Child Drowning Research Articles

Refractory dystonia with intracerebral hematoma after drowning

Drowning in children can have devastating consequences. The risk factors are inadequate supervision, seizure disorder, neurodevelopmental disorder, and cardiovascular disease. The duration of submersion is critical in determining outcomes. The lack of consensus guidelines on pediatric submersion injuries invites difficulty in managing the same. There is a lack of robust evidence on therapeutic hypothermia and, the use of pulmonary surfactants and barbiturates to improve clinical outcomes in such injuries. We present a case of a drowned child in cardiac arrest revived after resuscitation, developing sepsis, seizures, severe dystonia, and intracranial bleeding with hypoxic brain injury requiring vigorous management.

Public health interventions to prevent children drowning: an updated systematic review

Abstract Aim Injuries are a leading cause of death and disability for children and young people worldwide and a significant public health challenge. This updated review identifies and assesses public health interventions designed to prevent child drowning. It aimed to evaluate the global scope of literature and examine contributions made to the evidence since the last review was published. Subject and methods The review follows processes established in previous reviews and recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Articles were peer-reviewed, published in English between 2011 and 2023 and described and evaluated child drowning primary prevention interventions. Fifteen databases were searched, and articles were managed in Endnote and Rayyan.AI. The MetaQAT framework was applied to quality appraisal. Results We included a final sample of n = 43 studies. Most studies were from high-income countries and applied quantitative intervention designs. Just under half targeted children, most at the population level. Approximately one in three studies used behavioural theory to guide intervention development. Few studies reported formative research. Conclusion The past decade has seen a threefold increase in the number of papers describing public health interventions to prevent children drowning. Despite this increase, interventions remain primarily educational, focusing on behavioural strategies. A call for more comprehensive and systems-level interventions that tackle the upstream determinants of child drowning is timely.

Epidemiological characteristics of fatal drowning and related factors in children in Zhejiang Province, 2022

Objective: To understand the epidemiological characteristics of fatal drowning in children in Zhejiang Province in 2022, analyze factors such as the swimming ability of children, the caregiver behavior at drowning site, types of first aid personnel and methods of first aid of unintentional fatal drowning and provide evidence for targeted intervention. Methods: Using the "Survey Form of Fatal Drowning Case in Children" designed by National Center for Chronic and Non-communicable Disease Control and Prevention of the China CDC, we collected case information of children aged 0-17 years who died due to drowning in Zhejiang in 2022 from medical history/death investigation records, telephone interviews, and home visits. Results: A total of 341 fatal drowning cases in children occurred in Zhejiang in 2022 and 330 cases were investigated (96.77%). The male to female of the cases was 2.33∶1, most cases were aged 15-17 years and 0-4 years, and 54.24% of fatal drowning cases occurred in children from other provinces. In the drowning cases, 83.33% were unintentional ones, and the proportion of intentional fatal drowning cases in children increased with age. Fatal drowning cases mainly occurred in open natural water bodies and public water storage facilities. More fatal drowning cases occurred in open natural water bodies in older children, while more fatal drowning cases occurred in public water storage facilities in younger children. In 275 children who died due to unintentional drowning, 73.09% could not swim, and only 1.09% were fully supervised by adults within an arm's length. First aid personnel, mainly medical staffs, bystanders and adult caregivers, were present for 47.63% fatal drowning cases. The proportion of the cases who had cardiopulmonary resuscitation as the first aid within 5 minutes was 2.18%. Conclusions: Drowning poses a serious threat to children's lives and there are differences in reasons and locations of fatal drowning in children in different age groups in Zhejiang Province in 2022. It is necessary to conduct to interventions to improve children's swimming skills, strengthen effective adult care and conduct health education about field first aid of drowning to reduce the incidence of drowning and related deaths in children.

Drowning and Nonfatal Drowning in Children and Adolescents: A Subsequent Retrospective Data Analysis.

