Risk factors for nonfatal drowning in children in rural Bangladesh: a community–based case–control study.
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Date
2013-04
Authors
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Journal ISSN
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Publisher
WHO Regional Office for South-East Asia
Abstract
Introduction: Most studies of drowning in Bangladeshi populations to date have
described mortality and trends. We sought to identify associations between
socioeconomic status and child‑care practices and nonfatal drowning in rural
Bangladeshi children.
Materials and Methods: This community‑based case–control study was conducted
in rural children aged 1–5 years in Raiganj subdistrict of Bangladesh. 122 cases
and 134 age‑matched controls were recruited and their mothers were interviewed
by use of a structured questionnaire. Univariate analyses and logistic regression
were done to analyse the data.
Results: Child nonfatal drowning was significantly associated with mothers: With low
educational status (P < 0.001), of younger age (P < 0.005), of single status (P < 0.001)
and with more than three children (P < 0.001). Nonfatal drowning was 12 and five
times more likely in children of illiterate mothers than in children of mothers with
academic knowledge equivalent to sixth to tenth grade (OR [95% CI] 0.08 [0.02–0.26])
and above tenth grade (OR [95% CI] 0.21 [0.04–0.95]) (P < 0.001), respectively.
Low socioeconomic status, indicated by lower family expenditure (P < 0.001) and
no house (P < 0.05; OR [95% CI] 0.58 [0.17–0.99]), were found to be risk factors for
childhood nonfatal drowning. Improved child care, as measured by a child‑care index,
was associated with significantly lower non‑fatal drowning (P < 0.001). Child care
improved with higher educational attainment of mothers (P < 0.005) and increased
socioeconomic status. Nonfatal drowning was more common when the main caregiver
was not the mother (P < 0.001). Forward likelihood ratio logistic regression indicated
mothers’ lower educational status as the best predictor of nonfatal drowning.
Conclusion: Better child care and prevention of nonfatal drowning might be
ensured through increasing mothers’ educational attainment and improvements
in socioeconomic status.
Description
Keywords
Bangladesh, case–control study, child, drowning, nonfatal drowning, risk factors, safe community
Citation
WHO South-East Asia Journal of Public Health 2013;2(2): 88-95.