Vulnerability to fatal drowning among the population in Southern Bangladesh: findings from a cross-sectional household survey. Issue 9 (17th September 2019)

• Record Type: Journal Article
• Authors: Rahman, Aminur; Jagnoor, Jagnoor; Baset, Kamran ul; Ryan, Dan; Ahmed, Tahera; Rogers, Kris; Hossain, Mohammad Jahangir; Ivers, Rebecca; Rahman, A K M Fazlur
• Is Part Of: BMJ open. Volume 9:Issue 9(2019)
• Publication Date: 2019-09-17
• Subjects: drowning -- fatal drowning -- mortality -- injury -- risk factor -- Bangladesh; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2018-027896
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: This study aimed to determine the fatal drowning burden and associated risk factors in Southern Bangladesh. Settings: The survey was conducted in 39 subdistricts of all 6 districts of the Barisal division, Southern Bangladesh. Participants: All residents (for a minimum 6 months prior to survey) of the Barisal division, Southern Bangladesh. Intervention/methods: A cross-sectional, divisionally representative household survey was conducted in all six districts of the Barisal division between September 2016 and February 2017, covering a population of 386 016. Data were collected by face-to-face interview with adult respondents using handheld electronic tablets. International Classification of Diseases (ICD)-v. 10 (ICD-10) Chapter XX: External causes of morbidity and mortality codes for drowning, W65–W74, X36–X39, V90, V92, X71 or X92, were used as the operational definition of a drowning event. Results: The overall fatal drowning rate in Barisal was 37.9/100 000 population per year (95% CI 31.8 to 43.9). The highest fatal drowning rate was observed among children aged 1–4 years (262.2/100 000/year). Mortality rates among males (48.2/100 000/year) exceeded that for females (27.9/100 000/year). A higher rate of fatal drowning was found in rural (38.9/100 000/year) compared with urban areas (29.3/100 000/year). The results of the multivariable logistic regression identified that the factors significantly associated with fatal drowning were being male (OR 1.7, 95% CI 1.2 to 2.3), aged 1–4 years (OR 3.0, 95% CI 1.4 to 6.4) and residing in a household with four or more children (four or more children OR 1.8, 95% CI 1.1 to 2.9; and five or more children OR 2.1, 95% CI 1.2 to 3.7). Conclusion: Drowning is a public health problem, especially for children, in the Barisal division of Southern Bangladesh. Male gender, children 1–4 years of age and residing in a household with four or more children were associated with increased risk of fatal drowning events. The Barisal division demands urgent interventions targeted at high-risk groups identified in the survey.