Fatal and nonfatal drowning are among the leading causes of death and lifelong severe neurological impairment among children and adolescents. This study aimed to complement research from Leipzig 1994-2008 to seek trends within risk factors, treatments, and outcomes throughout the last decade. We retrospectively investigated data of 47 inpatients aged 0-18 admitted to Leipzig University Department of Pediatrics who matched ICD-10 code T75.1 from 2008 to 2020 and compared them to a preceding study at the same institution. We also examined the prognostic value of parameters regarding the patients' outcomes. There were three median incidents per annum. The median age was 2.75 years; 76% of incidents happened in males. An accumulation was seen during the summer months and weekends. Most drowning incidents occurred in private ponds or pools (48.9%). Thirty-nine children were discharged without resulting morbidity, four showed neurological impairment, and three died. Risk factors concerning age, sex, and incident characteristics were confirmed. Special supervision needs still apply to 1-3-year-old male children or children with pre-existing health conditions around private pools and ponds. Hospitalization duration shortened, and morbidity and lethality decreased since the previous study. There was structural improvement in primary care and medical documentation. Parameters suggesting good outcomes include a submersion time < 5 min, GCS > 3 points, spontaneous movement upon admission, remaining pupillary light response, the absence of cardiovascular arrest, body temperature ≥ 32 °C, pH > 7, blood glucose < 15 mmol/L, lactate < 14 mmol/L, base excess ≥ -15 mmol/L, and the absence of ARDS. Clear legislation can contribute to improved private home water safety. Further studies should include a broad in- and outpatient spectrum and standardized incident documentation presupposing Utstein-style reporting. Regular reinvestigation of consistent geographical regions facilitates process evaluations of drowning epidemiology and therapy evolution.

Long-Term Neurocognitive Outcomes in Pediatric Nonfatal Drowning: Results of a Family Caregiver Survey

BackgroundDrowning is a leading cause of brain injury in children. Long-term outcome data for drowning survivors are sparse. This study reports neurocognitive outcomes for 154 children hospitalized following drowning. MethodsA survey for parent caregivers was distributed online. Likert scale items assessed 10 outcome variables in four domains: motor (three), perception (three), language (three), and social/emotional (one). Cluster analysis, outcome relative risk, and descriptive statistics were applied. ResultsOf 208 surveys received, 154 met inclusion criteria. Coma was the most common admission status (n = 137). Cluster analysis identified three outcome groups: Mild (n = 39), Moderate (n = 75), and Severe (n = 40). Motor impairment with cognitive and perceptual sparing (deefferentation) was present in Moderate (P < 1 × 10−26) and Severe (P < 1 × 10−12) but absent in Mild. Locked-in state was endorsed in both Moderate (83%) and Severe (70%). The strongest predictor of good outcome (Mild) was hospitalization with no medical intervention (relative risk [RR] = 6.7). Responsivity on admission (RR = 4.2) or discharge (RR = 12.22) also predicted good outcome. In-hospital prognostication and counseling predicted outcome weakly (RR = 1.3) or not at all. ConclusionsLong-term outcomes in pediatric drowning ranged widely. Overall, motor impairments exceeded perceptual or cognitive (P < 1 × 10−18), with “locked-in state” endorsed in most (93 of 154). The strongest predictors of good outcome were the lack of necessity for interventions and responsivity on admission or discharge. The eponym “Conrad syndrome” is proposed for locked-in state following nonfatal drowning in children.

Child drowning and associated risk factors: Findings from a qualitative study in Bangladesh.

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. This study explored the surrounding circumstances and associated factors of child drownings in Bangladesh. 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." 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. 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.

Expanding the Concept of Caregiver Supervision to Prevent Child Drowning.

Expanding the Concept of Caregiver Supervision to Prevent Child Drowning.

A qualitative examination of causal factors and parent/caregiver experiences of non-fatal drowning-related hospitalisations of children aged 0-16 years.

Fatal and non-fatal drowning is a significant public health issue, which disproportionately impacts children and young people. In Australia, the highest fatal and non-fatal drowning rates occur in children under five years of age. To date, little qualitative research has been conducted on non-fatal drowning, with causal factor analysis generally conducted using coronial and hospital data. This study's aim was to identify causal factors in hospital treated cases of non-fatal drowning in children as qualitatively self-reported by parents and caregivers. Cases of unintentional child (0-16 years) non-fatal drowning admissions and Emergency Department presentations to three tertiary care paediatric hospitals in New South Wales, Australia were identified via International Classification of Diseases (ICD) coding. Parents and caregivers of drowning patients were invited to participate in a semi-structured interview. Data were thematically coded using an inductive approach, with a focus on causal factors and recommendations for preventive approaches. Of 169 incidents, 86 parents/caregivers were interviewed. Children hospitalised for drowning were more often male (59.3%), aged 0-4 years (79.1%) and 30.2% were from household who spoke a language other than English. Qualitative incident descriptions were coded to five themes: lapse of supervision, unintended access (commonly in home swimming pools), brief immersion (usually young children bathing), falls into water and ongoing impacts. Drowning prevention recommendations were grouped under supervision, pool barriers and maintenance, cardiopulmonary resuscitation (CPR) training and emergency response, drowning is quick and silent, and learning swimming. Parents and caregivers of young children require ongoing education regarding supervision distractions and pool barrier compliance. Additional challenges are faced by those in rental properties with pools, parents/caregivers who cannot swim, and parents/caregivers from culturally and linguistically diverse backgrounds. Affordable, accessible, and culturally appropriate swimming lessons, water safety education and CPR training should be made more available for adult caregivers, particularly in languages other than English.

