1
|
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.
Collapse
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
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Abihasira S, Moran DS, Orr D, Eliyahu U. Drowning rates among children and adolescents (aged 7-17) in Israel during the years 2008-2018. BMC Public Health 2023; 23:1695. [PMID: 37658286 PMCID: PMC10474651 DOI: 10.1186/s12889-023-16671-y] [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: 07/28/2022] [Accepted: 08/31/2023] [Indexed: 09/03/2023] Open
Abstract
OBJECTIVE Drowning is one of the leading causes of death among children and youth worldwide. This study aims to examine differences in the rates of drowning (fatal and non-fatal drowning) among children and youth in Israel stratified by age, sex, sector, place of drowning, and the drowning outcome. In addition, we compared the results of studies reported in other countries in specific age groups based on statistics of about 100,000 drowning cases. METHOD A statistical analysis of 474 drownings between 2008 and 2018 was conducted. All cases refer to youngsters aged 7-17 in the State of Israel. Statistical analysis was performed on data obtained from the Beterem - Safe Kids Israel organization and from the Israel Central Bureau of Statistics. Disparities between groups within the examined population were analyzed based on gender, sector (Jewish versus non-Jewish), and drowning site. RESULTS Of the 474 drownings that occurred during 2008-2018, 38.4% ended in death. 79% of the cases occurred in pools. The Arab minority sector (21.1% of the general population) accounted for 25.1% of all drownings, males accounted for 70.5% of the drowning cases, and the age group with the most drownings (48.5%) was that of 15-17 years. The Jewish population was involved in more than 75% of drownings in places designated for bathing and in more than 83% of all disaster scenarios, whereas the Arab minority was involved in more than 61% of drownings in places not designated for bathing. CONCLUSIONS The results are comparable to those of other studies worldwide. Boys drown twice as much as girls, mainly in the age group of 15-17. This may be explained by overconfidence in boys and a tendency to overestimate their actual swimming abilities. Most drownings occur in pools. Drowning among the Jewish population occurs mainly in designated bathing sites. PRACTICAL APPLICATIONS The findings can and, in fact, must be used to inform and educate the younger generation as to the potential dangers involving bathing in designated bathing sites.
Collapse
Affiliation(s)
- Sigalit Abihasira
- Department of Health Systems Management, Faculty of Health Sciences, Ariel University, 40700, Ariel, Israel.
| | - Daniel S Moran
- Department of Health Systems Management, Faculty of Health Sciences, Ariel University, 40700, Ariel, Israel
| | - Daniela Orr
- Beterem - Safe Kids Israel organization, 30 Hasivim St., Kiryat Matalon, P.O.B. 7050, 4917001, Petah-Tikva, Israel
| | - Uri Eliyahu
- Department of Nutrition, Faculty of Health Sciences, Ariel University, 40700, Ariel, Israel
| |
Collapse
|
5
|
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.
Collapse
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
| | | |
Collapse
|
6
|
Leavy JE, Gray C, Della Bona M, D'Orazio N, Crawford G. A Review of Interventions for Drowning Prevention Among Adults. J Community Health 2023; 48:539-556. [PMID: 36653593 DOI: 10.1007/s10900-023-01189-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2023] [Indexed: 01/20/2023]
Abstract
Adult drowning is a complex and multifactorial public health challenge requiring community, national and global efforts to mitigate impacts. This study updates the evidence base for public health interventions that address adult fatal and non-fatal drowning. A systematic review was undertaken of the peer-reviewed literature for English-language primary studies published between 2011 and 2021describing a drowning intervention with adults. Twenty-two studies were included. Most studies (n = 16) were conducted in high-income countries. Yearly trends in drowning prevention intervention publications were analysed with 2015 (n = 6) the peak publishing year. Over half of the study designs were pre-post (n = 15). Intervention duration ranged from 4 hours to 11 years. Ten studies described either behaviour change theory or formative evaluation to inform design. Thirteen studies targeted interventions at a population level, seven at a group level and two at individual level. Studies identified a range of prevention strategies, categorised as behavioural (n = 9) (e.g., swimming lessons), socio-ecological (n = 8) (e.g., mandatory personal flotation devices) and mixed (n = 5) (e.g., awareness campaign and barriers to prevent access to water). A range of outcomes were described including changes in awareness, water safety knowledge, attitudes, water safety behaviours and skills, environmental, policy and regulation changes and drowning rates. Findings indicate a small but important increase in the evaluation and publication of effective interventions to prevent adult drowning. The complexity of the issues surrounding drowning requires multi-strategy and context -specific adult focused prevention interventions. Contemporary evidence that identifies effective interventions that contribute to prevention efforts is an essential first step in addressing the challenge.
