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North Bethesda, MD, United States

Hyder A.A.,Johns Hopkins International Injury Research Unit
Journal of Public Health (United Kingdom) | Year: 2013

BackgroundBurns are a significant cause of mortality and morbidity in developing countries. We examined the epidemiology of unintentional burns in South Asia to identify trends and gaps in information.MethodsA MEDLINE/PUBMED search (1970-2011) was undertaken on empirical studies that focused on burns in India, Pakistan, Bangladesh and Sri Lanka. Data analyzed included demographics, injury details and risk factors.ResultsTwenty-seven studies were identified, mostly from India. Burns were more common among males at younger ages (0-12 years) and among females from adolescence onward (>14 years). Flame-related burns and scalds accounted for over 80% of burns in most cases, and were the most common types of injuries observed among children and women with most burns occurring in the home. Electrical burns occurred mostly among men. Important risk factors for burns included low socioeconomic status, being younger, wearing loose, flammable clothing and the use of kerosene. Data on care-seeking and treatment were limited.ConclusionsPreventing burns in the household in South Asia, particularly around kitchen activities, is essential. Children in South Asia are susceptible to burns and are an important target population. Future research should focus on filling the gaps in burn epidemiology found in this review. © The Author 2013, Published by Oxford University Press on behalf of Faculty of Public Health.

Bhalla K.,Johns Hopkins International Injury Research Unit | Harrison J.E.,Flinders University
International Journal of Epidemiology | Year: 2015

Background: We assessed the quality of Global Burden of Disease-2010 (GBD-2010) estimates of road injury deaths by comparing with government statistics for Organisation for Economic Co-operation and Development (OECD) countries that report to the International Road Traffic Accident Database (IRTAD).Methods: We obtained tabulated data for 25 OECD countries that report to IRTAD and also report vital registration (VR) data to WHO. We collated VR deaths corresponding to the GBD-2010 road injury definition and estimated 'traffic', 'non-traffic' and 'unspecified whether traffic or non-traffic' components. We estimated national road injury deaths by redistributing partially specified causes of death, as was done by GBD until this was replaced by more complex methods in GBD-2010.Results: GBD-2010 estimates of road injury deaths exceeded IRTAD by 45% overall. IRTAD values fell below the GBD-2010 95% uncertainty interval in all but three countries. Mismatch of conceptual scope accounted for about 8% of this discrepancy, 5% was because GBD-2010 included cases other than road traffic and 3% because GBD-2010 (unlike IRTAD) includes deaths >30 days after injury. Pro rata distribution of partially specified causes in VR data gave estimates that were 18% higher than IRTAD but closer than GBD-2010 estimates for all but two countries. Cases in VR data specified as road injury gave estimates closer to IRTAD. Conclusions: GBD-2010 road injury mortality estimates are substantially higher than the road death toll in OECD countries. The discrepancy is not explained by wider scope of the GBD road injury construct nor by undercounting by IRTAD. GBD-2010 likely attributed substantially more deaths with partially specified causes to road injuries than is appropriate. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Bhalla K.,Johns Hopkins International Injury Research Unit | Mohan D.,Indian Institute of Technology Delhi
IATSS Research | Year: 2015

The safety of children younger than 10. years on motorized two-wheeled vehicles (MTWs) in low- and middle-income countries receives substantial attention from global road safety advocates. However, there is little empirical evidence available to describe the magnitude of the problem. Therefore, we constructed a population-level database of road traffic injury statistics disaggregated by age (<. 5, 5-9, 10. + years) and mode of transport. Our database included mortality data from 44 countries and 5 Indian cities, and hospital admissions from 17 countries. The MTW fleet in these settings ranged from 2% to 70% of all registered vehicles. We find that children under 5. years averaged 0.05% (SD 0.13%) of all road traffic deaths, and 5-9. year olds averaged 0.11% (SD 0.25%). Even in regions with high prevalence of MTWs, young children comprised at most 1.5% of all road traffic deaths and 5.8% of all MTW deaths. Young children were a slightly larger proportion of all road traffic deaths in countries where MTWs were more common. However, after adjusting for population age structure, this effect was no longer evident. The percentage of child road traffic injuries that are due to MTWs increased with increasing MTW use, but at a much lower rate. Our findings suggest that children may be at lower risk from MTW crashes than previously assumed, and certainly at a lower risk than as pedestrians. Further studies are needed to explain the underlying mechanisms that regulate risk of road users. © 2014.

