Unintentional injury mortality among indigenous communities of Taiwan: trends from 2002 to 2013 and evaluation of a community-based intervention

2017 ◽  
Vol 25 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Stephen W Pan ◽  
Hiu Ha Chong ◽  
Hui-Chuan Kao
Keyword(s):  
Mortality Rate ◽  
Indigenous Population ◽  
Unintentional Injury ◽  
Indigenous Communities ◽  
Mortality Rates ◽  
Community Based ◽  
Injury Death ◽  
Injury Mortality ◽  
Injury Prevention Programme ◽  
Disproportionate Burden

IntroductionIndigenous communities in Taiwan shoulder a disproportionate burden of unintentional injury fatalities. We compare unintentional injury mortality rate trends among Taiwan’s indigenous communities and the general population from 2002 to 2013, and evaluate potential impact of a community-based injury prevention programme on indigenous unintentional injury death rates.MethodsStandardised and crude unintentional injury mortality rates were obtained from Taiwan government reports. Segmented linear regression was used to estimate and compare unintentional injury mortality rate trends before and after the intervention.ResultsBetween 2002 and 2013, unintentional injury mortality rates among Taiwan’s indigenous population significantly declined by about 4.5 deaths per 100 000 each year (p<0.0001). During that time, the unintentional injury mortality rate ratio between indigenous Taiwanese and the general population significantly decreased by approximately 1% each successive year (p=0.02). However, we were unable to detect evidence that the ‘Healthy and Safe Tribe’ programme was associated with a statistically significant decrease in the unintentional injury mortality rate trend among indigenous persons (p=0.81).ConclusionTaiwanese indigenous communities remain at significantly higher risk of unintentional injury death, though the gap may be slowly narrowing. We found no evidence that the ‘Healthy and Safe Tribe’ indigenous injury-prevention programme significantly contributed to the nationwide decline in unintentional injury mortality among indigenous Taiwanese communities from 2009 to 2013. Future interventions to address the disproportionate burden of unintentional injury fatalities among indigenous Taiwanese should consider interventions with wider coverage of the indigenous population, and complementing grass roots led community-based interventions with structural policy interventions as well.

scholarly journals Unintentional injury mortality and external causes in Canada from 2001 to 2007

2013 ◽  
Vol 33 (2) ◽  
pp. 95-102 ◽  
Author(s):  
Y Chen ◽  
F Mo ◽  
QL Yi ◽  
Y Jiang ◽  
Y Mao
Keyword(s):  
Mortality Rate ◽  
Motor Vehicle ◽  
Unintentional Injury ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Motor Vehicle Crashes ◽  
Vehicle Crashes ◽  
Female Ratio ◽  
Injury Mortality ◽  
External Causes

Introduction To understand the distribution pattern and time trend of unintentional injury mortalities is crucial in order to develop prevention strategies. Methods We analyzed vital statistics data from Canada (excluding Quebec) for 2001 to 2007. Mortality rates were age- and sex-standardized to the 2001 Canadian population. An autoregressive model was used for time-series analysis. Results Overall mortality rate steadily decreased but unintentional injury mortality rate was stable over the study period. The three territories had the highest mortality rates. Unintentional injury deaths were less common in children than in youths/adults. After 60, the mortality rate increased steadily with age. Males were more likely to die of unintentional injury, and the male/female ratio peaked in the 25- to 29-year age group. Motor vehicle crashes, falls and poisoning were the three major causes. There was a substantial year after year increase in mortality due to falls. Deaths due to motor vehicle crashes and drowning were more common in summer months, and deaths caused by falls and burns were more common in winter months. Conclusion The share of unintentional injury among all-cause mortality and the mortality from falls increased in Canada during the period 2001 to 2007.

scholarly journals Microscopic and submicroscopic Plasmodium infections in indigenous and non-indigenous communities in Colombia.

2020 ◽  
Author(s):  
Jehidys Montiel ◽  
Lina M. Zuluaga ◽  
Daniel C. Aguirre ◽  
Cesar Segura ◽  
Alberto Tobon-Castaño ◽  
...  
Keyword(s):  
Indigenous Population ◽  
Indigenous Communities ◽  
Access To Health Services ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional ◽  
High Exposure ◽  
Parasitological Diagnosis ◽  
Access To Health ◽  
Endemic Areas