Collapse
Affiliation(s)
- Justine E Leavy
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, WA, Australia.
| | - Corie Gray
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, WA, Australia
| | - Malena Della Bona
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, WA, Australia
| | - Nicola D'Orazio
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, WA, Australia
| | - Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, WA, Australia
| |
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
Fortuin J, Karangwa I, Mahlalela N, Robertson C. A South African Epidemiological Study of Fatal Drownings: 2016-2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15121. [PMID: 36429836 PMCID: PMC9690020 DOI: 10.3390/ijerph192215121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/03/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
Drowning is a serious public health concern. Low-and-middle-income countries are the most affected by drowning, as they carry 90% of the global drowning burden. The purpose of this retrospective epidemiological study is to provide an overview of fatal drownings in South Africa between 2016 and 2021. The data used for the study were obtained from the South African Police Service. Descriptive statistics were used to summarize the data. Statistical analyses included a t-test and chi-square test. The results indicate that the average number of fatal drownings per annum is 1477 in South Africa, with an average drowning rate of 2.54 per 100,000 population for the period 2016 to 2021. The KwaZulu-Natal province had the highest incidence of drowning. The 0-4-year-age group has the highest prevalence of drowning among all the age categories. More males drowned in South Africa compared to females.
Collapse
Affiliation(s)
- Jill Fortuin
- National Sea Rescue Institute, Cape Town 7441, South Africa
- Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town 7701, South Africa
| | - Innocent Karangwa
- Department of Statistical Science, University of Cape Town, Cape Town 7701, South Africa
| | | | | |
Collapse
|
9
|
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.
Collapse
|
10
|
Leavy JE, Della Bona M, Abercromby M, Crawford G. Drinking and swimming around waterways: The role of alcohol, sensation-seeking, peer influence and risk in young people. PLoS One 2022; 17:e0276558. [PMID: 36331939 PMCID: PMC9635690 DOI: 10.1371/journal.pone.0276558] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/09/2022] [Indexed: 11/06/2022] Open
Abstract
The role of individual and sociocultural factors contributing to drowning risk for young adults is complex and poorly understood. This study examined the relationship between behaviour in and around waterways and: 1) alcohol consumption; 2) resistance to peer influence; 3) sensation-seeking; 4) perception of risk among people aged 15–24 in Western Australia. A cross-sectional online survey was conducted at three time-points with a convenience sample. Predictor variables included: Alcohol Use Disorder Identification Test Consumption (AUDIT_C); Resistance to Peer Influence; Brief Sensation Seeking scale; Benthin’s Perception of risk. Pearson chi-squared tests determined the association between demographic and predictor variables. Logistic regression explored influence of potential predictor variables on behaviour in and around water. The final sample (n = 730) participants, consisted of females (n = 537, 74.5%), metropolitan dwelling (n = 616, 84.4%), and attended university (n = 410, 56.9%). Significant associations were found for those who swum after drinking alcohol compared with those that had not by age, gender, education. For every 1-unit increase in AUDIT-C participants were 60% more likely to swim after drinking (OR 95% CI 1.60 1.44–1.78). Participants who considered an adverse event serious were 15% less likely to have swum after drinking alcohol (OR 0.85 95% CI 0.73–0.99). The complex relationship between social participation in activities in and around waterways, higher drowning rates, propensity for risk, and the meaning young adults attach to risk locations and practices present unique challenges for drowning prevention research. Findings should be used to improve the awareness and education components of future youth water safety strategies in high-income settings.
