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Objective: To determine the epidemiology of child drowning in order to propose possible interventions for Bangladesh and other similar low-income countries. Design: Population-based cross-sectional study. Setting: Rural and urban communities in Bangladesh. Subjects: About 352 000 children 0-17 years were selected from over 171 000 households, using multistage cluster sampling. Main outcome measures: Incidence of fatal drowning. Results: Drowning was the leading cause of death (28.6 per 100 000 child-years) in children aged 1-17 years. The highest incidence (86.3 per 100 000 child-years) was in children aged 1-4 years. More than two-thirds of drownings occurred in ponds and ditches. Most drownings (85%) happened in daylight. In more than one-third of cases of drowning, the child was alone. In the two-thirds of cases in which the child was accompanied, almost half were with children who were 10 years or below. Only 7% of drowned children over 4 years of age knew how to swim. Conclusions: Drowning is a major cause of childhood mortality in Bangladesh. Creating drowning-safe homes, improving supervision of children, modifying the environment, and developing water safety skills for children and the community may be effective interventions for drowning prevention.

In terms of mortality, morbidity and disability, burns are emerging as a major child health problem in Bangladesh. This trend is similar to many other developing countries. To develop effective burn prevention programmes, information on its magnitude and determinants is necessary. The purpose of this study was to document the magnitude and determinant of childhood burns in Bangladesh, based on a population-based survey which was conducted between January and December 2003. Nationally representative data was collected from 171,366 rural and urban households, comprising of a total population of 819,429. To facilitate data collection, face-to-face interviews were conducted. The rate of non-fatal burn among children under 18 years of age was calculated as 288.1 per 100,000 children-year. The highest incidence (782.1/100,000 children-year) was found among the 1-4 years age group. About 46% of non-fatal burn injuries occurred between 9 a.m. and 3 p.m. The incidence of childhood burn was found to be more than four times higher in rural children than urban children. Ninety percent (90%) of the childhood burns occurred at homes and the kitchen was the most common place. The rate of disability due to burn was 5.7 per 100,000 children per year. The rate of fatal burn was 0.6 per 100,000 per year among all children. The study findings confirmed that childhood burn was a major childhood illness in Bangladesh. An urgent and appropriate prevention programme is required to prevent these unwanted morbidities, disabilities and deaths due to burn.

This study was intended to estimate the magnitude and explore the determinants of childhood drowning in rural Bangladesh. A cross-sectional survey as well as a population-based case - control study was conducted. By multistage cluster sampling 51 147 children aged 1 - 4 years were identified from 108 827 rural households. All drownings in children aged 1 - 4 years in the preceding 5 years were identified and recruited as cases and two living children of the same age group were selected from the same localities as controls. Socio-economic, demographic, environmental and other related information was collected from mothers of both cases and controls by face-to-face interview with the help of structured questionnaires. The incidence of drowning among children aged 1 - 4 years old was 156.4 per 100 000 children-year. The highest rate (328.1 per 100 000; 95% CI 254.8 - 421.7) was observed in 1 year old male children. The proportional mortality due to drowning in the children was 27.9%. Mothers' age and literacy and family income were identified as risk factors. Drowning is one of the major causes of 1 - 4 years childhood mortality in Bangladesh. One-year-old male children from poor families were at great risk of drowning in rural Bangladesh.