Abstract Background The indigenous population is considered a highly susceptible group to malaria because individuals usually live in areas with high exposure to Anopheles and poverty, and have limited access to health services. There is a great diversity of indigenous communities in Colombia living in malaria-endemic areas; however, the burden of infection in these populations has not been studied extensively. This study aimed to determine the prevalence of Plasmodium infections in indigenous and non-indigenous communities in two malaria-endemic areas in Colombia. Methods A community-based cross-sectional survey was conducted in seven villages of Turbo and El Bagre municipalities; three of these villages were indigenous communities. Inhabitants of all ages willing to participate were included. Sociodemographic and clinical data were recorded as well as household information. The parasitological diagnosis was performed by microscopy and nested PCR. The prevalence of microscopy and submicroscopic infection was estimated. An adjusted GEE model was used to explore risk factors associated with the infection. Results Among 713 participants, 60.7% were from indigenous communities. Plasmodium spp. was detected in 30 subjects (4.2%, CI 95% 2.9-5.9); from those, 29 were in the indigenous population, 47% of infections were afebrile, and most of them submicroscopic (10/14). Microscopic and submicroscopic prevalence was 2.5% (CI 95% 1.6-3.9) and 1.7% (CI 95% 0.9-2.9), respectively. In El Bagre, all infections occurred in indigenous participants (3.9%, CI 95% 2.2-7.1), and 81% were submicroscopic. By contrast, in Turbo, the highest prevalence occurred in indigenous people (11.5%; CI 95%: 7.3-17.5), but 88.8% were microscopic. Living in an indigenous population increased the prevalence of infection compared with a non-indigenous population (PR 19.4; CI 95% 2.3-166.7). Conclusion There is a high proportion of Plasmodium infection in indigenous communities. A substantial proportion of asymptomatic and submicroscopic carriers were detected. The identification of these infections, not only in indigenous but also in the non-indigenous population, as well as their associated factors, could help to implement specific malaria strategies for each context.

scholarly journals Temperature, Precipitation, Ozone Pollution, and Daily Fatal Unintentional Injuries in Jiangsu Province, China during 2015-2017

2020 ◽  
Author(s):  
Leon Robertson ◽  
Lian Zhou ◽  
Kai Chen
Keyword(s):  
Unintentional Injury ◽  
Jiangsu Province ◽  
Maximum Temperature ◽  
Daily Maximum Temperature ◽  
Daily Maximum ◽  
Ozone Pollution ◽  
Injury Death ◽  
Injury Mortality ◽  
Daily Data ◽  
Moderate Range

Abstract Background The correlation of unintentional injury mortality to rising temperatures found in several studies could result from changes in behavior that increases exposure to hazards or risk when exposed. Temperature, precipitation and air pollutants may contribute to symptoms and distractions that increase risk or avoidance behavior that reduces risk. This study examines data that allows estimates of the relation of daily maximum temperature, precipitation and ozone pollution to injury mortality risk, each corrected statistically for the correlation with the others.Methods Daily data on unintentional injury deaths and exposures to temperature, precipitation and ozone in 9 cities in Jiangsu Province, China during 2015-2017 were analyzed using Poisson regression. The regression estimates were adjusted for weekends, holidays, an anomalous difference in death rates in Nanjing, and population size.Results Non transport injury death risk increased substantially in relation to higher temperatures when temperatures were in the moderate range and even more so at temperatures 35 degrees (C) and higher. Transport deaths were related to increasing deaths when temperatures were low but the correlation reversed at higher temperatures. Deaths were lower on rainy days when temperatures were cool and moderate with the exception of non-transport injuries when temperatures were moderate. Higher ozone concentrations were associated with more deaths except when temperatures were low. Injury mortality on weekends and holidays varied in relation to temperature as well. Conclusions The variations in deaths in relation to temperature, precipitation and ozone suggest that people are behaving differently or are in different environments when specific combinations of the predictor variables are prevalent, putting them at greater or less risk. More study of the behaviors and circumstances that result in injury under those conditions is needed.

scholarly journals Child drowning mortality in the Sundarbans, India: Applying the Community Knowledge Approach

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Gupta ◽  
S Bhaumik ◽  
S Roy ◽  
R Panda ◽  
M Peden ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Data Collection ◽  
Current Data ◽  
Mortality Data ◽  
Community Based ◽  
Community Knowledge ◽  
Key Informants ◽  
Injury Mortality ◽  
Community Residents ◽  
The Sundarbans

