622 The landscape of fatal injuries in Bangladesh: findings from a nationwide health and injury survey

<h3>Background</h3> Injuries have become a major public health challenge in Bangladesh due to epidemiological transition from largely communicable disease to non-communicable diseases and injuries. However, injuries are not a priority health agenda in Bangladesh due to dearth of valid and reliable data. <h3>Objective</h3> This study aimed at exploring the magnitude of fatal injuries and their associated factors in Bangladesh. <h3>Methods</h3> A nationwide population-based household survey was conducted between March and June 2016 using a pretested structured questionnaire. It uses a complex multi-stage cluster sampling strategy based on probability proportional-to-size (PPS) with separate urban and rural samples. After cleaning, data from 299,216 household residents was available for analysis. There were 149,995 males and 149,221 females and 106,233 urban residents and 192,983 rural residents. Data was collected on tablets using a customized data entry program. After validation, data was exported to SPSS v21 for analysis. We estimated the prevalence of injuries and identified factors associated with injuries while multivariate logistic regression was used to identify potential factors associated with injuries. <h3>Results</h3> Injury accounted for 12.2% of all deaths among all age groups. It is estimated that over 108,600 people of all ages (45,600 children and 63,000 adults) died due to injury in the preceding year (i.e. 297 persons each day). Drowning was the leading cause of fatal injury among children (0–17 years), at 25.7/100.000 followed by suicide at 16.8/100,000 and road traffic at 8.9/100,000. Road traffic injuries (17.1/100,000), suicide (13.6/100,000) and falls (12.1/100,000) were the three leading causes of fatal injuries in adults. Fatal injuries raised rapidly in proportion from early childhood (52.6%) peaks in late adolescence (60.7%) then decreasing in young adulthood (47.6%) and adulthood (27.7%). There is a male predominance in each type of fatal injury, except in suicide. <h3>Conclusions</h3> Our study found that the true burden of fatal injury is extremely high in Bangladesh. Our study findings highlight the need for action in addressing the fatal injuries which will require interventions across the different stages of as well as addressing the differing types of injury—both unintentional and intentional.