Collapse
Affiliation(s)
- J. E. Leavy
- Collaboration for Evidence, Research and Impact in Public Health, Curtin University, Perth, Western Australia, Australia,* E-mail:
| | - M. Della Bona
- Collaboration for Evidence, Research and Impact in Public Health, Curtin University, Perth, Western Australia, Australia
| | - M. Abercromby
- Royal Life Saving Society Western Australia, Perth, Western Australia, Australia
| | - G. Crawford
- Collaboration for Evidence, Research and Impact in Public Health, Curtin University, Perth, Western Australia, Australia
| |
Collapse
|
11
|
Yadav J, John D, Menon GR, Franklin RC, Peden AE. Nonfatal drowning-related hospitalizations and associated healthcare expenditure in India: An analysis of nationally representative survey data. JOURNAL OF SAFETY RESEARCH 2022; 82:283-292. [PMID: 36031256 DOI: 10.1016/j.jsr.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/11/2022] [Accepted: 06/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Drowning is a global public health challenge, with significant burden in low- and middle-income countries. There are few studies exploring nonfatal drowning, including the economic and social impacts. This study aimed to quantify unintentional drowning-related hospitalization in India and associated healthcare expenditure. METHOD Unit level data on unintentional drowning-related hospitalization were obtained from the 75th rounds of the National Sample Survey of Indian households conducted in 2018. The outcome variables were indices of health care cost such as out of pocket expenditure (OOPE), health care burden (HCB), catastrophic health expenditure (CHE), impoverishment, and hardship financing. Descriptive statistics and multivariate analysis were conducted after adjusting for inflation using the pharmaceutical price index for December 2020. The association of socio-demographic characteristics with the outcome variable was reported as relative risk with 95% CI and expenditure reported in Indian Rupees (INR) and United States dollars (USD). RESULTS 174 respondents reported drowning-related hospitalization (a crude rate of 15.91-31.34 hospitalizations per 100,000 population). Proportionately, more males (63.4%), persons aged 21-50 years (44.9%) and rural dwelling respondents (69.9%) were hospitalized. Drowning-related hospitalization costs on average INR25,421 ($345.11USD) per person per drowning incident. Costs were higher among older respondents, females, urban respondents, and longer lengths of hospital stays. About 14.4% of respondents reported hardship financing as a result of treatment costs and 9.0% of households reported pushed below the poverty line when reporting drowning-related hospitalization. CONCLUSIONS Drowning can be an economically catastrophic injury, especially for those already impacted by poverty. Drowning is a significant public health problem in India. Investment in drowning prevention program will reduce hospitalization and economic burden. PRACTICAL APPLICATIONS This study provides support for investment in drowning prevention in India, including a need to ensure drowning prevention interventions address the determinants of health across the lifespan.
Collapse
Affiliation(s)
- Jeetendra Yadav
- ICMR-National Institute of Medical Statistics, Ansari Nagar, New Delhi 110029, India
| | - Denny John
- Faculty of Life and Allied Health Sciences, Ramaiah University of Applied Sciences, Bangalore - 560054, Karnataka, India; Department of Public Health, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Kochi 682041, Kerala, India; Center for Public Health Research, MANT, Kolkata-700078, West Bengal, India
| | - Geetha R Menon
- ICMR-National Institute of Medical Statistics, Ansari Nagar, New Delhi 110029, India.
| | - Richard C Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia; Royal Life Saving Society - Australia, Sydney, New South Wales, Australia.
| | - Amy E Peden
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia; Royal Life Saving Society - Australia, Sydney, New South Wales, Australia; School of Population Health, Faculty of Medicine, UNSW Sydney, Kensington, New South Wales, Australia.
| |
Collapse
|
12
|
Drowning in the Eastern Mediterranean region: a systematic literature review of the epidemiology, risk factors and strategies for prevention. BMC Public Health 2022; 22:1477. [PMID: 35922840 PMCID: PMC9351066 DOI: 10.1186/s12889-022-13778-6] [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: 02/15/2022] [Accepted: 07/11/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Globally, drowning is a significant cause of preventable mortality and morbidity. The Eastern Mediterranean region (EMR) comprises 22 countries of extreme disparity in income and is a region impacted by conflict and migration. We systematically review literature published on drowning in the EMR. METHODS Peer-reviewed literature (limited to original research) was identified using Embase, PubMed, Scopus, SportsDiscus, and Web of Science databases. Literature was independently dual screened at title/abstract and full text stages with dual data extraction (20% of included studies). Studies were included if they reported epidemiology, risk/protective factors and/or prevention strategies for drowning (unintentional and intentional; fatal and non-fatal) of residents, tourists or migrants in the EMR. Literature was assessed against the [Australian] National Health and Medical Research Council's Levels of Evidence. RESULTS Seventy-two studies were included in this review (epidemiology 68 studies; risk/protective factor 13 studies; prevention strategies 19 studies). Iran (n = 27), Saudia Arabia (n = 11) and Pakistan (n = 10) recorded the largest number of dedicated studies. Studies predominately focused on unintentional drowning. Ninety-two percent of included studies (n = 66) were ranked as being low evidence (level IV). The majority of studies explored drowning among children and adolescents (0-19 years). All-age fatal drowning rates varied from a low of 0.48 per 100,000 (United Arab Emirates; 2002; Ministry of Health death registry data) to a high of 18.5 per 100,000 (Egypt; 2014-15; WHO mortality database). Commonly identified risk factors included being male, young age, submersion time and resident status. Common prevention strategies public education, lifeguard supervision, and cardiopulmonary resuscitation. DISCUSSION Gaps in understanding of drowning burden in some countries within the region, as well as region-wide risk factor identification for adult drowning, intentional and migration-related drowning, impair the ability of nations to advance drowning prevention. There is a need for investment in implementation and evaluation of drowning prevention interventions in the EMR. CONCLUSION Drowning is a significant cause of mortality and morbidity in the EMR. The recent UN declaration on global drowning prevention may provide the impetus to invest in drowning prevention research, policy, and advocacy with the aim of reducing drowning-related harms in the EMR. TRIAL REGISTRATION Registration number: # CRD42021271215 .
