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Venugopal D, B R, K P, A M, A G, S J, Ky R, S A. Occupational Injuries and Health Status Among Rural Tribal Non-Traditional Fishing Communities in the Coastal Region of Tamil Nadu, India. J Agromedicine 2024; 29:344-354. [PMID: 38214268 DOI: 10.1080/1059924x.2024.2304197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
OBJECTIVES This study evaluated the occupational injuries and health hazards associated with fishing as an occupation among non-traditional rural tribal fishing communities in the coastal region of Tamil Nadu, India. METHODS This cross-sectional study included a total of 170 individuals belonging to a fishing community, comprising both male (n = 82) and female (n = 88) participants. The demographic details including occupational history, lifestyle characteristics, socio-economic status, personal habits, and health status were assessed through the questionnaire survey. RESULTS The fishing community has a low socioeconomic status and poor literacy, lifestyle, and personal habits. The mean age of the participants was 38.8 yrs (male 34.8; female 39.9 yrs). Only 10% reported usage of personal protective equipment (PPE), and the work duration varied from 8 to 24 hrs in a day. While male subjects reported smoking habits (12%) and alcohol consumption (23%), none of the females reported alcohol consumption and smoking habits. The major occupational injuries that occurred were due to catfish (72%) and oysters (48%). A large number of female subjects reported musculoskeletal pains. The body mass index of about 28% of fishermen was above the normal range. Abnormal blood sugar, blood pressure, and respiratory and neurological symptoms were the other major health complaints. The major environmental hazards reported were salinity, solar radiation, tides, and high wind. CONCLUSION Injuries from handling fish and oysters were observed to be the major occupational burden. Additonally, a high prevalence of musculoskeletal pain and chronic health illness was commonly observed among the fishers. Adequate training and awareness programs are required for effective management of occupational health hazards and health promotion.
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Affiliation(s)
- Dhananjayan Venugopal
- Industrial Hygiene & Toxicology division, ICMR-Regional Occupational Health Centre (Southern), NIOH, Devanahalli, Bangalore, India
| | - Ravichandran B
- Industrial Hygiene & Toxicology division, ICMR-Regional Occupational Health Centre (Southern), NIOH, Devanahalli, Bangalore, India
| | - Panjakumar K
- Industrial Hygiene & Toxicology division, ICMR-Regional Occupational Health Centre (Southern), NIOH, Devanahalli, Bangalore, India
| | - Mala A
- Industrial Hygiene & Toxicology division, ICMR-Regional Occupational Health Centre (Southern), NIOH, Devanahalli, Bangalore, India
| | - Gopalakrishnan A
- Centre of Advanced Study in Marine Biology, Annamalai University, Parangipettai, Tamil Nadu, India
| | - Jayaraman S
- Department of Community Medicine, Mahatma Gandhi Medical College & Research Institute, Puducherry, India
| | - Rajeev Ky
- Industrial Hygiene & Toxicology division, ICMR-Regional Occupational Health Centre (Southern), NIOH, Devanahalli, Bangalore, India
| | - Arun S
- Department of Community Medicine, Mahatma Gandhi Medical College & Research Institute, Puducherry, India
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Rasolofoson RA, Onyango HO, Awuor FJ, Aura CM, Fiorella KJ. Climate change: A pointer to increased small-scale fisher drowning deaths. PLoS One 2024; 19:e0302397. [PMID: 38776265 PMCID: PMC11111062 DOI: 10.1371/journal.pone.0302397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 04/02/2024] [Indexed: 05/24/2024] Open
Abstract
Drowning is an overlooked public health concern and drowning risk is dependent on environmental risk factors. The preponderance of drowning deaths occurs in low- and middle-income countries. Small-scale fishers face high occupational risk of drowning. Climate change increases the frequency and intensity of storms, thereby exacerbating fishers' risks and creating a need to examine the contribution of storms to fisher drowning deaths for the development of mitigation strategies. We examined this relationship between weather and fisher drowning deaths in Lake Victoria, which is Africa's largest lake, a site of high fishing pressure, and where climate change is predicted to increase thunderstorms. We conducted a verbal autopsy with people knowledgeable about recent fatal fisher drowning incidents to collect information about the deceased fishers and circumstances surrounding the incidents across 43 landing sites in the Kenyan shore of Lake Victoria. Semi-structured interviews with stakeholders also elucidated community perspectives on drowning risks. Fatal drownings were often attributed to bad weather (41.8%). Other risk factors, such as non-use of life jacket and navigation equipment, co-occurred with bad weather at high rates (69.5% and 67.8%, respectively) to jointly contribute to fatal drowning incidents. Such co-occurrence of risk factors indicates that actions across multiple risk factors can help mitigate the issue. Stakeholder analysis revealed a range of opportunities for improved communication of risks and action to mitigate risks across boat operators and manufacturers, as well as multiple levels of management. Across global small-scale fisheries, limited use of safety equipment and intensive fishing pressure may coincide with increases in extreme weather events, necessitating action to address current and mitigate future drowning risks to small-scale fishers.
