Injury death pattern in 2009 in the districts in Sri Lanka: a descriptive study

Abstract

BackgroundTraumatic injuries have been the leading causes of hospital admissions in Sri Lanka for the past 15 years and were among the ten leading causes of hospital deaths for the same period. The distribution of the pattern of injury deaths (cause of death [CoD]) by district has not been documented. Therefore, we analysed the external causes of morbidity and mortality (ECMM) (V01–Y99) and the gender difference of deaths in the 25 districts to describe their contribution. MethodsWe analysed the 2009 CoD data from the Department of Registrar General and described the contribution made by ECMM in each district and the gender difference. FindingsECMM contributed 14·0% (17 760 of 127 268) of all deaths (18·4% [13 993 of 75 804] in males, 7·3% [3767 of 51 464] in females) in 2009. All other external causes (W20–W64, W75–W99, X10–X39) contributed 49·8% (8850 of 17 760) of ECMM (50·8% [7103 of 13 993] in males, 46·4% [1747 of 3767] in females), while intentional self-harm (X60–X84) and transport accidents (V01–V99) contributed 20·2% (19·9% [2781 of 13 993] in males, 21·2% [800 of 3767] in females) and 13·8% (14·3% [2004 of 13 993] in males, 11·7% [441 of 3767] in females) of ECMM, respectively. ECMM as a percentage of total deaths in each district varied from 5·4% (208 of 3871) in Nuwara Eliya (a rural hill country district) to 18·3% (900 of 4906) in Anuradhapura (a rural north central district). Distribution of categories in ECMM also showed significant variation among the districts. In Colombo (the capital and the main urban district), 50·0% (978 of 1956) of ECMM deaths were by transport accidents (V01–V99), though in a majority of the other districts the main contribution came from intentional self-harm (X60–X84), ranging from 29·6% (246 of 831) in Gampaha to 49·8% (207 of 416) in Badulla, both urban districts. Gender contribution also varied considerably among the districts, with higher rates of deaths due to falls (W00–W19), accidental drowning and submersions (W65–W74), and exposure to smoke, fire, and flames (X00–X09) among females in the majority of districts. InterpretationA significant variation in injury deaths among districts was seen, and the social, economic, demographic, and environmental variations present could have contributed to these differences. Control programmes should address these for them to be effective. FundingNone.