Fall Injuries in Nepal: A Countrywide Population-based Survey

Gupta, Shailvi; Gupta, Shyam; Devkota, S; Ranjit, Anju; Swaroop, Mamta; Kushner, Adam L.; Nwomeh, Benedict C.; Victorino, Gregory P.

doi:10.1016/j.aogh.2015.07.004

Cited by 26 publications

(28 citation statements)

References 17 publications

(15 reference statements)

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“…6,11,13,25,27,28,33 The majority (n = 248, 51%) of falls occurred at the ground level, which is similar to that reported earlier. 11,27,28 Results of a multivariate logistic regression demonstrated that type of residence, number of members in the family, type of cooking area, and whether the mother was alive were significantly associated with fall injuries. Moreover, the surrounding environment plays a crucial role in the occurrence of injuries; rural outmigration has resulted in overcrowded cities, which makes children living in urban areas more prone to unintentional fall-related injuries.…”

Section: Discussionsupporting

confidence: 87%

“…Our study reports a higher incidence of injuries in Ujjain than that reported by other studies from India 20,[24][25][26][27] and Nepal, which reported an incidence of 5.72% among children between 0 and 14 years of age. 28 Other LMICs also reported a high incidence of childhood fall injuries. [29][30][31][32] A total of 338 (69%) fall injuries received first aid and 40 (8%) falls resulted in hospital admissions.…”

Section: Discussionmentioning

confidence: 99%

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<p>Incidence, Risk and Protective Factors for Unintentional, Nonfatal, Fall-Related Injuries at Home: A Community-Based Household Survey from Ujjain, India</p>

Pathak¹,

Agarwal²,

Mehra³

et al. 2020

PHMT

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Background: Childhood injury is an increasing public health burden and considered a major cause of childhood morbidity and mortality worldwide. In this study, we identified the distribution and risk factors for fall-related child injuries at home in Ujjain, India. Methods: A community-based, cross-sectional study was conducted in 2017 in Ujjain, India, which included 6308 children up to 18 years of age living in 2518 households. Data were collected using a pretested, semi-structured, proforma from the parents of the included children. Results: The overall incidence of home injury was 7.78% (95% confidence interval [CI]: 7.12-8.84) in the last 1 year, ie, 2015-16. The incidence was significantly higher at 5-10 years of age (odds ratio [OR]: 2.91, 95% CI: 1.75-4.85; P < 0.001), followed by 1-5 years (OR: 2.66, 95% CI: 1.59-4.45; P < 0.001). The incidence of injuries was higher in boys than in girls (adjusted odds ratio [aOR]: 1.73, 95% CI: 1.43-2.10; P < 0.001). Other risk factors associated with unintentional fall injuries at home were residence (rural vs urban; aOR: 1.25, 95% CI: 1.03-1.51; P = 0.018), number of family members (≤4 vs 5-10 and ≤4 vs >10; aOR: 0.69, 95% CI: 0.56-0.86; P < 0.001 and aOR: 0.67, CI: 0.48-0.94; P < 0.023, respectively), cooking area (combined vs separate; aOR: 0.82, 95% CI: 0.68-1.00; P = 0.057), and whether mother is alive vs not alive (aOR: 2.09, 95% CI: 1.10-3.94; P = 0.023). Conclusion: The incidence of fall injuries among children at home in Ujjain, India, was similar to other resource constraint settings. The incidence was higher in rural areas, in the age group of 5-10 years, and in families in which the mother was not alive. By contrast, large and combined families had a lower incidence of falls.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

<p>Incidence, Risk and Protective Factors for Unintentional, Nonfatal, Fall-Related Injuries at Home: A Community-Based Household Survey from Ujjain, India</p>

Pathak¹,

Agarwal²,

Mehra³

et al. 2020

PHMT

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“…The study estimated death and disability from every cause of injury for all ages and both sexes over a time range spanning from 1990 to 2017 2–7. Past research and commentaries have focused on changes in the injury burden in Nepal and have attributed trends in injury burden to rapid urbanisation, infrastructure development, increasing numbers of new and old vehicles (mainly two-wheeler motorised vehicles), poorly designed roads, limited prehospital and emergency care, poor healthcare infrastructure and rehabilitation services, an ageing population and natural disasters 8–17. Catastrophic events in Nepal, such as the 2015 massive earthquake and its aftershocks, which killed approximately 9000 and injured over 22 000 people, are known to contribute significantly to the burden of injury 14…”

