CONCLUSION Drowning-related morbidity and mortality have a significant impact on India, with risk factors identified for this setting similar to those within other low-income and middle-income countries. Regional data which look beyond routinely collected data are required to accurately investigate the burden and impact of drowning, to inform targeted, context-specific approaches for drowning reduction initiatives.
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Affiliation(s)
- Caroline Lukaszyk
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Rebecca Q Ivers
- The George Institute for Global Health, University of New South Wales, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia.,Southgate Institute, Flinders University, Adelaide, Australia
| | - Jagnoor Jagnoor
- The George Institute for Global Health, University of New South Wales, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
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17
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Wu Y, Huang Y, Schwebel DC, Hu G. Unintentional Child and Adolescent Drowning Mortality from 2000 to 2013 in 21 Countries: Analysis of the WHO Mortality Database. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080875. [PMID: 28777318 PMCID: PMC5580579 DOI: 10.3390/ijerph14080875] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 07/27/2017] [Accepted: 08/02/2017] [Indexed: 12/05/2022]
Abstract
Limited research considers change over time for drowning mortality among individuals under 20 years of age, or the sub-cause (method) of those drownings. We assessed changes in under-20 drowning mortality from 2000 to 2013 among 21 countries. Age-standardized drowning mortality data were obtained through the World Health Organization (WHO) Mortality Database. Twenty of the 21 included countries experienced a reduction in under-20 drowning mortality rate between 2000 and 2013, with decreases ranging from −80 to −13%. Detailed analysis by drowning method presented large variations in the cause of drowning across countries. Data were missing due to unspecified methods in some countries but, when known, drowning in natural bodies of water was the primary cause of child and adolescent drowning in Poland (56–92%), Cuba (53–81%), Venezuela (43–56%), and Japan (39–60%), while drowning in swimming pools and bathtubs was common in the United States (26–37%) and Japan (28–39%), respectively. We recommend efforts to raise the quality of drowning death reporting systems and discuss prevention strategies that may reduce child and adolescent drowning risk, both in individual countries and globally.
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Affiliation(s)
- Yue Wu
- Department of Environmental and Occupational Health, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China.
| | - Yun Huang
- Department of Environmental and Occupational Health, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China.
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China.
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18
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Rahman A, Alonge O, Bhuiyan AA, Agrawal P, Salam SS, Talab A, Rahman QSU, Hyder AA. Epidemiology of Drowning in Bangladesh: An Update. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E488. [PMID: 28475138 PMCID: PMC5451939 DOI: 10.3390/ijerph14050488] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 04/07/2017] [Accepted: 05/03/2017] [Indexed: 11/01/2022]
Abstract
Over one-quarter of deaths among 1-4 year-olds in Bangladesh were due to drowning in 2003, and the proportion increased to 42% in 2011. This study describes the current burden and risk factors for drowning across all demographics in rural Bangladesh. A household survey was carried out in 51 union parishads of rural Bangladesh between June and November 2013, covering 1.17 million individuals. Information on fatal and nonfatal drowning events was collected by face-to-face interviews using a structured questionnaire. Fatal and non-fatal drowning rates were 15.8/100,000/year and 318.4/100,000/6 months, respectively, for all age groups. The highest rates of fatal (121.5/100,000/year) and non-fatal (3057.7/100,000/6 months) drowning were observed among children 1 to 4 years of age. These children had higher rates of fatal (13 times) and non-fatal drowning (16 times) compared with infants. Males had slightly higher rates of both fatal and non-fatal drowning. Individuals with no education had 3 times higher rates of non-fatal drowning compared with those with high school or higher education. Non-fatal drowning rates increased significantly with decrease in socio-economic status (SES) quintiles, from the highest to the lowest. Drowning is a major public health issue in Bangladesh, and is now a major threat to child survival.
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Affiliation(s)
- Aminur Rahman
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), House B162, Road 23, New DOHS, Mohakhali, Dhaka 1206, Bangladesh.
| | - Olakunle Alonge
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
| | - Al-Amin Bhuiyan
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), House B162, Road 23, New DOHS, Mohakhali, Dhaka 1206, Bangladesh.
| | - Priyanka Agrawal
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
| | - Shumona Sharmin Salam
- Centre for Child and Adolescent Health, icddr,b. 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh.
| | - Abu Talab
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), House B162, Road 23, New DOHS, Mohakhali, Dhaka 1206, Bangladesh.
| | - Qazi Sadeq-Ur Rahman
- Centre for Child and Adolescent Health, icddr,b. 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh.
