Content area
Full text
1. Introduction
Children and adolescents are vulnerable for drowning because they are mobile, curious, and like to explore their environment [1], and also because they lack adult levels of risk consciousness and water-safety knowledge [2]. According to the latest Global Burden of Disease (GBD) estimates, 127,577 children and youth under the age of 20 years died from drowning in 2015 in the world, constituting over 39.4% of all-age drowning deaths [3].
Assessment of the epidemiological characteristics and monitoring of trends in drowning at the national level is critical to understand the mechanisms of drowning and develop feasible solutions to reduce risk. However, only a few studies report recent child drowning mortality at the national level for multiple countries. GBD 2015 estimates are helpful to the field, as they provide national estimates of child and adolescent drowning rates for 195 countries, and subnational estimate for seven large countries [4]. GBD data are, however, limited in their scope. They combine all methods of drowning into a single category and thus do not offer data concerning the frequency of drowning from different methods or causes.
Existing research has quantified some aspects of drowning rates around the world. Huang et al. [5], for example, used GBD 2013 data and reported large decreases in global under-5 years of age drowning mortality between 1990 and 2013, including a greater drop in drowning mortality in developing countries compared to developed countries. Other reports have focused on changes in drowning rates in single countries or regions, such as manuscripts by Dai et al. in Georgia [6]; Anary et al. in Mazandaran Province, Iran [7]; Tyebally and Ang in Singapore [8]; and Ahlm et al. in Sweden [9]. A few studies have extended broad information on drowning rates to examine rates by method and cause. One recent paper, for example, used the combined mortality data for the latest available three years (2004-2011) in the WHO Health Statistics and Information Services to examine differences in unintentional drowning mortality by age and body of water across 60 countries, revealing huge variations in age-adjusted mortality rate, from 0.12 in Turkey to 9.19 per 100,000 persons in Guyana; the authors ascribed the large country variations to be resulting from differences in coding practice for drownings [10]. A report...