Abstract Background The Sundarbans in India is a rural, forested region where children are exposed to a high risk of drowning due to its waterlogged geography. Current data collection systems capture few drowning deaths in this region due to its remoteness and poor coverage of health and police systems. Household methodology was found to be resource and time intensive, and so a Community Knowledge Approach was used and applied to calculate injury mortality for the first time. Methods A community-based survey was conducted in the Sundarbans to determine the drowning mortality rate for 1-4 and 5-9 year old children. A Community Knowledge Approach was applied. Meetings were held with law community residents and key informants to identify drowning deaths in the population. Identified deaths were verified by the child's household through a structured survey, inquiring on the circumstances around the drowning death. Results The drowning mortality rate for children aged 1-4 years old was 243.8 per 100,000 children and 38.8 per 100,000 children for 5-9-year olds. 58.0% of deaths were of 1-2-year-old children. Most children drowned in ponds within 50 metres of their homes. Children were usually unaccompanied with their primary caretaker engaged in household work. Only one third of deaths were reported to hospitals or civil registration systems. Of deaths listed by community members, 63.0% were identified by both residents and by at least one key informant, 25.6% by key informants only, and 11.4% (n = 79) by community residents only. Conclusions Drowning is a major cause of death among children in the Sundarbans, particularly those aged 1-4 years old. The results illustrate how routine data collection systems grossly underestimate drowning deaths, emphasising the importance of community-based in rural low-and middle-income country contexts. Key messages Drowning is likely the largest killer of 1-9 year old children in the Sundarbans region, emphasising the need to better understanding drowning epidemiology in similar rural LMICs contexts. The Community Knowledge Approach provides a low-resource, valid method for capturing injury mortality data.

scholarly journals Microscopic and submicroscopic Plasmodium infections in indigenous and non-indigenous communities in Colombia.

2020 ◽  
Author(s):  
Jehidys Montiel ◽  
Lina M. Zuluaga ◽  
Daniel C. Aguirre ◽  
Cesar Segura ◽  
Alberto Tobon-Castaño ◽  
...  
Keyword(s):  
Indigenous Population ◽  
Indigenous Communities ◽  
Access To Health Services ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional ◽  
High Exposure ◽  
Parasitological Diagnosis ◽  
Access To Health ◽  
Endemic Areas

Abstract Background: The indigenous population is considered a highly susceptible group to malaria because they usually live in areas with high exposure to Anopheles and poverty, and have limited access to health services. There is a great diversity of indigenous communities in Colombia living in malaria-endemic areas; however, the burden of infection in these populations has not been studied extensively. This study aimed to determine the prevalence of Plasmodium infections in indigenous and non-indigenous communities in two malaria-endemic areas in Colombia. Methods: A Community-based cross-sectional survey was conducted in seven villages of Turbo and El Bagre municipalities; three of these villages were indigenous communities. Inhabitants of all ages willing to participate were included. Sociodemographic and clinical data were recorded as well as household information. The parasitological diagnosis was performed by microscopy and nested PCR. The prevalence of microscopy and submicroscopic infection was estimated. An adjusted GEE model was used to explore risk factors associated with the infection. Results: Among 713 participants, 60.7% were from indigenous communities. Plasmodium spp. was detected in 30 subjects (4.2%, CI 95% 2.9-5.9); from those, 29 were in the indigenous population, 47% of infections were afebrile, and most of them submicroscopic (10/14). Microscopic and submicroscopic prevalence was 2.5% (CI 95% 1.6-3.9) and 1.7% (CI 95% 0.9-2.9) respectively. In El Bagre, all infections occurred in indigenous participants (3.9%, CI 95% 2.2-7.1), and 81% were submicroscopic. By contrast, in Turbo, the highest prevalence occurred in indigenous people (11.5%; CI 95%: 7.3-17.5), but 88.8% were microscopic. Living in an indigenous population increased the incidence rate of infection compared with a non-indigenous population (IRR 19.4; CI 95% 2.3-166.7). Conclusion: There is a high proportion of Plasmodium infection in indigenous communities. A substantial proportion of asymptomatic and submicroscopic carriers were detected. The identification of these infections, not only in indigenous but also in the non-indigenous population, as well as their associated factors, could help to implement specific malaria strategies for each context.

Prevention of Traumatic Deaths to Children in the United States: How Far Have We Come and Where Do We Need to Go?

PEDIATRICS ◽  
1996 ◽  
Vol 97 (6) ◽  
pp. 791-797
Author(s):  
Frederick P. Rivara ◽  
David C. Grossman
Keyword(s):  
Unintentional Injury ◽  
The United States ◽  
Mortality Data ◽  
Review Of The Literature ◽  
Prevention Strategies ◽  
Unintentional Injuries ◽  
Injury Death ◽  
Injury Mortality ◽  
Injury Control ◽  
Made In