| | - Adnan A Hyder
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
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Stewart BT, Yankson IK, Afukaar F, Medina MCH, Cuong PV, Mock C. Road Traffic and Other Unintentional Injuries Among Travelers to Developing Countries. Med Clin North Am 2016; 100:331-43. [PMID: 26900117 PMCID: PMC4764791 DOI: 10.1016/j.mcna.2015.07.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Injuries result in nearly 6 million deaths and incur 52 million disability-adjusted life-years annually, making up 15% of the global disease burden. More than 90% of this burden occurs in low- and middle-income countries. Given this burden, it is not unexpected that injuries are the leading cause of death among travelers to low- and middle-income countries, namely, from road traffic crashes and drowning. Therefore, pretravel advice regarding foreseeable dangers and how to avoid them may significantly mitigate injury risk, such as wearing seatbelts, helmets, and personal flotation devices when appropriate; responsibly consuming alcohol; and closely supervising children.
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Affiliation(s)
- Barclay T Stewart
- Department of Surgery, University of Washington, 1959 Northeast Pacific Street, Suite BB-487, PO Box 356410, Seattle, WA 98195-6410, USA; School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
| | - Isaac Kofi Yankson
- CSIR-Building and Road Research Institute, University PO Box 40, Kumasi, Ghana
| | - Francis Afukaar
- CSIR-Building and Road Research Institute, University PO Box 40, Kumasi, Ghana
| | - Martha C Hijar Medina
- Secretaria Técnica del CONAPRA, Subsecretaría de Prevención y Promoción Secretaría Salud, Guadalajara 46 3er. Piso Col Roma Norte, CP 06700, Mexico DF, Mexico
| | - Pham Viet Cuong
- Center for Injury Policy and Prevention Research, Department of Public Health Informatics, Hanoi School of Public Health, 138 Giảng Võ, Kim Mã, Ba Đình, Hanoi, Vietnam
| | - Charles Mock
- Department of Surgery, University of Washington, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA; Harborview Injury Prevention & Research Center, Patricia Bracelin Steel Memorial Building, 401 Broadway, 4th Floor, Seattle, WA 98122, USA; Harborview Medical Center, 325 9th Avenue, Seattle, WA 98104, USA
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20
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Abstract
OBJECTIVE This retrospective population-based study examined drowning location by the site of immersion for both fatal and non-fatal drowning events in Queensland. Drowning location is not routinely collected, and this study used data linkage to identify drowning sites. The resulting enhanced quality data quantify drowning incidence for specific locations by geographic region, age group and by severity for the first time. DESIGN Linked data were accessed from the continuum of care (prehospital, emergency, hospital admission and death data) on fatal and non-fatal drowning episodes in children aged 0-19 years in Queensland for the years 2002-2008 inclusive. RESULTS Drowning locations ranked in order of overall incidence were pools, inland water, coastal water, baths and other man-made water hazards. Swimming pools produced the highest incidence rates (7.31/100,000) for overall drowning events and were more often privately owned pools and in affluent neighbourhoods. Toddlers 0-4 years were most at risk around pools (23.94/100,000), and static water bodies such as dams and buckets-the fatality ratios were highest at these 2 locations for this age group. Children 5-14 years incurred the lowest incidence rates regardless of drowning location. Adolescents 15-19 years were more frequently involved in a drowning incident on the coast shoreline, followed by inland dynamic water bodies. CONCLUSIONS Linked data have resulted in the most comprehensive data collection on drowning location and severity to date for children in the state of Queensland. Most mortality and morbidity could have been prevented by improving water safety through engaged supervision around pools and bath time, and a heightened awareness of buckets and man-made water hazards around the farm home for young children. These data provide a different approach to inform prevention strategies.