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Affiliation(s)
- Ranaivo A. Rasolofoson
- Duke University Marine Laboratory, Nicholas School of the Environment, Duke University, Beaufort, North Carolina, United States of America
- Department of Public and Ecosystem Health, Cornell University, Ithaca, New York, United States of America
- School of the Environment, University of Toronto, Toronto, Ontario, Canada
| | - Horace Owiti Onyango
- Department of Natural Resources and the Environment, Cornell University, Ithaca, New York, United States of America
- Kenya Marine and Fisheries Research Institute, Kisumu, Kenya
| | | | | | - Kathryn J. Fiorella
- Department of Public and Ecosystem Health, Cornell University, Ithaca, New York, United States of America
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Vincenten JA, Meddings DR, Eardley K, Sufiur Rahman M, White N. Advancing child survival: commitment to act on drowning prevention and opportunity for impactful change. BMJ Glob Health 2023; 8:e014633. [PMID: 38081773 PMCID: PMC10728994 DOI: 10.1136/bmjgh-2023-014633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023] Open
Affiliation(s)
| | - David R Meddings
- Department of the Social Determinants of Health, Division of UHC/Healthier Populations, World Health Organization, Geneva, GE, Switzerland
| | - Kate Eardley
- International Programme, Royal National Lifeboat Institution, Poole, UK
| | - Mohammad Sufiur Rahman
- Ambassador and Permanent Representative of Bangladesh, Permanent Mission of Bangladesh to the United Nations, Geneva, Switzerland
| | - Noel White
- Ambassador and Permanent Representative of Ireland, Permanent Mission of Ireland to the United Nations, Geneva, Switzerland
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Oporia F, Nuwaha F, Kobusingye O, Jagnoor J, Makumbi FE, Isunju JB, Kibira SPS. Development and validation of an intervention package to improve lifejacket wear for drowning prevention among occupational boaters on Lake Albert, Uganda. Inj Prev 2023; 29:493-499. [PMID: 37507211 DOI: 10.1136/ip-2022-044840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 07/13/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Occupational drowning is a growing public health concern globally. The human cost of fishing is highest in sub-Saharan Africa. Although lifejackets prevent drowning, the majority of boaters in Uganda do not wear them. We developed and validated a peer-to-peer training manual to improve lifejacket wear among occupational boaters on Lake Albert, Uganda. METHODS The intervention was developed in three stages. In stage one, we conducted baseline studies to explore and identify aspects of practices that need to change. In stage two, we held a stakeholder workshop to identify relevant interventions following the intervention functions of the behaviour change wheel (BCW). In stage three, we developed the content and identified its implementation strategies. We validated the intervention package using the Content Validity Index for each item (I-CVI) and scale (S-CVI/Ave). RESULTS Seven interventions were identified and proposed by stakeholders. Training and sensitisation by peers were unanimously preferred. The lowest I-CVI for the content was 86%, with an S-CVI/Ave of 98%. This indicates that the intervention package was highly relevant to the target community. CONCLUSION The stakeholder workshop enabled a participatory approach to identify the most appropriate intervention. All the proposed interventions fell under one of the intervention functions of the BCW. The intervention should be evaluated for its effectiveness in improving lifejacket wear among occupational boaters.