Objective. To describe the changes in injury mortality from 1978 to 1991 and determine the number of preventable deaths with currently available intervention strategies. Methods. Comparison of injury mortality data for children and adolescents 0 to 19 years in 1978 and 1991. Review of the literature to determine the effectiveness of currently available prevention strategies and application of these to deaths in 1991. Results. The injury death rate declined by 26% over the 14-year period. Death rates of unintentional injuries decreased by 39%, with declines in all categories of unintentional injuries. Homicides increased by 67% and suicides by 17%; nearly all of this increase was in deaths from firearms. If currently available prevention strategies were fully used, 6640 deaths could have been prevented, a further 31% decrease. Conclusions. Although great strides have been made in preventing deaths from trauma, the application of currently available prevention strategies could save a large number of additional lives. However, the increasing problem of intentional injury will partly counterbalance the success in unintentional injury control.

scholarly journals Trends of drowning mortality in Vietnam: evidence from the national injury mortality surveillance system

2019 ◽  
Vol 26 (1) ◽  
pp. 42-48 ◽  
Author(s):  
Ha Nguyen ◽  
Rebecca Q Ivers ◽  
Cuong Pham ◽  
Jagnoor Jagnoor
Keyword(s):  
Mortality Rate ◽  
Surveillance System ◽  
Population Change ◽  
Mortality Rates ◽  
Socioeconomic Characteristics ◽  
Provincial Level ◽  
Injury Mortality ◽  
Geographical Regions ◽  
Central Highland ◽  
Mortality Surveillance

ObjectiveTo describe the trends of drowning mortality in Vietnam over time and to identify socioeconomic characteristics associated with higher drowning mortality at the provincial level.MethodsWe analysed data from the Ministry of Health injury mortality surveillance system from 1 January 2009 to 31 December 2013. The surveillance covers more than 11 000 commune health centres in all provinces of Vietnam. For provincial population and socioeconomic characteristics, we extracted data from the National census 2009, the Population change and family planning surveys in 2011 and 2013. Multilevel linear models were used to identify provincial characteristics associated with higher mortality rates.ResultsOver the 5-year period between 2009 and 2013, 31 232 drowning deaths were reported, equivalent to a 5-year average of 6246 drowning deaths. During this period, drowning mortality rate decreased 7.2/100 000 to 6.9/100 000 (p=0.035). Of six major geographical regions, Northern midland, Central highland and Mekong delta were those with highest mortality rates. In all regions, children aged 1–4 years had the highest mortality rates, followed by those aged 5–9 and 10–14 years. At provincial level, having a coastline was not associated with higher mortality rate. Provinces with larger population size and greater proportion of poor households were statistically significantly associated with higher mortality rates (p=0.042 and 0.006, respectively).ConclusionWhile some gains have been made in reducing drowning mortality, child deaths due to drowning in Vietnam remain alarmingly high. Targeted scale-up of known effective interventions such as child supervision and basic survival skills are needed for reducing child mortality due to drowning, particularly in socioeconomically disadvantaged provinces.

scholarly journals P.080 Traumatic brain injury in a rural indigenous population in Canada: a community-based approach to surveillance

2016 ◽  
Vol 43 (S2) ◽  
pp. S39-S39
Author(s):  
O Lasry ◽  
RW Dudley ◽  
R Fuhrer ◽  
J Torrie ◽  
R Carlin ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Regression Models ◽  
Indigenous Population ◽  
Indigenous Communities ◽  
Population Based ◽  
Indigenous Populations ◽  
Prevention Strategies ◽  
Community Based ◽  
Multiple Imputations

Background: Indigenous populations are disproportionately affected by traumatic brain injury (TBI). These populations rely on large jurisdiction surveillance efforts to inform their prevention strategies, which may not address their needs. This study describes the TBI determinants of a Quebec indigenous population, the Cree served by the Terres-Cries-de-la-Baie-James health region, and compares them to the determinants of two neighbouring health regions and the entire Province of Quebec. Methods: We conducted a retrospective population-based cohort study of incident TBI hospitalizations, stratified by the aforementioned health regions, in Quebec from 2000-2012. MED-éCHO administrative data were used for case finding. A sub-analysis of the Terres-Cries-de-la-Baie-James adults was completed to assess for determinants of TBI severity and outcomes. Regression models, multiple imputations and a sensitivity analysis were used to account for biased associations. Results: 172 incident TBI hospitalizations occurred in the Terres-Cries-de-la-Baie-James region from 2000-2012. The incidence rate was 92.1 per 100,000 person-years and the adjusted IRR was 1.86 (95% CI 1.56-2.17) when compared to the entire province. Determinants of TBI for the Terres-Cries-de-la-Baie-James were significantly different from those of neighboring populations and the entire province. Conclusions: TBI surveillance information from large jurisdiction initiatives can be misleading for indigenous communities. Community-based surveillance provides evidence that these populations should use to prioritize prevention strategies.