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Affiliation(s)
- Belinda A Wallis
- Centre for Children's Burns & Trauma Research, Queensland University Child Health Research Centre, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
- Dept of Paediatric Surgery, Urology, Burns & Trauma, Lady Cilento Children’s Hospital, Brisbane, Queensland, Australia
| | - Kerrianne Watt
- Centre for Children's Burns & Trauma Research, Queensland University Child Health Research Centre, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Richard C Franklin
- Centre for Children's Burns & Trauma Research, Queensland University Child Health Research Centre, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
- Royal Life Saving Society Australia, Townsville, Queensland, Australia
| | - James W Nixon
- Centre for Children's Burns & Trauma Research, Queensland University Child Health Research Centre, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Roy M Kimble
- Centre for Children's Burns & Trauma Research, Queensland University Child Health Research Centre, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
- Dept of Paediatric Surgery, Urology, Burns & Trauma, Lady Cilento Children’s Hospital, Brisbane, Queensland, Australia
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Rahman M, Sohel N, Hore SK, Yunus M, Bhuiya A, Streatfield PK. Prenatal arsenic exposure and drowning among children in Bangladesh. Glob Health Action 2015; 8:28702. [PMID: 26511679 PMCID: PMC4624574 DOI: 10.3402/gha.v8.28702] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 09/25/2015] [Accepted: 09/26/2015] [Indexed: 01/10/2023] Open
Abstract
There is increasing concern regarding adverse effects of prenatal arsenic exposure on the neurodevelopment of children. We analyzed mortality data for children, who were born to 11,414 pregnant women between 2002 and 2004, with an average age of 5 years of follow-up. Individual drinking-water arsenic exposure during pregnancy was calculated using tubewell water arsenic concentration between last menstrual period and date of birth. There were 84 drowning deaths registered, with cause of death ascertained using verbal autopsy (International Classification of Diseases, 10th revision, codes X65–X70). The prenatal water arsenic exposure distribution was tertiled, and the risk of drowning mortality was estimated by Cox proportional hazard models, adjusted for potential confounders. We observed a significant association between prenatal arsenic exposure and drowning in children aged 1–5 years in the highest exposure tertile (HR=1.74, 95% CI: 1.03–2.94). This study showed that in utero arsenic exposure might be associated with excess mortality among children aged 1–5 years due to drowning.
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Affiliation(s)
| | - Nazmul Sohel
- Department of Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
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A Review of Drowning Prevention Interventions for Children and Young People in High, Low and Middle Income Countries. J Community Health 2015; 41:424-41. [DOI: 10.1007/s10900-015-0105-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Chasimpha S, McLean E, Chihana M, Kachiwanda L, Koole O, Tafatatha T, Mvula H, Nyirenda M, Crampin AC, Glynn JR. Patterns and risk factors for deaths from external causes in rural Malawi over 10 years: a prospective population-based study. BMC Public Health 2015; 15:1036. [PMID: 26449491 PMCID: PMC4599750 DOI: 10.1186/s12889-015-2323-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 09/22/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Little is known about the pattern or risk factors for deaths from external causes in sub-Saharan Africa: there is a lack of reliable data, and public health priorities have been focussed on other causes. This study assessed the prevalence and risk factor for deaths from external causes in rural Malawi. METHODS We analysed data from 2002-2012 from the Karonga demographic surveillance site which covers ~35,000 people in rural northern Malawi. Verbal autopsies with clinician coding are used to assign cause of death. Repeated annual surveys capture data on socio-economic factors. Using Poisson regression models we calculated age, sex and cause-specific rates and rate ratios of external deaths. We used a nested case-control study, matched on age, sex and time period, to investigate risk factors for these deaths, using conditional logistic regression. RESULTS In 315,580 person years at risk (pyar) there were 2673 deaths, including 143 from external causes. The mortality rate from external causes was 47.1/100,000 pyar (95 % CI 32.5-68.2) among under-fives; 20.1/100,000 pyar (95 % CI 13.1-32.2) among 5-14 year olds; 46.3/100,000 pyar (95 % CI 35.8-59.9) among 15-44 year olds; and 98.7/100,000 pyar (95 % CI 71.8-135.7) among those aged ≥45 years. Drowning (including four deaths in people with epilepsy), road injury and suicide were the leading external causes. Adult males had the highest rates (100.7/100,000 pyar), compared to 21.8/100,000pyar in adult females, and the rate continued to increase with increasing age in men. Alcohol contributed to 21 deaths, all in adult males. Children had high rates of drowning (9.2/100,000 pyar, 95 % CI 5.5-15.6) but low rates of road injury (2.6/100,000 pyar, 95 % CI 1.0-7.0). Among 5-14 year olds, attending school was associated with fewer deaths from external causes than among those who had never attended school (adjusted OR 0.15, 95 % CI 0.08-0.81). Fishermen had increased risks of death from drowning and suicide compared to farmers. DISCUSSION In this population the rate of deaths from external causes was lowest at age 5-14 years. Adult males had the highest rate of death from external causes, 5 times the rate in adult females. Drowning, road injury and suicide were the leading causes of death; alcohol consumption contributed to more than one quarter of the deaths in men CONCLUSIONS The high proportion of alcohol-related deaths in men, the predominance of drowning, deaths linked to uncontrolled epilepsy, and the possible protective effect of school attendance suggest areas for intervention.