Puvanachandra P.,Johns Hopkins International Injury Research Unit | Hoe C.,Johns Hopkins International Injury Research Unit | Ozkan T.,Ankara University | Lajunen T.,Ankara University
Traffic Injury Prevention | Year: 2012

Objective: Road traffic injuries (RTIs) are one of the leading causes of global deaths, contributing to 1.3 million lives lost each year. Although all regions are affected, low- and middle-income countries share a disproportionate burden. The significance of this public health threat is growing in Turkey, where current estimates show that 2.0 percent of all deaths in the country are due to RTIs. Despite the significance of this growing epidemic, data pertaining to RTIs in Turkey are limited. In order to address the gap in knowledge, this article presents an overview of the epidemiology of RTIs in Turkey through an analysis of available secondary data sets and a comprehensive review of scientifically published studies. Methods: A literature review was performed during December 2010 using PubMed, Embase, and ISIS Web of Knowledge databases and Google search engines. Peer-reviewed literature pertaining to Turkey and RTIs were selected for screening. Secondary data were also procured with assistance from Turkish colleagues through an exploration of data sources pertaining to RTIs in Turkey. Results: The literature review yielded a total of 70 studies with publication years ranging from 1988 to 2010. Secondary data sources were procured from the ministries of Health and Interior as well as the Turkish Statistical Institute. These data sources focus primarily on crashes, injuries, and fatalities (crash rate of 1328.5 per 100,000 population; injury rate of 257.9 per 100,000 population; fatality rate of 5.9 per 100,000). Risk factor data surrounding road safety are limited. Conclusion: The findings reveal the significant burden that RTIs pose on the health of the Turkish population. The introduction of new technologies such as the novel digital recording systems in place to record pre-hospital services and Global Positioning System (GPS) tracking of road traffic crashes by the police have allowed for a more accurate picture of the burden of RTIs in Turkey. There are, however, some considerable gaps and limitations within the data systems. Incorporation of standardized definitions, regular data audits, and timely review of collated data will improve the utility of RTI data and allow it to be used for policy influence. © 2012 Copyright Taylor and Francis Group, LLC.

Barffour M.,Johns Hopkins International Injury Research Unit | Gupta S.,Johns Hopkins International Injury Research Unit | Gururaj G.,National Institute of Mental Health and Neuro Sciences | Hyder A.A.,Johns Hopkins International Injury Research Unit
Traffic Injury Prevention | Year: 2012

Objective: To assess the availability and coverage of publicly available road safety data at the national and state levels in India. Methods: We reviewed the 2 publicly accessible data sources in India for the availability of data related to traffic injuries and deaths: (1) the National Crime Records Bureau (NCRB) and (2) the Ministry of Road Transport and Highways (MORTH). Using the World Health Organization (WHO) manual for the comprehensive assessment of road safety data, we developed a checklist of indicators required for comprehensive road safety assessment. These indicators were then used to assess the availability of road safety data in India using the NCRB and MORTH data. We assessed the availability of data on outcomes and exposures indicators (i.e., number of crashes, injuries, deaths, timing of deaths, gender and age distribution of injuries and deaths), safety performance indicators (i.e., with reference to select risk factors of speeding, alcohol, and helmet use), and cost indicators (i.e., medical costs, material costs, intervention costs, productivity costs, time costs, and losses to quality of life). Results: Information on outcome indicators was the most comprehensive in terms of availability. Both NCRB and MORTH databases had data for most of the need areas specified by the WHO under outcomes and exposure indicators. Regarding outcome and exposure indicators, data were available for 81 and 91 percent of specified need areas at the national level from NCRB and MORTH databases, respectively. At the state level, data on outcome and exposure indicators were available for only 54 percent of need areas from either of the 2 sources. There were no data on safety performance indicators in the NCRB database. From the MORTH database, data availability on safety performance indicators was 60 percent at both national and state levels. Data availability on costs and process indicators was found to be below 20 percent at the national and state levels. Conclusion: Overall, there is an urgent need to improve the publicly available road safety data in India. This will enhance monitoring of the burden of traffic injuries and deaths, enable sound interpretation of national road safety data, and allow the formulation effective road safety policies. © 2012 Copyright Taylor and Francis Group, LLC.

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