Burden of Injuries in Bangladesh: A Population-Based Assessment

Injuries claim over 5 million lives, with more than 90% of those occurring in low- and middle-income countries (LMICS) [...].

Additionally, in Epidemiology of Fall Injury in Rural Bangladesh, elderly people, 65 years of age and above, were seen to be at highest risk of both fatal and non-fatal fall injuries. The physical, mental and emotional wellbeing of elderly individuals can be disrupted by a debilitating fall injury and drive them into greater vulnerability. These papers highlight the need for targeted approaches in the form of interventions, policy changes and programs to address respective burdens of disease.
The notion of a center-based, early childhood education program may not be entirely new in Bangladesh, but there is a lack of research on the cognitive benefits of such an approach in LMICs. In high-income countries, it has been shown that early childhood education has both short term and long-term benefits for children exposed to it. The paper Developmental Assessments during Injury Research: Is Enrollment of Very Young Children in Crèches Associated with Better Scores? showed that being enrolled in a crèche intervention had a positive dose-response relationship on fine and gross motor skills, personal-social and problem-solving skills for children 1-5 years of age. This reiterated the importance of engaging young children in formal age-appropriate education systems.
The authors of Caregiver Supervision Practices and Risk of Childhood Unintentional Injury Mortality in Bangladesh, used a large population-level dataset to suggest that adult caregiver supervision significantly reduced the risk of drowning deaths for children under 5 years of age. This notion of adult supervision needs to be effectively communicated amongst communities in LMICs, mainly because injuries are still conceived of as unforeseeable "accidents" that cannot be prevented. Additionally, with injuries comes a high risk of sustaining a long-term disability, along with loss of productivity and other economic costs. First aid, by a formal medical provider, can improve the odds of faster recovery for an individual with injuries. However, informal providers are readily available in LMICs such as Bangladesh. Thus, authors of the paper Impact of First Aid on Treatment Outcomes for Non-Fatal Injuries in Rural Bangladesh: Findings from an Injury and Demographic Census, suggest that public health interventions should be designed to train and improve first aid skills for informal providers.
It is important to consider the economic ramifications of injuries and associated disabilities, because the majority one-income households in rural Bangladesh undergo financial distress in dealing with the aftermath of fatal and non-fatal injuries. In the paper, Care-Seeking Patterns and Direct Economic Burden of Injuries in Bangladesh, the authors tested the relationship between care-seeking behavior of injured households and financial distress, and suggested that enforcing occupational safety regulations, worksite inspections, home safety inspections and such promotions, should help alleviate the economic distress caused by injury.
This collection of papers, therefore, provides a base for new channels of future research. These scholars have shown correlations between injury and age, sex and wealth. Additionally, they focus on demonstrating the link between various types of interventions-be it childcare centers, playpens, or first aid training-and injury prevention. What needs further study is why certain correlations exist and the how specific interventions work. To address these deficiencies, future studies must be of longer duration to include the eventual impact and include qualitative measurements of behavior to trace links between risks and actual injury prevention. The group involved in these papers is now working to address this gap in incidence. When researchers have a better handle on causal links, they can also look at antecedents, such as cultural and social norms, that influence behavior, all questions that need to be addressed to reduce the millions of deaths caused by injuries around the world.
Author Contributions: A.A.H. is the guarantor of the project and participated in the design, implementation and supervision of the project as well as reviewed and edited the manuscript. P.A. conceptualized the idea for the manuscript, wrote the initial and subsequent drafts of the manuscript.

Conflicts of Interest:
The authors declare no conflict of interest. The funding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.