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Affiliation(s)
- Steady Chasimpha
- Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK.
- Malawi National Cancer Registry, Blantyre, Malawi.
| | - Estelle McLean
- Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK.
| | | | | | - Olivier Koole
- Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK.
| | | | | | - Moffat Nyirenda
- Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK.
| | - Amelia C Crampin
- Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK.
- Karonga Prevention Study, Chilumba, Malawi.
| | - Judith R Glynn
- Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK.
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Zhu Y, Jiang X, Li H, Li F, Chen J. Mortality among drowning rescuers in China, 2013: a review of 225 rescue incidents from the press. BMC Public Health 2015; 15:631. [PMID: 26156246 PMCID: PMC4496822 DOI: 10.1186/s12889-015-2010-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 07/01/2015] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Drowning is common worldwide. Rescue efforts attempted by untrained bystanders often lead to the death of the primary drowning victim (PDV), the rescuer or both. Our study aimed to inform prevention by identifying risk factors in rescuer drowning. METHODS Data on drowning rescue incidents reported online in mainland China, 2013, were reviewed. Information on the drowning incidents, PDVs and rescuers were retrieved for analysis. RESULTS A total of 225 rescue incidents were identified, of which 14 were victim-rescuer drowning incidents (VRDIs) (6.2%). A person-to-person rescue by swimming to PDVs was the most commonly used method (58.9%). Resuscitation was given immediately to 35.5% of PDVs after rescue. The mortality rate of the rescuers (13.3%) was similar to that of the PDVs (11.5%) (χ(2) = 0.5, p =0.49). Being an adult (OR = 0.2, 95% CI: 0.1-0.5) and other than the first rescuer (OR = 0.4, 95% CI: 0.2-0.9) decreased the risk of rescuers drowning. CONCLUSIONS Most of the currently employed life-saving methods are dangerous and even potentially life threatening. The idea of "rescuers' safety first" should be embraced, especially with teenage and child rescuers, who should never be encouraged to rescue others without first guaranteeing their own safety. Promotion of basic rescue skills should be implemented in the general public.
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Affiliation(s)
- Yinchao Zhu
- Institute of Non-Communicable Disease Control and Prevention, Ningbo Municipal Center for Disease Control and Prevention, No. 237, Yongfeng Road, Haishu District, Ningbo, Zhejiang Province, 315010, People's Republic of China.
| | - Xia Jiang
- Cardiovascular Epidemiology Unit, Institute of Environmental Medicine, Karolinska Institutet, Solna, 17172, Stockholm, Sweden.
| | - Hui Li
- Institute of Non-Communicable Disease Control and Prevention, Ningbo Municipal Center for Disease Control and Prevention, No. 237, Yongfeng Road, Haishu District, Ningbo, Zhejiang Province, 315010, People's Republic of China.
| | - Fudong Li
- Department of Public Health Surveillance & Advisory Division, Zhejiang Province Center for Disease Control and Prevention, No.630, Xincheng Road, Binjiang District, Hangzhou, Zhejiang Province, 310051, People's Republic of China.
| | - Jieping Chen
- Institute of Non-Communicable Disease Control and Prevention, Ningbo Municipal Center for Disease Control and Prevention, No. 237, Yongfeng Road, Haishu District, Ningbo, Zhejiang Province, 315010, People's Republic of China.
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Woo SH, Park JH, Choi SP, Wee JH. Comparison of clinical characteristics of intentional vs accidental drowning patients. Am J Emerg Med 2015; 33:1062-5. [PMID: 25963676 DOI: 10.1016/j.ajem.2015.04.051] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 04/23/2015] [Accepted: 04/24/2015] [Indexed: 11/26/2022] Open
Abstract
PURPOSES Drowning may happen by accident or as a method of committing suicide. The aim of this study was to determine some characteristics of drowning patients who committed intentionally. METHODS A retrospective review was performed on 462 patients who visited the emergency department complaining of drowning between January 1998 and October 2011. Of these patients, we only included the patients for whom the cause could be identified. Age, sex, cause, time of drowning, season, mechanism, cardiopulmonary resuscitation performance, body temperature, alcohol ingestion, history of previous suicide attempts, outcome, and other characteristics were collected. RESULTS A total of 380 patients were included. Among them, 282 (74.2%) had drowned themselves intentionally, and they were older than those who had drowned accidentally (median age, 35.0 years [25.0-49.0 years] vs 26.5 years [19.0-35.5 years], P < .001) and showed lower body temperature (below 34°C, 32.1% vs 12.2%, P = .027). Ninety-four cases (33.3%) jumped off the river from a bridge, and 185 (65.6%) walked into the river from the riverside. In the intentional group, 59 (20.9%) had depressive disorder in their history. The rate of death showed no clinical difference (19.5% vs 16.3%, P = .487), but more males died in the accidental group (61.8% vs 93.8%, P = .015). CONCLUSIONS Intentional drowning happened more in older subjects and presented lower initial body temperature. Walking from the riverside happened more often than jumping off a bridge. More males died of drowning regardless of intentionality.