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Affiliation(s)
- Frederick Oporia
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Fred Nuwaha
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Olive Kobusingye
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
- The George Institute for Global Health Injury Division, Camperdown, New South Wales, Australia
| | - Jagnoor Jagnoor
- The George Institute for Global Health, Camperdown, New South Wales, Australia
| | - Fredrick Edward Makumbi
- Department of Epidemiology and Biostatistics, Makerere University College of Health Sciences, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Simon P S Kibira
- Department of Community Health and Behavioural Sciences, Makerere University College of Health Sciences, Kampala, Uganda
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Oporia F, Kibira SPS, Jagnoor J, Kobusingye O, Makumbi FE, Isunju JB, Nuwaha F. Peer-led training improves lifejacket wear among occupational boaters: Evidence from a cluster randomized controlled trial on Lake Albert, Uganda. PLoS One 2023; 18:e0292754. [PMID: 37862363 PMCID: PMC10588873 DOI: 10.1371/journal.pone.0292754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/21/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND The burden of drowning among occupational boaters in low and middle-income countries is highest globally. In Uganda, over 95% of people who drowned from boating-related activities were not wearing lifejackets at the time of the incident. We implemented and evaluated a peer-led training program to improve lifejacket wear among occupational boaters on Lake Albert, Uganda. METHODS We conducted a two-arm cluster randomized controlled trial in which fourteen landing sites were randomized to the intervention and non-intervention arm with a 1:1 allocation ratio. In the intervention arm, a six-month peer-to-peer training program on lifejacket wear was implemented while the non-intervention arm continued to receive the routine Marine Police sensitizations on drowning prevention through its community policing program. The effect of the intervention was assessed on self-reported and observed lifejacket wear using a test of differences in proportions of wear following the intention to treat principle. The effect of contamination was assessed using mixed effect modified Poisson regression following the As Treated analysis principle at 95% CI. Results are reported according to the CONSORT statement-extension for cluster randomized trials. RESULTS Self-reported lifejacket wear increased markedly from 30.8% to 65.1% in the intervention arm compared to the non-intervention arm which rose from 29.9% to 43.2%. Observed wear increased from 1.0% to 26.8% in the intervention arm and from 0.6% to 8.8% in the non-intervention arm. The test of differences in proportions of self-reported lifejacket wear (65.1%- 43.2% = 21.9%, p-value <0.001) and observed wear (26.8%- 8.8% = 18%, p-value <0.001) showed statistically significant differences between the intervention and non-intervention arm. Self-reported lifejacket wear was higher among boaters who received peer training than those who did not (Adj. PR 1.78, 95% CI 1.38-2.30). CONCLUSION This study demonstrated that peer-led training significantly improves lifejacket wear among occupational boaters. The government of Uganda through the relevant ministries, and the Landing Site Management Committees should embrace and scale up peer-led training programs on lifejacket wear to reduce drowning deaths.
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Affiliation(s)
- Frederick Oporia
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Simon P. S. Kibira
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Jagnoor Jagnoor
- The George Institute for Global Health, University of New South Wales, Camperdown, New South Wales, Australia
| | - Olive Kobusingye
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
- The George Institute for Global Health, University of New South Wales, Camperdown, New South Wales, Australia
| | - Fredrick Edward Makumbi
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Fred Nuwaha
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
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Scarr JP, Jagnoor J. Identifying strategic priorities for advancing global drowning prevention: a Delphi method. BMJ Glob Health 2023; 8:e013303. [PMID: 37709301 PMCID: PMC10503336 DOI: 10.1136/bmjgh-2023-013303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/20/2023] [Indexed: 09/16/2023] Open
Abstract
INTRODUCTION The burden of drowning is gaining prominence on the global agenda. Two United Nations system resolutions in 3 years reflect rising political support, but priorities remain undefined, and the issue lacks a global strategy. We aimed to identify strategic priorities for advancing global drowning prevention using a modified Delphi method. METHODS An advisory group was formed, and participants recruited with diverse expertise and backgrounds. We used document review, and data extracted from global health partnerships to identify strategic domains and draft priorities for global drowning prevention. Participants rated the priorities in two Delphi rounds, guided by relevance, feasibility and impact on equity, and where consensus was ≥70% of participants rating the priority as critical. RESULTS We recruited 134 participants from research (40.2%), policy (26.9%), technical (25.4%) and community (7.5%) backgrounds, with 38.1% representing low- and middle-income countries. We drafted 75 priorities. Following two Delphi rounds, 50 priorities were selected across the seven domains of research and further contextualisation, best practice guidance, capacity building, engagement with other health and sustainable development agendas, high-level political advocacy, multisectoral action and strengthening inclusive global governance. Participants scored priorities based on relevance (43.2%), feasibility (29.4%) and impact on equity (27.4%). CONCLUSION Our study identifies global priorities for drowning prevention and provides evidence for advocacy of drowning prevention in all pertinent policies, and in all relevant agendas. The priorities can be applied by funders to guide investment, by researchers to frame study questions, by policymakers to contrast views of expert groups and by national coalitions to anchor national drowning prevention plans. We identify agendas including disaster risk reduction, sustainable development, child and adolescent health, and climate resilience, where drowning prevention might offer co-benefits. Finally, our findings offer a strategic blueprint as the field looks to accelerate action, and develop a global strategy for drowning prevention.
