School of Population Health, UNSW Sydney, Samuels Building, UNSW Sydney, Kensington, NSW, 2052, Australia.
College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, 4811, Australia.
BMC Public Health. 2022 Aug 3;22(1):1477. doi: 10.1186/s12889-022-13778-6.
Globally, drowning is a significant cause of preventable mortality and morbidity. The Eastern Mediterranean region (EMR) comprises 22 countries of extreme disparity in income and is a region impacted by conflict and migration. We systematically review literature published on drowning in the EMR.
Peer-reviewed literature (limited to original research) was identified using Embase, PubMed, Scopus, SportsDiscus, and Web of Science databases. Literature was independently dual screened at title/abstract and full text stages with dual data extraction (20% of included studies). Studies were included if they reported epidemiology, risk/protective factors and/or prevention strategies for drowning (unintentional and intentional; fatal and non-fatal) of residents, tourists or migrants in the EMR. Literature was assessed against the [Australian] National Health and Medical Research Council's Levels of Evidence.
Seventy-two studies were included in this review (epidemiology 68 studies; risk/protective factor 13 studies; prevention strategies 19 studies). Iran (n = 27), Saudia Arabia (n = 11) and Pakistan (n = 10) recorded the largest number of dedicated studies. Studies predominately focused on unintentional drowning. Ninety-two percent of included studies (n = 66) were ranked as being low evidence (level IV). The majority of studies explored drowning among children and adolescents (0-19 years). All-age fatal drowning rates varied from a low of 0.48 per 100,000 (United Arab Emirates; 2002; Ministry of Health death registry data) to a high of 18.5 per 100,000 (Egypt; 2014-15; WHO mortality database). Commonly identified risk factors included being male, young age, submersion time and resident status. Common prevention strategies public education, lifeguard supervision, and cardiopulmonary resuscitation.
Gaps in understanding of drowning burden in some countries within the region, as well as region-wide risk factor identification for adult drowning, intentional and migration-related drowning, impair the ability of nations to advance drowning prevention. There is a need for investment in implementation and evaluation of drowning prevention interventions in the EMR.
Drowning is a significant cause of mortality and morbidity in the EMR. The recent UN declaration on global drowning prevention may provide the impetus to invest in drowning prevention research, policy, and advocacy with the aim of reducing drowning-related harms in the EMR.
Registration number: # CRD42021271215 .
在全球范围内，溺水是可预防的死亡和发病的主要原因。东地中海区域（EMR）由 22 个收入水平差异极大的国家组成，是一个受冲突和移民影响的地区。我们系统地回顾了在 EMR 地区发表的有关溺水的文献。
使用 Embase、PubMed、Scopus、SportsDiscus 和 Web of Science 数据库，确定同行评议的文献（仅限于原始研究）。文献在标题/摘要和全文阶段进行独立的双重筛选，并进行双重数据提取（包括 20%的研究）。如果研究报告了 EMR 地区居民、游客或移民溺水（意外和故意；死亡和非死亡）的流行病学、风险/保护因素和/或预防策略，则将文献纳入研究。文献根据澳大利亚国家卫生和医学研究委员会的证据水平进行评估。
本综述纳入了 72 项研究（流行病学 68 项研究；风险/保护因素 13 项研究；预防策略 19 项研究）。伊朗（n=27）、沙特阿拉伯（n=11）和巴基斯坦（n=10）记录了最多的专门研究。研究主要集中在非故意溺水上。纳入的 92%（n=66）的研究被评为低证据（IV 级）。大多数研究都探讨了儿童和青少年（0-19 岁）的溺水问题。所有年龄段的致命溺水率从低至每 10 万人 0.48 人（阿拉伯联合酋长国；2002 年；卫生部死亡登记数据）到高至每 10 万人 18.5 人（埃及；2014-15 年；世界卫生组织死亡率数据库）不等。常见的风险因素包括男性、年轻、浸没时间和居民身份。常见的预防策略包括公众教育、救生员监督和心肺复苏术。
该地区一些国家对溺水负担的认识不足，以及整个地区成年溺水、故意和与移民有关的溺水的风险因素识别，这影响了各国推进溺水预防的能力。该地区需要投资实施和评估溺水预防干预措施。
溺水是 EMR 地区死亡和发病的主要原因。最近联合国关于全球溺水预防的宣言可能会促使人们投资溺水预防研究、政策和宣传，以减少 EMR 地区与溺水相关的伤害。
注册号：#CRD42021271215。