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Affiliation(s)
- Seon Hee Woo
- Department of Emergency Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jeong Ho Park
- Department of Emergency Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung Pill Choi
- Department of Emergency Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Hee Wee
- Department of Emergency Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Cordovil R, Araújo D, Pepping GJ, Barreiros J. An ecological stance on risk and safe behaviors in children: The role of affordances and emergent behaviors. NEW IDEAS IN PSYCHOLOGY 2015. [DOI: 10.1016/j.newideapsych.2014.10.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Laosee O, Khiewyoo J, Somrongthong R. Drowning risk perceptions among rural guardians of Thailand: A community-based household survey. J Child Health Care 2014; 18:168-77. [PMID: 24092868 DOI: 10.1177/1367493513485477] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Drowning is one of the most common causes of death among young children in Thailand. Children in primary school in rural settings have a high rate of fatal drowning. Guardians' perceptions are important since children are normally in their care. This study aims to describe drowning risk perceptions of guardians and to identify barriers to developing a child's swimming skills. A cross-sectional household survey was conducted among guardians of children who attended 12 schools serving 48 villages in a rural community. The results revealed that less than one-fifth (18%) of children in the household could swim. Guardians reported that children should learn to swim at the age of seven years. About one-quarter (23%) of guardians did not perceive drowning as the leading cause of death among children. More than a quarter (25.4%) perceived that their child was not at the risk of drowning. No statistical differences were reported on drowning perception among guardians with different swimming skills as well as child's swimming skill. Significantly more parents of children who could not swim perceived lack of swimming instructors, clean water and school swimming lessons as barriers to a child's acquisition of swimming skill. The results highlight the need to consider improving the infrastructure in rural areas to facilitate swimming skills for school children to reduce drowning risk.
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Affiliation(s)
- Orapin Laosee
- ASEAN Institute for Health Development, Mahidol University, Thailand
| | - Jiraporn Khiewyoo
- Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen University, Thailand
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Kitulwatte ID, Edirisinghe PAS. Study on unnatural childhood deaths presented to North Colombo Teaching Hospital, Sri Lanka. MEDICINE, SCIENCE, AND THE LAW 2014; 54:74-77. [PMID: 23966353 DOI: 10.1177/0025802413491249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Unnatural childhood deaths are not only associated with intense trauma and separation distress, but also relate to a sense of neglect to protect children from harm. Accurate information on causes and circumstances of such deaths through a process of medico-legal investigations is essential in creating an awareness among the policy makers and educators/caregivers, to prevent these tragic deaths. OBJECTIVE The aim of the study was to determine the causes and the circumstances of unnatural deaths of children among the medico-legal autopsy population presented to North Colombo Teaching Hospital, Sri Lanka. STUDY DESIGN A retrospective descriptive study was carried out based on Reports of Postmortem Examination performed in a Tertiary Care Hospital, on children who died of unnatural causes during the period from 2009 to 2011. RESULTS Out of 48 unnatural childhood deaths, 24 (50%) children were older than 10 years of age. The most frequent circumstance of death was accidental 39 (81%), while the most frequent cause of death was drowning 16 (33%). Fifteen died due to accidental drowning while one was a homicidal drowning. Suicidal deaths were found only among the children older than 16 years of age. Fifty-four percent of the accidental deaths had taken place at or around the home. CONCLUSION Accidents accounted for the majority (or greatest number) of tragic childhood deaths. The presence of drowning as the most common cause of death indicates that an immense responsibility lies with the parents and caregivers to prevent such deaths.