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Affiliation(s)
- Justin-Paul Scarr
- The George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia
- Royal Life Saving Society - Australia, Broadway, New South Wales, Australia
| | - Jagnoor Jagnoor
- The George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia
- Injury Division, The George Institute for Global Health, New Delhi, India
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Kushitor MK, Bour H, Nyame P, Yabila S. Context of boat drowning in Ghana: a mixed qualitative research study. Inj Prev 2023; 29:8-15. [PMID: 36697022 DOI: 10.1136/ip-2022-044567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/05/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Drowning is a significant public health challenge globally. In Africa and Ghana, drowning has remained a silent epidemic among poor communities. Limited evidence has challenged advances in drowning knowledge and prevention. While drowning deaths are often widely circulated in the newspapers, drowning data are not systematically organised to constitute a body of evidence sufficient for scientific exploration. Although drowning was frequent, they were poorly understood. We explore the context of drowning from multiple perspectives from the Volta-basin where the largest man-made lake in the world has become a hotspot for drowning. METHOD This study adopts a sequential-mix-qualitative study comprising content analysis of newspaper reports on drowning, structured-observations and in-depth interviews with boaters and fisherfolk. We first explored, the content of newspapers over a 10-year period. This information provided the context of drowning. We followed up with extensive observation of activities on the lake by a team of five. Photovoice qualitative interviews were conducted with 22 boaters, fishers and community members. Thematic content analysis was applied to both the newspaper reports and the in-depth interviews. RESULTS Drowning was attributed to both proximate and distal causes. Distal causes were the reasons for movement, while proximate causes were the immediate cause of the drowning. Travelling to farm, market, hospital, church, sell were important distal causes of drowning. Proximate determinants included strong winds, tree stumps, overcrowding, no-adherence to safety procedures, spiritual reasons and high tides. Four types of boat accidents were observed: boat-capsizing, boat-sinking, boat-splitting and boat-catching-fire. Ideas converged and diverged in comparing the newspaper content analysis to the photovoice interviews.