Deep Learning and 5G and Beyond for Child Drowning Prevention in Swimming Pools.

Drowning is a major health issue worldwide. The World Health Organization’s global report on drowning states that the highest rates of drowning deaths occur among children aged 1–4 years, followed by children aged 5–9 years. Young children can drown silently in as little as 25 s, even in the shallow end or in a baby pool. The report also identifies that the main risk factor for children drowning is the lack of or inadequate supervision. Therefore, in this paper, we propose a novel 5G and beyond child drowning prevention system based on deep learning that detects and classifies distractions of inattentive parents or caregivers and alerts them to focus on active child supervision in swimming pools. In this proposal, we have generated our own dataset, which consists of images of parents/caregivers watching the children or being distracted. The proposed model can successfully perform a seven-class classification with very high accuracies (98%, 94%, and 90% for each model, respectively). ResNet-50, compared with the other models, performs better classifications for most classes.

Schoolchildren's inland water transport adoption barriers in Tanzania: Health belief model application

In small islands of low and middle-income countries, schoolchildren rely on canoe transport to access education. Although this is associated with rampant drowning and barriers to access schooling, there is little empirical evidence in the drowning prevention and rural transport literature. Consequently, there are high school dropouts among children in rural islands. This study investigates inland water transport barriers and the factors influencing the adoption of canoes in rural areas. A household survey of 350 parents/caregivers was conducted in 17 small islands of Ukerewe District, Tanzania. Based on the Health Belief Model, structural equation modeling was performed to measure how perceived susceptibility, severity/risk, self-efficacy, and barriers can affect intentions to use inland water transport using perceived benefits as a moderator. Overall, schoolchildren ride canoes without the aid of adults, exposing them to negative health effects such as injury, tiredness, and drowning. Notably, only perceived severity had statistically significant effects on the adoption of water transport to school when mediated by the perceived benefits. These findings imply that the provision of safer transport modes and policies aimed at reducing the perceived risks can enhance inland water transport adoption and reduce the rate of child drowning and school dropouts in rural islands.

Childhood Drownings: An Opportunity for Injury Prevention in a Resource-Limited Setting.

Drowning is a public health problem that is under-reported in Africa. We sought to evaluate the epidemiology and risk factors for drownings in Malawi. We performed a retrospective review of all pediatric (≤15 years old) patients who presented following a drowning incident to Kamuzu Central Hospital in Lilongwe, Malawi, from 2009-19. Demographics and outcomes were compared between survivors and non-survivors. Logistic multivariate regression analysis was used to identify factors associated with increased odds of mortality. There were 156 pediatric drowning victims during the study period. The median age at presentation was 3 (IQR: 2-7 years). Survivors were younger [median age: 2 years (IQR: 2-5) vs. 5 years (IQR: 2-10), p = 0.004], with a higher proportion of drownings occurring at home (85.6% vs. 58.3%, p = 0.001) compared to non-survivors. Patients who had a drowning event at a public space had increased odds of mortality (OR 8.17, 95% CI 2.34-28.6). Patients who were transferred (OR 0.03, 95% CI 0.003-0.25) and had other injuries (OR 0.20, 95% CI 0.06-0.70) had decreased odds of mortality following drowning. Over half of pediatric drowning victims at a tertiary-care facility in Malawi survived. Drowning survivors were significantly younger, more likely to have drowned at home, and transported by private vehicles and minibus than non-survivors. There is a need for scalable, cost-effective drowning prevention strategies that focus on water safety education and training community members and police officers in basic life support and resuscitation.

