WHO South-East Asia Journal of Public Health
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ORIGINAL RESEARCH
Year : 2013  |  Volume : 2  |  Issue : 2  |  Page : 88-95

Risk factors for nonfatal drowning in children in rural Bangladesh: a community-based case-control study


1 Assistant Military Secretary (Medical), Army Headquarters, Dhaka Cantonment, Dhaka, Bangladesh
2 National Institute of Preventive and Social Medicine, Dhaka, Bangladesh

Correspondence Address:
Meerjady S Flora
Department of Epidemiology, National Institute of Preventive and Social Medicine, Mohakhali, Dhaka - 1212
Bangladesh
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DOI: 10.4103/2224-3151.122939

PMID: 28612765

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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.


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