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Affiliation(s)
- Mawuli Komla Kushitor
- School of Public Health, Department of Health Policy Planning and Management, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Helen Bour
- School of Public Health, Department of Health Policy Planning and Management, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Prince Nyame
- School of Public Health, Department of Health Policy Planning and Management, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Solomon Yabila
- School of Public Health, Department of Health Policy Planning and Management, University of Health and Allied Sciences, Ho, Volta Region, Ghana
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Oporia F, Nuwaha F, Kibira SPS, Kobusingye O, Makumbi FE, Nakafeero M, Ssenyonga R, Isunju JB, Jagnoor J. Lifejacket wear and the associated factors among boaters involved in occupational boating activities on Lake Albert, Uganda: a cross-sectional survey. Inj Prev 2022; 28:513-520. [PMID: 35636933 PMCID: PMC9726957 DOI: 10.1136/injuryprev-2022-044608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/12/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Drowning death rates in lakeside fishing communities in Uganda are the highest recorded globally. Over 95% of people who drowned from a boating activity in Uganda were not wearing a lifejacket. This study describes the prevalence of lifejacket wear and associated factors among boaters involved in occupational boating activities on Lake Albert, Uganda. METHODS We conducted a cross-sectional survey, grounded on etic epistemology and a positivist ontological paradigm. We interviewed 1343 boaters across 18 landing sites on Lake Albert, Uganda. Lifejacket wear was assessed through observation as boaters disembarked from their boats and self-reported wear for those who 'always wore a life jacket while on the lake'. We used a mixed-effects multilevel Poisson regression, with landing site-specific random intercepts to elicit associations with lifejacket wear. We report adjusted prevalence ratios (PRs) at 95% confidence intervals. RESULTS The majority of respondents were male, 99.6% (1338/1343), and the largest proportion, 38.4% (516/1343) was aged 20-29 years. Observed lifejacket wear was 0.7% (10/1343). However, self-reported wear was 31.9% (428/1343). Tertiary-level education (adjusted PR 1.57, 95% CI 1.29- 1.91), boat occupancy of at least four people (adjusted PR 2.12, 95% CI 1.28 - 3.52), big boat size (adjusted PR 1.55, 95% CI 1.13 - 2.12) and attending a lifejacket-use training session (adjusted PR 1.25, 95% CI 1.01 - 1.56) were associated with higher prevalence of self-reported lifejacket wear. Self-reported wear was lower among the 30-39 year-olds compared to those who were aged less than 20 years (adjusted PR 0.66, 95% CI 0.45 - 0.99). CONCLUSION Lifejacket wear was low. Training on lifejacket use may improve wear among boaters involved in occupational boating activities on Lake Albert.
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Affiliation(s)
- Frederick Oporia
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Fred Nuwaha
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Simon P S Kibira
- Department of Community Health and Behavioural Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | - Olive Kobusingye
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
- The George Institute for Global Health, Camperdown, New South Wales, Australia
| | - Fredrick Edward Makumbi
- Department of Epidemiology and Biostatistics, Makerere University College of Health Sciences, Kampala, Uganda
| | - Mary Nakafeero
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ronald Ssenyonga
- Department of Epidemiology and Biostatistics, Makerere University College of Health Sciences, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Jagnoor Jagnoor
- George Institute for Global Health, Camperdown, New South Wales, Australia
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Buyinza Mugeere A, Oporia F, Kobusingye O. A qualitative study of the causes and circumstances of drowning in Uganda. BMC Public Health 2022; 22:2024. [PMCID: PMC9636780 DOI: 10.1186/s12889-022-14461-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022] Open
Abstract
Abstract
Background
Drowning is a serious worldwide and preventable injury problem, especially in low- and middle-income countries (LMICs). The aim of this paper is to draw on the results of semi-structured interviews with witnesses, family members and friends of persons involved in fatal and nonfatal drowning incidents to describe the circumstances of drowning in both lakeside and non-lakeside districts and to identify potential contextually appropriate interventions for drowning prevention and surveillance in Uganda.
Methods
The findings presented in this study were based on data collected from study participants selected through purposive sampling comprising 324 individual face-to-face interviews with drowning witnesses, family members, friends of and survivors of drowning and ten (10) focus group discussions held with community members in 14 districts in Uganda. Data analysis was done using the Framework Analysis Approach with the aid of the Microsoft Atlas ti software (version 8) program.
Results
The study results reveal a range of circumstances under which drowning occurs in Uganda, poor record keeping of drowning incidents, fear of reporting drowning incidences to the authorities, challenges in preventing drowning and proposed strategies for mitigating the problem.
Conclusions
This study found that there is no specialized record keeping system for drowning cases in Uganda and where such records are kept, the system is entirely manual (in hard copy form) with no electronic storage of data. Secondly, the drowning cases reported to police posts and stations in various parts of the country are not transmitted to the district headquarters and national database. These and other conclusions not only provide valuable insights into understanding of drowning circumstances but also the key policy and programme interventions for water-based economic activities such as fishing and public water transportation in Uganda and other LMICs.