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Affiliation(s)
- Indira D Kitulwatte
- Department of Forensic Medicine, Faculty of Medicine, University of Kelaniya, Sri Lanka
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He S, Lunnen JC, Puvanachandra P, Amar-Singh, Zia N, Hyder AA. Global childhood unintentional injury study: multisite surveillance data. Am J Public Health 2014; 104:e79-84. [PMID: 24432924 DOI: 10.2105/ajph.2013.301607] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We aimed to analyze the epidemiology of childhood unintentional injuries presenting to hospitals in 5 select sites in low- and middle-income countries (LMICs) (Bangladesh, Colombia, Egypt, Malaysia, and Pakistan). METHODS We collected standardized data from children ages 0 to 12 years at participating emergency departments (EDs) in 2007. Statistical analyses were conducted to compare the characteristics of these injuries and to explore the determinants of injury outcomes. RESULTS Among 2686 injured children, falls (50.4%) and road traffic injuries (16.4%) were the most common, affecting boys more often (64.7%). Home injuries were more common among younger children (average 5.41 vs 7.06 years) and girls (38.2% vs 31.7%). Following an ED visit, 24% of injured children were admitted to the hospital, and 6 died. Injury outcomes were associated with risk factors, such as age and sex, to varying extents. CONCLUSIONS Standardized ED surveillance revealed unintentional injuries are a threat to child health. The majority of events took place inside the home, challenging traditional concepts of children's safety and underscoring the need for intensified context-appropriate injury prevention.
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Affiliation(s)
- Siran He
- Siran He, Jeffrey C. Lunnen, Prasanthi Puvanachandra, Nukhba Zia, and Adnan A. Hyder are with Johns Hopkins International Injury Research Unit, Bloomberg School of Public Health, Baltimore, MD. Amar Singh is with the Paediatric Department, Ipoh General Hospital, Perak, Malaysia
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Crawford G, Leavy J, Portsmouth L, Jancey J, Leaversuch F, Nimmo L, Reid-Dornbusch L, Hills E. Development of a Systematic Review of Public Health Interventions to Prevent Children Drowning. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ojpm.2014.43014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Prameprart M, Lim A, Tongkumchum P. Modeling Unintentional Drowning Mortality Rates in Thailand, 2000-2009. Asia Pac J Public Health 2013; 27:NP2471-9. [DOI: 10.1177/1010539513488796] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objectives of this study were to investigate the pattern of unintentional drowning deaths and to identify the factors associated with drowning deaths in Thailand from 2000 to 2009. Reported death data were obtained from the Bureau of Health Policy and Strategy, Ministry of Public Health. During the period from 2000 to 2009, 41 620 deaths were reported and 1016 deaths were excluded from this study because of unknown place of death. The overall drowning death rate per 100 000 population was 6.3 (9.6 in males and 3.0 in females). The highest death rate was in males aged 0 to 4 years and in year 2006. Males in all age-groups (except in those aged 15-29 years) and females aged 0 to 4 years had higher drowning death rates than the average rate. Death rates in some public health areas in the central, the northeast, and the northern regions and in year 2005 and 2006 were higher than the average rate.
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Ahlm K, Saveman BI, Björnstig U. Drowning deaths in Sweden with emphasis on the presence of alcohol and drugs - a retrospective study, 1992-2009. BMC Public Health 2013; 13:216. [PMID: 23497055 PMCID: PMC3610133 DOI: 10.1186/1471-2458-13-216] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 03/05/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Drowning deaths constitute a significant proportion of unnatural deaths globally. In Sweden and other high-income countries, drowning deaths have decreased. This study investigates the epidemiology and current trends of unintentional, intentional, and undetermined drowning deaths with emphasis on the presence of alcohol and other drugs. METHODS During an 18-years period, 5,125 drowning deaths were autopsied in Sweden. Data on cases including toxicological analysis on alcohol, pharmaceutical drugs, and illicit drugs were obtained from the National Board of Forensic Medicine. RESULTS During the study period, the annual incidence of drowning deaths in Sweden was 3.1/100,000 inhabitants and decreased on average by about 2% each year (p<0.001). The highest incidence was found among males and in middle/older age groups. The incidence increased 3% for each year of age. Children/adolescents (≤18 years) constituted 5% of all drowning deaths. Of all drowned females in the study, 55% (847/1,547) committed suicide, which was a significantly higher proportion compared with males (21%, 763/3,578) (p<0.001). In total, 38% (1,656/4,377) of tested drowned persons had alcohol in their blood and the mean concentration was 1.8 g/l. In the unintentional drowning group, intentional drowning group, and the undetermined group, the proportion of alcohol positive was 44%, 24%, and 45%, respectively. One or several psychoactive drugs were present in the blood in 40% (1,688 /4,181) of all tested persons and in 69% (965/1,394) of tested persons who died from suicidal drowning. The most common drug was benzodiazepines (21%, 891/4,181). Illicit drugs were detected in 10% (82/854) of tested persons. CONCLUSION Presence of alcohol and drugs were frequent and may have contributed to the drowning deaths. The incidence of drowning deaths significantly decreased during the study period. Males and the middle/older age groups had a higher incidence compared to females and children. Suicidal drowning was common especially among women. Alcohol and drugs are significant contributors in drowning deaths in Sweden and should be considered as part of a comprehensive prevention program.