Collapse
|
13
|
Hassall S, Smith DM, Rust S, Wittkowski A. A systematic review and integrative sequential explanatory narrative synthesis: The psychosocial impact of parenting a child with a lysosomal storage disorder. J Inherit Metab Dis 2022; 45:406-416. [PMID: 35124835 PMCID: PMC9305282 DOI: 10.1002/jimd.12482] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 11/11/2022]
Abstract
Lysosomal storage disorders are rare multiorgan, degenerative conditions requiring invasive treatment. Rare disorders pose unique challenges; therefore, exploring their impact is crucial for understanding family needs. This novel review aimed to understand the psychosocial outcomes for parents of children with lysosomal storage disorders. Five electronic databases were systematically searched. Thirty-eight (23 qualitative, 10 qualitative and 5 mixed methods) studies were included, analysed using a sequential explanatory narrative synthesis and appraised for their methodological quality. Quantitative data revealed the multifaceted impact on parents' psychological and social wellbeing. Qualitative data informed the challenges that these parents faced which were expressed within three main themes: (a) Uncertainty and the unknown, (b) All-encompassing impact and (c) Finding a way forward. The synthesis demonstrated that factors associated with the condition (symptoms, behaviour and severity) had a substantial negative impact on parental outcomes, upheld by concurrent loss (deterioration and poor prognosis) and uncertainty. This substantive integrated review revealed considerable unmet parental psychosocial needs.
Collapse
Affiliation(s)
- Sadie Hassall
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Greater Manchester Mental Health NHS Foundation TrustManchesterUK
| | - Debbie Michelle Smith
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Manchester Academic Health Science CentreManchesterUK
| | - Stewart Rust
- Royal Manchester Children's Hospital, Paediatric Psychosocial ServiceManchesterUK
| | - Anja Wittkowski
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Greater Manchester Mental Health NHS Foundation TrustManchesterUK
- Manchester Academic Health Science CentreManchesterUK
| |
Collapse
|
14
|
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.
Collapse
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.
| |
Collapse
|
15
|
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.
Collapse
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
| |
Collapse
|
16
|
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.
Collapse
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
| |
Collapse
|
17
|
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.
Collapse
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
| |
Collapse
|
18
|
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
| |
Collapse
|
19
|
A Mixed Methods Exploration of Surf Therapy Piloted for Youth Well-Being in Post-Conflict Sierra Leone. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126267. [PMID: 34200523 PMCID: PMC8296059 DOI: 10.3390/ijerph18126267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 11/16/2022]
Abstract
Young people in post-conflict and post-epidemic contexts such as Sierra Leone face a range of mental health challenges as part of their daily life. An innovative approach to Sport for Development that could offer support to youth mental health is surf therapy. This research used an uncontrolled mixed methods approach to explore surf therapy pilots run by five youth-focused and community development organizations around Freetown. Four sites provided useable pre/post data using the Stirling Children’s Well-Being Scale (n = 58, average age = 12.9). Three sites were associated with significant (p < 0.017) large effects (r = 0.65–0.84) on participant well-being. One site was associated with a non-significant (p < 0.380) small negative effect (r = −0.22). A synthesis of qualitative data within the five evaluations triangulated with quantitative findings and provided important context in terms of challenges to service delivery. This included low attendance as a plausible mediator for why one site saw very different results than other sites. Combined, these processes highlight the need for future research exploring possible dose-response relationships in surf therapy. This study also provides a foundation for more rigorous research in the future. These promising findings support continued and optimized delivery of surf therapy in Sierra Leone to support youth mental health.