Section: Introductionmentioning

confidence: 99%

Burden of injuries in Nepal, 1990–2017: findings from the Global Burden of Disease Study 2017

et al. 2020

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BackgroundNepal is a low-income country undergoing rapid political, economic and social development. To date, there has been little evidence published on the burden of injuries during this period of transition.MethodsThe Global Burden of Disease Study (GBD) is a comprehensive measurement of population health outcomes in terms of morbidity and mortality. We analysed the GBD 2017 estimates for deaths, years of life lost, years lived with disability, incidence and disability-adjusted life years (DALYs) from injuries to ascertain the burden of injuries in Nepal from 1990 to 2017.ResultsThere were 16 831 (95% uncertainty interval 13 323 to 20 579) deaths caused by injuries (9.21% of all-cause deaths (7.45% to 11.25%)) in 2017 while the proportion of deaths from injuries was 6.31% in 1990. Overall, the injury-specific age-standardised mortality rate declined from 88.91 (71.54 to 105.31) per 100 000 in 1990 to 70.25 (56.75 to 85.11) per 100 000 in 2017. In 2017, 4.11% (2.47% to 6.10%) of all deaths in Nepal were attributed to transport injuries, 3.54% (2.86% to 4.08%) were attributed to unintentional injuries and 1.55% (1.16% to 1.85%) were attributed to self-harm and interpersonal violence. From 1990 to 2017, road injuries, falls and self-harm all rose in rank for all causes of death.ConclusionsThe increase in injury-related deaths and DALYs in Nepal between 1990 and 2017 indicates the need for further research and prevention interventions. Injuries remain an important public health burden in Nepal with the magnitude and trend of burden varying over time by cause-specific, sex and age group. Findings from this study may be used by the federal, provincial and local governments in Nepal to prioritise injury prevention as a public health agenda and as evidence for country-specific interventions.

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“…A large populationbased survey was conducted in 2014 inventorising basic demographic properties and perceived unmet needs and disabilities of the populations of Nepal, Rwanda and Sierra Leone. Various cross-sections based on this data set were described and published before [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31], mainly focusing on Nepal. The aim was to evaluate the unmet surgical needs and perceived disabilities of the people of Nepal.…”

Section: Introductionmentioning

confidence: 99%

Directions for surgical capacity developments in Nepal: a population‐based assessment

Knulst

Gupta

Groen

et al. 2019

Tropical Med Int Health

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ObjectivesLack of access to safe surgery is seen as a major issue that needs to be addressed. The aim of this study was to understand which combinations of factors relate to high occurrences of unmet needs and disability in Nepal, and consequently, how to focus future work to maximise impact in this country.MethodsA large population‐based survey was conducted in Nepal in 2014 to evaluate the unmet surgical needs that result in disability. Recorded factors included diseased anatomical areas, disease specifics, disease locations, injury types, reasons for having an unmet need and the types of disability.ResultsIncluded in the study were 2695 individuals. The anatomical areas facing the highest disabling unmet surgical need were Head (3.9% of population), Groin/Genitalia (2.2% of population) and Extremities (3.6% of population). Four focus areas could be defined. Increase affordability, availability and acceptability of surgical care to non‐traumatic disabling conditions of (i) the eye, and (ii) extremities, and (iii) to traumatic disabling conditions of extremities and finally (iv) increase acceptability of having surgical care for non‐traumatic conditions in the groin and genital area. For the latter, fear/no trust was the main reason for receiving no surgical care despite the resulting shame.ConclusionsThis study defined four focus areas that showed the largest unmet needs that resulted in a perceived disability. For those areas, affordability, availability and acceptability of surgical need to be addressed through technical developments, capacity building and raising awareness.

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Fall Injuries in Nepal: A Countrywide Population-based Survey

Cited by 26 publications

References 17 publications

<p>Incidence, Risk and Protective Factors for Unintentional, Nonfatal, Fall-Related Injuries at Home: A Community-Based Household Survey from Ujjain, India</p>

<p>Incidence, Risk and Protective Factors for Unintentional, Nonfatal, Fall-Related Injuries at Home: A Community-Based Household Survey from Ujjain, India</p>

Burden of injuries in Nepal, 1990–2017: findings from the Global Burden of Disease Study 2017

Directions for surgical capacity developments in Nepal: a population‐based assessment

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