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Affiliation(s)
- Kristin Ahlm
- Section of Forensic Medicine, Department of Community Medicine and Rehabilitation, Umeå University, POB 7616, Umeå, SE 907 12, Sweden.
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Solomon R, Giganti MJ, Weiner A, Akpinar-Elci M. Water safety education among primary school children in Grenada. Int J Inj Contr Saf Promot 2012; 20:266-70. [PMID: 22950942 DOI: 10.1080/17457300.2012.717083] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Drowning is a common cause of death among children. Successful prevention interventions currently used in developed countries are often not transferable into developing countries due to differences in both environment and resources. In this study, we adapted a water safety education programme developed by the American Red Cross for primary school students in Grenada. Water safety knowledge before and after the training session was assessed using a nine-question evaluation tool. Following the training, a survey was administered to all teachers to assess the adaptability and effectiveness of the WHALE Tales training. Fifty-six students (30% males) completed the training. The age range was between 5 and 12 years old. Participants' water safety knowledge increased 15% (p < 0.01). Mean scores of correct answers increased for every grade level, ranging from a 5% increase for first graders to 33% increase for second graders. The findings from this study suggested that implementation of such a programme is effective. With cultural modifications and outsourcing, we believe this adapted programme would be successful in Grenada and other similar settings.
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Affiliation(s)
- Rachele Solomon
- a Department of Public Health and Preventive Medicine , St. George's University , St. Georges , Grenada , West Indies
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Cordovil R, Vieira F, Barreiros J. Crossing safety barriers: influence of children's morphological and functional variables. APPLIED ERGONOMICS 2012; 43:515-520. [PMID: 21871604 DOI: 10.1016/j.apergo.2011.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Revised: 07/25/2011] [Accepted: 08/05/2011] [Indexed: 05/31/2023]
Abstract
Thirty-three children between 3 and 6 years of age were asked to climb four different types of safety barriers. Morphological and functional variables of the children, which were expected to influence climbing or passing through skills, were collected. The influence of those variables on children's success rate and time to cross was tested. No barrier offered a total restraining efficacy. The horizontal bars barrier was crossed by 97% of the children. In the group of children that succeeded in crossing the four barriers, mean time to cross the most difficult barrier was 15 s. Age was the best predictor for success in crossing most barriers but morphology and strength were important predictors of time to cross. The influence of anthropometric variables in time to cross was dependent upon the characteristics of the barrier. A good design of safety barriers should consider children's age, morphology and strength.
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Affiliation(s)
- Rita Cordovil
- Faculty of Human Kinetics - Technical University of Lisbon, Department of Health and Sport Sciences, Estrada da Costa, 1495-688 Cruz Quebrada, Portugal.
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Childhood unintentional injuries: need for a community-based home injury risk assessments in pakistan. Int J Pediatr 2012; 2012:203204. [PMID: 22577399 PMCID: PMC3332195 DOI: 10.1155/2012/203204] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Revised: 01/27/2012] [Accepted: 01/30/2012] [Indexed: 11/21/2022] Open
Abstract
Background. A substantial proportion of the annual 875,000 childhood unintentional injury deaths occur in the home. Very few printed tools are available in South Asia for disseminating home injury prevention information. Methods. Three tools were planned: an injury hazard assessment tool appropriate for a developing country setting, an educational pamphlet highlighting strategies for reducing home injury hazards, and an in-home safety tutorial program to be delivered by a trained community health worker. Results. The three tools were successfully developed. Two intervention neighborhoods in Karachi, Pakistan, were mapped. The tools were pretested in this local setting and are now ready for pilot testing in an intervention study. Conclusion. Planning for an innovative, community-based pilot study takes considerable time and effort in a low-income setting like Pakistan. The primary outcome of the pre-testing phase of the study was the development of three important tools geared for low-income housing communities in Pakistan.