Collapse
|
20
|
Clemens T, Oporia F, Parker EM, Yellman MA, Ballesteros MF, Kobusingye O. Drowning in Uganda: examining data from administrative sources. Inj Prev 2021; 28:9-15. [PMID: 33637592 DOI: 10.1136/injuryprev-2020-044131] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/02/2021] [Accepted: 02/06/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Drowning death rates in the African region are estimated to be the highest in the world. Data collection and surveillance for drowning in African countries are limited. We aimed to establish the availability of drowning data in multiple existing administrative data sources in Uganda and to describe the characteristics of drowning based on available data. METHODS We conducted a retrospective descriptive study in 60 districts in Uganda using existing administrative records on drowning cases from January 2016 to June 2018 in district police offices, marine police detachments, fire/rescue brigade detachments, and the largest mortuary in those districts. Data were systematically deduplicated to determine and quantify unique drowning cases. RESULTS A total of 1435 fatal and non-fatal drowning cases were recorded; 1009 (70%) in lakeside districts and 426 (30%) in non-lakeside districts. Of 1292 fatal cases, 1041 (81%) were identified in only one source. After deduplication, 1283 (89% of recorded cases; 1160 fatal, 123 non-fatal) unique drowning cases remained. Data completeness varied by source and variable. When demographic characteristics were known, fatal victims were predominantly male (n=876, 85%), and the average age was 24 years. In lakeside districts, 81% of fatal cases with a known activity at the time of drowning involved boating. CONCLUSION Drowning cases are recorded in administrative sources in Uganda; however, opportunities to improve data coverage and completeness exist. An improved understanding of circumstances of drowning in both lakeside and non-lakeside districts in Uganda is required to plan drowning prevention strategies.
Collapse
Affiliation(s)
- Tessa Clemens
- CDC Foundation, Atlanta, Georgia, USA .,National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Frederick Oporia
- Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, Uganda
| | - Erin M Parker
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Merissa A Yellman
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michael F Ballesteros
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Olive Kobusingye
- Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, Uganda
| |
Collapse
|
21
|
Harrison R, Jones B, Gardner P, Lawton R. Quality assessment with diverse studies (QuADS): an appraisal tool for methodological and reporting quality in systematic reviews of mixed- or multi-method studies. BMC Health Serv Res 2021; 21:144. [PMID: 33588842 PMCID: PMC7885606 DOI: 10.1186/s12913-021-06122-y] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 01/26/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In the context of the volume of mixed- and multi-methods studies in health services research, the present study sought to develop an appraisal tool to determine the methodological and reporting quality of such studies when included in systematic reviews. Evaluative evidence regarding the design and use of our existing Quality Assessment Tool for Studies with Diverse Designs (QATSDD) was synthesised to enhance and refine it for application across health services research. METHODS Secondary data were collected through a literature review of all articles identified using Google Scholar that had cited the QATSDD tool from its inception in 2012 to December 2019. First authors of all papers that had cited the QATSDD (n=197) were also invited to provide further evaluative data via a qualitative online survey. Evaluative findings from the survey and literature review were synthesised narratively and these data used to identify areas requiring refinement. The refined tool was subject to inter-rater reliability, face and content validity analyses. RESULTS Key limitations of the QATSDD tool identified related to a lack of clarity regarding scope of use of the tool and in the ease of application of criteria beyond experimental psychological research. The Quality Appraisal for Diverse Studies (QuADS) tool emerged as a revised tool to address the limitations of the QATSDD. The QuADS tool demonstrated substantial inter-rater reliability (k=0.66), face and content validity for application in systematic reviews with mixed, or multi-methods health services research. CONCLUSION Our findings highlight the perceived value of appraisal tools to determine the methodological and reporting quality of studies in reviews that include heterogeneous studies. The QuADS tool demonstrates strong reliability and ease of use for application to multi or mixed-methods health services research.
Collapse
Affiliation(s)
- Reema Harrison
- School of Population Health, UNSW Sydney, Sydney, Australia.
| | - Benjamin Jones
- School of Population Health, UNSW Sydney, Sydney, Australia
| | - Peter Gardner
- School of Pharmacy and Medical Sciences, University of Bradford, Bradford, UK
| | - Rebecca Lawton
- Institute of Psychological Sciences, University of Leeds, Leeds, UK
| |
Collapse
|