Abstract
BackgroundUnintentional injuries are an important cause of death in India. However, no reliable nationally representative estimates of unintentional injury deaths are available. Thus, we examined unintentional injury deaths in a nationally representative mortality survey.MethodsTrained field staff interviewed a living relative of those who had died during 2001-03. The verbal autopsy reports were sent to two of the130 trained physicians, who independently assigned an ICD-10 code to each death. Discrepancies were resolved through reconciliation and adjudication. Proportionate cause specific mortality was used to produce national unintentional injury mortality estimates based on United Nations population and death estimates.ResultsIn 2005, unintentional injury caused 648 000 deaths (7% of all deaths; 58/100 000 population). Unintentional injury mortality rates were higher among males than females, and in rural versus urban areas. Road traffic injuries (185 000 deaths; 29% of all unintentional injury deaths), falls (160 000 deaths, 25%) and drowning (73 000 deaths, 11%) were the three leading causes of unintentional injury mortality, with fire-related injury causing 5% of these deaths. The highest unintentional mortality rates were in those aged 70years or older (410/100 000).ConclusionsThese direct estimates of unintentional injury deaths in India (0.6 million) are lower than WHO indirect estimates (0.8 million), but double the estimates which rely on police reports (0.3 million). Importantly, they revise upward the mortality due to falls, particularly in the elderly, and revise downward mortality due to fires. Ongoing monitoring of injury mortality will enable development of evidence based injury prevention programs.
Highlights
IntroductionIntroduction to variance estimationNew York: Springer Verlag; 2007.24. Murray C, Lopez A, Barofsky J, Bryson-Cahn C, Lozano R: Estimating population cause-specific mortality fractions from in-hospital mortality: validation of a new method
Introduction to variance estimationNew York: Springer Verlag; 2007.24
Indirect estimates by the World Health Organization (WHO) and the Global Burden of Diseases Study (GBD) suggest that unintentional injuries account for 3.9 million deaths worldwide [1], of which about 90% occur in low- and middle-income countries
Summary
Introduction to variance estimationNew York: Springer Verlag; 2007.24. Murray C, Lopez A, Barofsky J, Bryson-Cahn C, Lozano R: Estimating population cause-specific mortality fractions from in-hospital mortality: validation of a new method. Indirect estimates by the World Health Organization (WHO) and the Global Burden of Diseases Study (GBD) suggest that unintentional injuries account for 3.9 million deaths worldwide [1], of which about 90% occur in low- and middle-income countries. The majority of these deaths are attributable to road traffic injuries, falls, drowning, poisoning and burns [1]. The objective of this paper is to estimate total unintentional injury mortality in India and its variation by gender, rural/urban residence and region using results from a nationally representative survey of the causes of deaths Other sources of mortality data from selected health centres in rural areas [6], and selected urban hospitals [7] are not representative of the population of India, and have other methodological limitations [8].
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