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de Ramirez SS, Hyder AA, Herbert HK, Stevens K. Unintentional injuries: magnitude, prevention, and control. Annu Rev Public Health 2012; 33:175-91. [PMID: 22224893 DOI: 10.1146/annurev-publhealth-031811-124558] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The World Health Organization estimates injuries accounted for more than 5 million deaths in 2004, significantly impacting the global burden of disease. Nearly 3.9 million of these deaths were due to unintentional injury, a cause also responsible for more than 138 million disability-adjusted life years (DALYs) lost in the same year. More than 90% of the DALYs lost occur in low- and middle-income countries (LMICs), highlighting the disproportionate burden that injuries place on developing countries. This article examines the health and social impact of injury, injury data availability, and injury prevention interventions. By proposing initiatives to minimize the magnitude of death and disability due to unintentional injuries, particularly in LMICs, this review serves as a call to action for further investment in injury surveillance, prevention interventions, and health systems strengthening.
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Abstract
Injury and violence rank among the leading causes of death worldwide, with more than 5 million deaths annually, representing a significant portion of the global burden of disease. This article examines how injury and violence relate to global health using recent global burden of disease data and selected key studies and databases, and further explores risk factors and intervention initiatives that address unintentional and intentional injuries. The article serves as a call to action to enhance understanding of the growing burden of injury and violence, especially in low-income and middle-income countries, where more than 90% of injuries occur.
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Borse NN, Hyder AA, Bishai D, Baker T, Arifeen SE. Potential Risk Estimation Drowning Index for Children (PREDIC): a pilot study from Matlab, Bangladesh. ACCIDENT; ANALYSIS AND PREVENTION 2011; 43:1901-1906. [PMID: 21819817 DOI: 10.1016/j.aap.2011.04.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2010] [Revised: 04/25/2011] [Accepted: 04/27/2011] [Indexed: 05/31/2023]
Abstract
UNLABELLED Childhood drowning is a major public health problem that has been neglected in many low- and middle-income countries. In Matlab, rural Bangladesh, more than 40% of child deaths aged 1-4 years are due to drowning. AIM The main objective of this paper was to develop and evaluate a childhood drowning risk prediction index. METHODOLOGY A literature review was carried out to document risk factors identified for childhood drowning in Bangladesh. The Newacheck model for special health care needs for children was adapted and applied to construct a childhood drowning risk index called "Potential Risk Estimation Drowning Index for Children" (PREDIC). Finally, the proposed PREDIC Index was applied to childhood drowning deaths and compared with the comparison group from children living in Matlab, Bangladesh. This pilot study used t-tests and Receiver Operating Characteristic (ROC) curve to analyze the results. RESULTS The PREDIC index was applied to 302 drowning deaths and 624 children 0-4 years old living in Matlab. The results of t-test indicate that the drowned children had a statistically (t=-8.58, p=0.0001) significant higher mean PREDIC score (6.01) than those in comparison group (5.26). Drowning cases had a PREDIC score of 6 or more for 68% of the children however, the comparison group had 43% of the children with score of 6 or more which was statistically significant (t=-7.36, p<0.001). The area under the curve for the Receiver Operating Characteristic curve was 0.662. CONCLUSION Index score construction was scientifically plausible; and the index is relatively complete, fairly accurate, and practical. The risk index can help identify and target high risk children with drowning prevention programs. PREDIC index needs to be further tested for its accuracy, feasibility and effectiveness in drowning risk reduction in Bangladesh and other countries.
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Affiliation(s)
- N N Borse
- Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA(1); Public Health Sciences Division, The International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
| | - A A Hyder
- Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA(1); International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - D Bishai
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - T Baker
- International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - S E Arifeen
- Public Health Sciences Division, The International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
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Placing emergency care on the global agenda. Ann Emerg Med 2010; 56:142-9. [PMID: 20138398 DOI: 10.1016/j.annemergmed.2010.01.013] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2008] [Revised: 11/26/2009] [Accepted: 01/11/2010] [Indexed: 11/20/2022]
Abstract
Emergency care serves a key function within health care systems by providing an entry point to health care and by decreasing morbidity and mortality. Although primarily focused on evaluation and treatment for acute conditions, emergency care also serves as an important locus of provision for preventive care with regard to injuries and disease progression. Despite its important and increasing role, however, emergency care has been frequently overlooked in the discussion of health systems and delivery platforms, particularly in developing countries. Little research has been done in lower- and middle-income countries on the burden of disease reduction attributable to emergency care, whether through injury treatment and prevention, urgent and emergency treatment of acute conditions, or emergency treatment of complications from chronic conditions. There is a critical need for research documenting the role of emergency care services in reducing the global burden of disease. In addition to applying existing methodologies toward this aim, new methodologies should be developed to determine the cost-effectiveness of these interventions and how to effectively cover the costs of and demands for emergency care needs. These analyses could be used to emphasize the public health and clinical importance of emergency care within health systems as policymakers determine health and budgeting priorities in resource-limited settings.
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