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Int. J. Environ. Res. Public Health 2017, 14(5), 515; doi:10.3390/ijerph14050515

Caregiver Supervision Practices and Risk of Childhood Unintentional Injury Mortality in Bangladesh

1
Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
2
Department of Preventive Medicine, Griffin Hospital, Derby, CT 06418, USA
3
Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka 1206, Bangladesh
4
International Centre for Diarrheal Diseases Research in Bangladesh (ICDDR,B), Dhaka 1212, Bangladesh
*
Author to whom correspondence should be addressed.
Academic Editor: David C. Schwebel
Received: 15 February 2017 / Revised: 3 May 2017 / Accepted: 5 May 2017 / Published: 11 May 2017
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Abstract

Unintentional injury-related mortality rate, including drowning among children under five, is disproportionately higher in low- and middle-income countries. The evidence links lapse of supervision with childhood unintentional injury deaths. We determined the relationship between caregiver supervision and unintentional injury mortality among children under five in rural Bangladesh. We conducted a nested, matched, case-control study within the cohort of a large-scale drowning prevention project in Bangladesh, “SOLID—Saving of Children’s Lives from Drowning”. From the baseline survey of the project, 126 cases (children under five with unintentional injury deaths) and 378 controls (alive children under five) were selected at case-control ratio of 1:3 and individually matched on neighborhood. The association between adult caregiver supervision and fatal injuries among children under five was determined in a multivariable conditional logistic regression analysis, and reported as adjusted matched odds ratio (MOR) with 95% confidence intervals (CIs). Children under five experiencing death due to unintentional injuries, including drowning, had 3.3 times increased odds of being unsupervised as compared with alive children (MOR = 3.3, 95% CI: 1.6–7.0), while adjusting for children’s sex, age, socioeconomic index, and adult caregivers’ age, education, occupation, and marital status. These findings are concerning and call for concerted, multi-sectoral efforts to design community-level prevention strategies. Public awareness and promotion of appropriate adult supervision strategies are needed. View Full-Text
Keywords: childhood unintentional injuries; drowning; drowning mortality; caregiver supervision; children under five; developing country; Bangladesh childhood unintentional injuries; drowning; drowning mortality; caregiver supervision; children under five; developing country; Bangladesh
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Khatlani, K.; Alonge, O.; Rahman, A.; Hoque, D.M.E.; Bhuiyan, A.-A.; Agrawal, P.; Rahman, F. Caregiver Supervision Practices and Risk of Childhood Unintentional Injury Mortality in Bangladesh. Int. J. Environ. Res. Public Health 2017, 14, 515.

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