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Shrestha S, Shrestha B, Bygvraa DA, Jensen OC. Risk Assessment in Artisanal Fisheries in Developing Countries: A Systematic Review. Am J Prev Med 2022; 62:e255-e264. [PMID: 34922785 DOI: 10.1016/j.amepre.2021.08.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/09/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Artisanal fisheries generally do not have injury prevention plans and safety or quality management systems on board, thus making them prone to more fatal and nonfatal injuries. The objective of the study is to systematically review and synthesize the literature to identify the risks of injuries (fatal and nonfatal) and health problems in artisanal fisheries in developing countries. METHODS A systematic literature search was carried out from December 2019 to March 2020. Articles were included with at least 1 outcome of interest (fatal injuries, nonfatal injuries, health problems, causal factors). In all, 18 articles on occupational safety and health aspects in artisanal fisheries from developing countries were kept for final analysis. RESULTS Of the 4 studies on fatal injuries, only 1 reported fatal incidence rates (14 per 1,000 person-years). Vessel disasters were the most common cause of fatal injuries, with 14.3%-81% drownings. The prevalence of nonfatal injuries was between 55% and 61%. The most common causes were falls on the deck or into the sea/river, blows from objects/tools, punctures and cuts by fishhooks/fish rays and fishing equipment, and animal attacks or bites. Health problems included eye, ear, cardiovascular (hypertension), respiratory (decompression sickness), dermatological, and musculoskeletal problems. DISCUSSION There is a serious gap of health and safety information in artisanal fishery, which is more extensive in developing countries. Epidemiological studies are needed with comparable incidence and prevalence rates. For adequate prevention and compliance with the UN sustainable goals, there is an urgent need to establish a health information system in the countries to register the relevant demographic and epidemiologic characteristics of the population.
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Affiliation(s)
- Sharad Shrestha
- Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
| | - Bipna Shrestha
- Faculty of Public Health, Mahidol University, Salaya, Thailand
| | - Despena Andrioti Bygvraa
- School of Public Health and Community Medicine, Department of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Olaf C Jensen
- Center for Maritime Health and Society, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark.
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Sindall R, Mecrow T, Queiroga AC, Boyer C, Koon W, Peden AE. Drowning risk and climate change: a state-of-the-art review. Inj Prev 2022; 28:185-191. [PMID: 35197275 PMCID: PMC8938664 DOI: 10.1136/injuryprev-2021-044486] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/01/2022] [Indexed: 11/05/2022]
Abstract
Drowning and climate change are both significant global health threats, yet little research links climate change to drowning risk. Research into the epidemiology, risk factors and preventive strategies for unintentional drowning in high-income and in low-income and middle-income countries has expanded understanding, but understanding of disaster and extreme weather-related drowning needs research focus. As nation states and researchers call for action on climate change, its impact on drowning has been largely ignored. This state-of-the-art review considers existing literature on climate change as a contributor to changes in drowning risks globally. Using selected climate change-related risks identified by the World Meteorological Organization and key risks to the Sustainable Development Goals as a framework, we consider the drowning risks associated with heat waves, hydrometeorological hazards, drought and water scarcity, damaged infrastructure, marine ecosystem collapse, displacement, and rising poverty and inequality. Although the degree of atmospheric warming remains uncertain, the impact of climate change on drowning risk is already taking place and can no longer be ignored. Greater evidence characterising the links between drowning and climate change across both high-income and low-income and middle-income contexts is required, and the implementation and evaluation of drowning interventions must reflect climate change risks at a local level, accounting for both geographical variation and the consequences of inequality. Furthermore, collaboration between the injury prevention, disaster risk reduction and climate change mitigation sectors is crucial to both prevent climate change from stalling progress on preventing drowning and further advocate for climate change mitigation as a drowning risk reduction mechanism.