Relasi Magis, Agama dan Pengetahuan dengan Sistem Kepercayaan Tradisional pada Long Storage Kalimati

Related to the traditional belief in the Long Storage of Kalimati, this study aims to explain the relationship between various kinds of beliefs that exist in the residents of Leminggir Village, Mojosari District, Mojokerto Regency. The focus of this study is to determine the relationship between magic, religion and knowledge with the traditional belief system of society. This descriptive study was prepared using ethnographic methods and the use of J.G Frazer's theory of religious evolution because it is in accordance with the main concepts that discuss magic, religion, and science. The main object of this research is the Kalimati Long Storage. The main data source of this study was obtained based on the results of interviews with Mr. Turoikhan, an elder, a resident of Leminggir Village.The results of the discussion show that there is a belief in the people of Leminggir Village towards magic, religion and knowledge that go hand in hand. As shown by the public's belief in supernatural beings who are the cause of the drowning of children, so that in their search efforts use magic, as well as religious methods as well as the use of technological advances like a motorized boat. The benefit of this research is that it can be used as an educational medium about a culture of tolerance and mutual respect for the existence of various beliefs.&#x0D; Keywords: evolution religi; traditional belief system; Long Storage Kalimati

Analysis of Climate and Income-Related Factors for High Regional Child Drowning Mortality in China.

Objectives: To assess the relationship between regional climatic factors and child drowning in China. Methods: Provincial age-specific drowning rate, climatic and income data were collected. We conducted a geographically weighted regression to evaluate the association between drowning and climatic factors. A generalized additive model was used to comprise a bivariate term with which to investigate the interaction of environmental risk factors and whether such interactions influence drowning mortality. Results: In southern China, an abundance of water systems and increased precipitation, as well as hotter and longer summers, lead to significantly higher drowning compared with that in northern China. Long summers and low economic performance in parts of Xinjiang were key factors for its high drowning mortality rate. Linear and nonlinear joint effects were observed between the risk factors of drowning. Conclusion: Different regions should use adaptive measures to reduce drowning risks, for example, communication campaigns during the summer period or when the weather changes.

Infant Swimming Increase the Risk of Atopy and Respiratory Tract Infections: A Systematic Review and Meta-Analysis

Purpose: The benefits of infant swimming must be considered against the risk of adverse occurrences during infant swimming practice. Several research studies have recommended against newborn swimming since there is little data to support its use in preventing drowning in infants. &#x0D; Methodology / Evidence Acquisitionː In the context of the PRISMA guidelines, the researcher did a systematic review and meta-analysis research on infant swimming. From 1950 to 2021, an online database search was conducted using keywords and MeSH terms such as "infant swimming", "safety", "infant swimming lessons", and "infant diving" on healthcare search engines such as PubMed, Google Scholar, BioMed Central, Cochrane Library, ERIC, PILOTS, PsycARTICLES, MEDLINE, AMED, CINAHL, EMBASE, Web of Science, Science Direct, Taylor &amp; Francis, and Med SC. The researcher excluded articles that were first published in a foreign language and did not have an English translation.&#x0D; Findings / Evidence Synthesisː The risk of respiratory tract infection is greater in the control group, 95% confidence interval is 1.95 [1.24, 1.97] (p = 0.000). The difference in risk of atopy is between infant swimmers and the control group is significant, and the risk is greater in the control group compared to swimming infants; 95% confidence interval is 1.36 [1.01, 1.84] (p = 0.000).&#x0D; Conclusions/ Originality Value: Swimming does not raise the risk of infection in infants, nor does it predispose them to asthma. We propose further more research into the benefits of infant swimming in reducing the burden of childhood drowning, which is the leading cause of death in this age group.

Quantifying fatal and non‐fatal drowning in children under five in Aotearoa, New Zealand

ObjectiveTo quantify unintentional drowning trends and risk factors for children under five years of age in Aotearoa, New Zealand. MethodsA population‐based analyses of fatal and non‐fatal (hospitalisations and Accident Compensation Corporation [ACC] claims) unintentional drowning of children 0‐4 years of age between 2005 and 2019 was conducted using DrownBase™ data. Analyses comprises calculation of linear temporal trends, crude drowning rates per 100,000 and relative risk (95% confidence interval) and ratios of fatal to non‐fatal drowning. Results557 incidents (16.0% fatal) were recorded. Fatalities declined (y=−0.0769x+2.5678;R2=0.01509), while hospitalisations increased (y=0.1418x+9.1093;R2=0.0979). Males were overrepresented. One year‐olds recorded the highest rates (fatal=4.39/100,000) and (non‐fatal=2.14/100,000). ‘Other’ ethnicity (8.77/100,000) and Māori (2.49/100,000) children recorded the highest fatal drowning rates. Home pools were the leading fatal location, while domestic environments attracted the highest hospitalisation rate. For every one fatal drowning there were 6.9 hospitalisations and 74.7 ACC claims. ConclusionsDrowning among young children represents a preventable cause of injury‐related harm. While fatalities are declining, non‐fatal drowning is increasing. Implications for public healthStrategies to prevent drowning among young children are well understood, particularly restricting water access and active adult supervision. Further investment in effective prevention strategies for young children will deliver significant social, economic and health system savings.