Trends and disparities in American Indian/Alaska Native unintentional injury mortality from 1999 to 2016

2020 ◽  
pp. injuryprev-2020-043951
Author(s):  
William C Kerr ◽  
Yu Ye ◽  
Edwina Williams ◽  
Nina Mulia ◽  
Cheryl J Cherpitel
Keyword(s):  
New York ◽  
American Indian ◽  
Alaska Native ◽  
Motor Vehicle ◽  
Unintentional Injury ◽  
Mortality Rates ◽  
Situational Factors ◽  
Drug Poisoning ◽  
Alcohol Poisoning ◽  
Injury Mortality

IntroductionAlcohol and drug use are significant problems in the US, and American Indian/Alaska Native (AI/AN) communities and individuals are known to be among the most affected. This study evaluates disparities in unintentional injury mortality causes since 1999.MethodsAnalyses in 2020 of unintentional injury mortality rate disparities between AI/ANs and white population over the 1999–2016 period with attention to motor vehicle crashes, alcohol poisoning, drug poisoning and all other cause types. Rates in each of the 10 states with the largest AI/AN populations were also investigated to account for geographical concentration.ResultsMotor vehicle mortality rates declined for both AI/AN and white groups, but a large racial disparity was maintained. Conversely, poisoning mortality rates rose substantially in both groups, with a jump in rates in 2007 due to a coding change, resulting in a large disparity that was maintained through 2016. Comparison of alcohol and drug poisonings showed that the AI/AN alcohol poisoning rate was about eight times the white rate, whereas drug poisoning rates were similar. For ‘all other’ unintentional injuries, the highest rates were seen for AI/AN men, with rates generally rising over the study period. State-specific analyses found substantial variation in AI/AN rates, with few or no disparities in New York and Texas.ConclusionsResults indicate substantial and persisting disparities in unintentional injury mortality, with especially large differences in alcohol poisoning. The absence of disparities in New York and Texas suggest the importance of situational factors.

scholarly journals Microscopic and submicroscopic Plasmodium infections in indigenous and non-indigenous communities in Colombia.

2019 ◽  
Author(s):  
Jehidys Montiel ◽  
Lina M. Zuluaga ◽  
Daniel C. Aguirre ◽  
Cesar Segura ◽  
Alberto Tobon-Castaño ◽  
...  
Keyword(s):  
Indigenous Population ◽  
Indigenous Communities ◽  
Access To Health Services ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional ◽  
Parasitological Diagnosis ◽  
Access To Health ◽  
Endemic Areas ◽  
Submicroscopic Infection

Abstract Background The indigenous population is considered a highly susceptible group to malaria becouse they usually live in areas with high Anopheles exposure and poverty, and have low access to health services. There is a great diversity of indigenous communities in Colombia living in malaria-endemic areas; however, the burden of infection in these populations has not extensively studied. This study aimed to determine the prevalence of Plasmodium infections in indigenous and non-indigenous communities in two malaria-endemic areas in Colombia.Methods A Community-based cross-sectional survey was conducted in seven villages of Turbo and El Bagre municipalities; three of these villages were indigenous communities. All inhabitants of all ages that were willing to participate were included. Sociodemographic and clinical data were recorded as well as household information. The parasitological diagnosis was performed by microscopy and nested PCR. The prevalence of microscopy and submicroscopic infection was estimated. An adjusted GEE model was used to explore risk factors associated with the infection.Results Among 713 participants, 60.1% were from indigenous communities. Plasmodium spp. was detected in 30 subjects (4.2%, CI 95% 2.9-5.9); from those, 29 were in the indigenous population, 47% of infections were afebrile, and most of them submicroscopic (10/14). Microscopic and submicroscopic prevalence was 2.5% (CI 95% 1.6-3.9) and 1.7% (CI 95% 0.9-2.9) respectively. In El Bagre, all infections occurred in indigenous participants (3.9%, CI 95% 2.2-7.1), and 81% were submicroscopic. By contrast, in Turbo, the highest prevalence occurred in indigenous people (11.5%; CI 95%: 7.3-17.5), but 88.8% were microscopic. Living in an indigenous population increased the incidence rate of infection compared with a non-indigenous population (IRR 19.4; CI 95% 2.3-166.7).Conclusion There is a high proportion of Plasmodium infection in indigenous communities. A substantial proportion of asymptomatic and submicroscopic carriers were detected. The identification of these infections, not only in indigenous but also in the non-indigenous population, as well as their associated factors, could help to implement specific malaria strategies for each context.

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