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Affiliation(s)
- Rebecca Sindall
- International Department, Royal National Lifeboat Institution, Poole, UK .,International Drowning Prevention Researchers Alliance (IDRA), Kuna, Idaho, USA
| | - Thomas Mecrow
- International Department, Royal National Lifeboat Institution, Poole, UK.,International Drowning Prevention Researchers Alliance (IDRA), Kuna, Idaho, USA
| | - Ana Catarina Queiroga
- International Drowning Prevention Researchers Alliance (IDRA), Kuna, Idaho, USA.,ITR Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health University of Porto, Porto, Portugal.,Drowning Prevention Commission, International Lifesaving Federation, Leuven, Belgium
| | - Christopher Boyer
- Centre for Health and the Global Environment, University of Washington, Seattle, Washington, USA
| | - William Koon
- International Drowning Prevention Researchers Alliance (IDRA), Kuna, Idaho, USA.,School of Biological, Earth and Environmental Sciences, University of New South Wales Faculty of Science, Sydney, New South Wales, Australia
| | - Amy E Peden
- International Drowning Prevention Researchers Alliance (IDRA), Kuna, Idaho, USA.,Drowning Prevention Commission, International Lifesaving Federation, Leuven, Belgium.,School of Population Health, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
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Bierens J, Hoogenboezem J. Fatal drowning statistics from the Netherlands - an example of an aggregated demographic profile. BMC Public Health 2022; 22:339. [PMID: 35177025 PMCID: PMC8851711 DOI: 10.1186/s12889-022-12620-3] [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: 08/09/2021] [Accepted: 01/14/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Incompleteness of fatal drowning statistics is a familiar problem impeding public health measures. Part of the problem may be that only data on accidental drowning are used and not the full potential of accessible data. Methods This study combines cause-of-death certificates and public prosecutor’s court documents between 1998 and 2017 to obtain an aggregated profile. Data are also used as a basis for a trend analysis. Results The dataset includes 5571 drowned persons (1.69 per 100,000). The highest risk group are persons above the age of 50. Demographic differences are observed between suicide by drowning, accidental drowning, and drowning due to transportation (0.72, 0.64, 0.28 per 100.000) and between native Dutch, and Dutch with western and non-western background (1.46, 1.43, 1.76 per 100.000). Non-residents account for another 12.2%. When comparing the periods 1998–2007 with 2008–2017, the Standard Mortality declines for suicide drowning and accidental drowning among persons with a native Dutch and non-western background. Single regression analysis confirms a decrease of drowning over the full period, breakpoint analysis shows an increase in the incidence of the total number of drowning, suicide by drowning and accidental drowning starting in 2007, 2008 resp. 2012. Discussion Compared to the formal number of fatal accidental drowning in the Netherlands (n = 1718; incidence 0.52 per 100,000), the study identifies 350% more drowning. Differences in demographic data and the recent increase needs to be explored for public health interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12620-3.
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Affiliation(s)
- Joost Bierens
- Research Group Emergency and Disaster Medicine, Vrije Universiteit Brussels, Laarbeeklaan 103, 1090, Brussels, Belgium.
| | - Jan Hoogenboezem
- Centraal Bureau voor de Statistiek (Statistics Netherlands), Department of Causes of Death Statistics, Henri Faasdreef 312, 2492, JP, Den Haag, the Netherlands
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Oporia F, Kibira SPS, Jagnoor J, Nuwaha F, Makumbi FE, Muwonge T, Ninsiima LR, Torén K, Isunju JB, Kobusingye O. Determinants of lifejacket use among boaters on Lake Albert, Uganda: a qualitative study. Inj Prev 2022; 28:335-339. [PMID: 35074860 PMCID: PMC9340019 DOI: 10.1136/injuryprev-2021-044483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/10/2022] [Indexed: 11/21/2022]
Abstract
Background Drowning is a major cause of unintentional injury death worldwide. The toll is greatest in low and middle-income countries. Over 95% of people who drowned while boating in Uganda were not wearing a lifejacket. We explored the determinants of lifejacket use among boaters on Lake Albert, Uganda. Methods We conducted a qualitative enquiry with a hermeneutic phenomenological undertone leaning on relativism ontology and emic subjectivism epistemology. Focus group discussions (FGDs) and in-depth interviews (IDIs) were held with boaters in 10 landing sites. We explored experiences and perspectives on lifejacket use. We used thematic analysis technique to analyse data and report results according to the Consolidated Criteria for Reporting Qualitative Research. Results We recruited 88 boaters in 10 FGDs and 11 to take part in the IDIs. We identified three themes: motivators and opportunities for lifejacket use, barriers and threats to lifejacket use, and strategies to improve lifejacket use. Many boaters attributed their lifejacket use to prior experience or witness of a drowning. Perceived high costs of lifejackets, limited knowledge, reluctance to use lifejackets because of distrust in their effectiveness, and the belief that it is women who should wear lifejackets were among the barriers and threats. Participants mentioned the need for mandatory enforcement together with community sensitisations as strategies to improve lifejacket use. Conclusion Determinants of lifejacket use among boaters include experience or witness of drowning, limited knowledge about lifejackets and distrust in the effectiveness of the available lifejackets. Mandatory lifejacket wearing alongside educational interventions might improve lifejacket use.