The 2021 Joseph St Geme, Jr, Leadership Award Address: The Role of Structural Racism in Injuries to Children and Adolescents.

The 2021 Joseph St Geme, Jr, Leadership Award Address: The Role of Structural Racism in Injuries to Children and Adolescents.

Preventing Child Drowning in the Philippines: The Need to Address the Determinants of Health.

Drowning is a public health issue in the Philippines, with children at significantly increased risk. Determinants of health (DoH) such as education, socio-economic status, ethnicity, and urbanization are factors that impact drowning risk. As drowning is a multisectoral issue, a national drowning prevention plan can drive collaboration with relevant stakeholders. This study reports trends in unintentional child (0–14 years) drowning in the Philippines (incidence, rates, and trends over time for fatal and non-fatal (years lived with a disability (YLDs) and disability adjusted life years (DALYs) from 2008–2017 and conducts an analysis of the Philippines’ Multisector Action Plan (MSAP) on Drowning Prevention. From 2008–2017, 27,928 (95%UI [Uncertainty Interval]: 22,794–33,828) children aged 0–14 years died from drowning (52.7% aged 5–14 years old). Rates of drowning have declined among both age groups, with greater reductions seen among 0–4 year olds (y = −0.3368x + 13.035; R2 = 0.9588). The MSAP has 12 child drowning-specific activities and 20 activities were identified where DoH will need to be considered during development and implementation. The MSAP activities, and work done to prevent drowning more generally, must consider DoH such as education, urbanization, water and sanitation health, and safe water transportation. A national drowning surveillance system and investment in research in the Philippines are recommended.

Contributing factor leading to child drowning: Epidemiologic study over 15 years in Bihor County

Contributing factor leading to child drowning: Epidemiologic study over 15 years in Bihor County

Interventions for Child Drowning Reduction in the Indian Sundarbans: Perspectives from the Ground.

Drowning is a leading cause of child death in the coastal Sundarbans region of India due to the presence of open water, lack of supervision and poor infrastructure, but no prevention programs are currently implemented. The World Health Organization has identified interventions that may prevent child drowning in rural low-and middle-income country contexts, including the provision of home-based barriers, supervised childcare, swim and rescue training and first responder training. Child health programs should consider the local context and identify barriers for implementation. To ensure the sustainability of any drowning prevention programs implemented, we conducted a qualitative study to identify the considerations for the implementation of these interventions, and to understand how existing government programs could be leveraged. We also identified key stakeholders for involvement. We found that contextual factors such as geography, cultural beliefs around drowning, as well as skillsets of local people, would influence program delivery. Government programs such as accredited social health activists (ASHAs) and self-help groups could be leveraged for program implementation, while Anganwadi centres would require additional support due to poor resourcing. Gaining government permissions to change Anganwadi processes to provide childcare services may be challenging. The results showed that adapting drowning programs to the Sundarbans context presents unique challenges and program customisation.

Social and environmental risk factors for the accidental drowning of children under five in China

BackgroundAccidental drowning of children under five is a serious problem in China. The present study analyzed data on environmental and sociodemographic factors and on primary caregivers of drowned children to understand factors that may contribute to this problem.MethodsThe present study collected information on 563 cases of drowning in children under five from October 1, 2015, to September 30, 2016, in 334 sampling districts in China. Primary caregivers were interviewed individually using the Drowning Mortality among Children under 5 Questionnaire.ResultsMost drowned children under 5 years old were boys, and 71.6% lived within 100 m of a body of water. The drownings primarily occurred in ponds, canals, rivers, and wells, and over 90% of these water bodies had no safety measures. There were 28.1% of primary caregivers who did not provide full-time care for the children, and 83.1% of them had no knowledge of first aid skills for drowning.ConclusionEncouraging kindergarten enrollment and providing safety education for children may reduce drowning in children under 5 years of age. Public water body protection measures should be strengthened to prevent children from drowning. Encouraging primary caregivers to care full-time for the children and learning first aid skills for drowning may also help reduce fatalities.