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Abstract
Over one-quarter of deaths among 1–4 year-olds in Bangladesh were due to drowning in 2003, and the proportion increased to 42% in 2011. This study describes the current burden and risk factors for drowning across all demographics in rural Bangladesh. A household survey was carried out in 51 union parishads of rural Bangladesh between June and November 2013, covering 1.17 million individuals. Information on fatal and nonfatal drowning events was collected by face-to-face interviews using a structured questionnaire. Fatal and non-fatal drowning rates were 15.8/100,000/year and 318.4/100,000/6 months, respectively, for all age groups. The highest rates of fatal (121.5/100,000/year) and non-fatal (3057.7/100,000/6 months) drowning were observed among children 1 to 4 years of age. These children had higher rates of fatal (13 times) and non-fatal drowning (16 times) compared with infants. Males had slightly higher rates of both fatal and non-fatal drowning. Individuals with no education had 3 times higher rates of non-fatal drowning compared with those with high school or higher education. Non-fatal drowning rates increased significantly with decrease in socio-economic status (SES) quintiles, from the highest to the lowest. Drowning is a major public health issue in Bangladesh, and is now a major threat to child survival.
Highlights
The World Health Organization (WHO) estimated that 372,000 deaths occurred from drowning in 2012, which has made it the world’s third leading unintentional injury killer [1]
These findings suggest that the burden of global drowning may be disproportionately borne by a few low- and middle-income countries (LMICs), including Bangladesh; initial efforts on global drowning prevention may focus on such countries
The study suggests that the magnitude of fatal and non-fatal drowning is very high in rural communities of Bangladesh, and that drowning rates may be on the rise
Summary
The World Health Organization (WHO) estimated that 372,000 deaths occurred from drowning in 2012, which has made it the world’s third leading unintentional injury killer [1]. Ninety-one percent of drowning deaths across all ages occur in low- and middle-income countries (LMICs) [2]. Fatal drowning rates among children in LMICs are 6 times higher than that of high-income countries (HICs), and several studies suggest that children aged 1–4 years are at the highest risk [3,4,5,6,7,8]. The Bangladesh Health and Injury Survey (BHIS) conducted in 2003–2004 revealed that drowning was the leading cause of deaths in children 1–17 years of age (28.6 per 100,000 children-years), and children 1–4 years-old were at highest risk (86.3 per 100,000 children-years) of drowning. The study showed that the proportion of all deaths due to drowning among 1–4 year-olds was 26.0% in 2005; by 2011 this had increased to 42.0% [9,10]
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