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Affiliation(s)
- Frederick Oporia
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Simon P S Kibira
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Jagnoor Jagnoor
- The George Institute for Global Health, University of New South Wales, Camperdown, New South Wales, Australia
| | - Fred Nuwaha
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Fredrick Edward Makumbi
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda
| | - Tonny Muwonge
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Lesley Rose Ninsiima
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Kjell Torén
- School of Public Health and Community Medicine, University of Gothenburg Institute of Medicine, Gothenburg, Sweden
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Olive Kobusingye
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
- The George Institute for Global Health, University of New South Wales, Camperdown, New South Wales, Australia
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Meddings DR, Scarr JP, Larson K, Vaughan J, Krug EG. Drowning prevention: turning the tide on a leading killer. Lancet Public Health 2021; 6:e692-e695. [PMID: 34310906 PMCID: PMC8391011 DOI: 10.1016/s2468-2667(21)00165-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/13/2021] [Indexed: 11/19/2022]
Abstract
Drowning is a leading killer, particularly of children and young adults, yet has been greatly neglected. Despite accounting for a higher number of deaths than many other substantial public health issues, drowning has not benefitted from the targeted attention it requires, which is particularly tragic because low cost and effective drowning prevention interventions exist. Therefore, the recent UN General Assembly's adoption of a resolution on global drowning prevention is a historic first, and offers an exciting opportunity by providing a comprehensive framework and a practical roadmap that a range of actors and sectors, including governments, can follow to address the challenge of drowning prevention.
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Jagnoor J, Kobusingye O, Scarr JP. Drowning prevention: priorities to accelerate multisectoral action. Lancet 2021; 398:564-566. [PMID: 34303411 DOI: 10.1016/s0140-6736(21)01601-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 06/22/2021] [Accepted: 07/06/2021] [Indexed: 12/29/2022]
Affiliation(s)
- Jagnoor Jagnoor
- The George Institute for Global Health, New Delhi 110025, India; The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.
| | - Olive Kobusingye
- School of Public Health, Makerere University, Mulago, Kampala, Uganda
| | - Justin-Paul Scarr
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia; Royal Life Saving Society Australia, Broadway, NSW, Australia
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Preventing Child Drowning in the Philippines: The Need to Address the Determinants of Health. CHILDREN-BASEL 2021; 8:children8010029. [PMID: 33430273 PMCID: PMC7825742 DOI: 10.3390/children8010029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 12/24/2020] [Accepted: 12/28/2020] [Indexed: 02/07/2023]
Abstract
Drowning is a public health issue in the Philippines, with children at significantly increased risk. Determinants of health (DoH) such as education, socio-economic status, ethnicity, and urbanization are factors that impact drowning risk. As drowning is a multisectoral issue, a national drowning prevention plan can drive collaboration with relevant stakeholders. This study reports trends in unintentional child (0-14 years) drowning in the Philippines (incidence, rates, and trends over time for fatal and non-fatal (years lived with a disability (YLDs) and disability adjusted life years (DALYs) from 2008-2017 and conducts an analysis of the Philippines' Multisector Action Plan (MSAP) on Drowning Prevention. From 2008-2017, 27,928 (95%UI [Uncertainty Interval]: 22,794-33,828) children aged 0-14 years died from drowning (52.7% aged 5-14 years old). Rates of drowning have declined among both age groups, with greater reductions seen among 0-4 year olds (y = -0.3368x + 13.035; R2 = 0.9588). The MSAP has 12 child drowning-specific activities and 20 activities were identified where DoH will need to be considered during development and implementation. The MSAP activities, and work done to prevent drowning more generally, must consider DoH such as education, urbanization, water and sanitation health, and safe water transportation. A national drowning surveillance system and investment in research in the Philippines are recommended.
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