Public Health Foundation of India, Gurugram, India.
Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.
Inj Prev. 2019 Oct;25(5):364-371. doi: 10.1136/injuryprev-2018-042743. Epub 2018 May 19.
We report on incidence of drowning deaths and related contextual factors in children from a population-based study in the Indian state of Bihar which estimated the causes of death using verbal autopsy (VA).
Interviews were conducted for deaths in 1-14 years population that occurred from January 2012 to March 2014 in 109 689 households (87.1% participation) in 1017 clusters representative of the state. The Population Health Metrics Research Consortium shortened VA questionnaire was used for interview and cause of death was assigned using the SmartVA automated algorithm. The annualised unintentional drowning death incidence, activity prior to drowning, the body of water where drowning death had occurred and contextual information are reported.
The survey covered 224 077 children aged 1-14 years. Drowning deaths accounted for 7.2%, 12.5% and 5.8% of all deaths in 1-4, 5-9 and 10-14 years age groups, respectively. The adjusted incidence of drowning deaths was 14.3 (95% CI 14.0 to 14.7) per 100 000 children, with it being higher in urban (16.1, 95% CI 14.8 to 17.3) areas. Nearly half of the children drowned in a river (5.9, 95% CI 5.6 to 6.1) followed by in a pond (2.8, 95% CI 2.6 to 2.9). Drowning death incidence was the highest while playing (5.1, 95% CI 4.9 to 5.4) and bathing (4.0, 95% CI 3.8 to 4.2) with the former accounting for more deaths in 1-4 years age group. Sixty per cent of children were already dead when found. None of these deaths were reported to the civil registration system to obtain death certificate.
The findings from this large representative sample of children document the magnitude of and variations in unintentional drowning deaths in Bihar. Urgent targeted drowning interventions are needed to address the risk in children. Gross under-reporting of drowning deaths in children in India needs attention.
我们报告了在印度比哈尔邦进行的一项基于人群的研究中，溺水死亡的发生率以及与溺水相关的儿童死亡的相关因素，该研究使用了死因推断（VA）来估计死亡原因。
在 2012 年 1 月至 2014 年 3 月期间，对居住在 1017 个有代表性的社区（参与率为 87.1%）的 109689 户家庭中 1 至 14 岁人群的死亡事件进行了访谈。采用人口健康指标研究联盟简化版 VA 问卷进行访谈，并使用 SmartVA 自动算法分配死因。报告了溺水死亡的年发生率、溺水前的活动、发生溺水的水体以及背景信息。
调查覆盖了 224077 名 1 至 14 岁的儿童。1 至 4 岁、5 至 9 岁和 10 至 14 岁年龄组中，溺水死亡分别占所有死亡的 7.2%、12.5%和 5.8%。调整后的溺水死亡率为每 100000 名儿童 14.3（95%CI 14.0 至 14.7），城市地区（16.1，95%CI 14.8 至 17.3）的溺水死亡率更高。将近一半的儿童在河中（5.9，95%CI 5.6 至 6.1）溺水，其次是池塘（2.8，95%CI 2.6 至 2.9）。溺水死亡发生率最高的是玩耍时（5.1，95%CI 4.9 至 5.4）和洗澡时（4.0，95%CI 3.8 至 4.2），前者导致 1 至 4 岁年龄组的死亡人数更多。发现时，60%的儿童已经死亡。这些死亡均未向民事登记系统报告以获得死亡证明。
本项基于大样本代表性儿童的研究结果记录了比哈尔邦非故意伤害性溺水死亡的严重程度和变化情况。需要采取有针对性的紧急溺水干预措施来降低儿童的风险。印度儿童溺水死亡的严重漏报问题值得关注。
