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      Injury and its associated factors among residents of an urban slum during the festival month in South India: A community-based survey

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          Abstract

          Introduction:

          Injury morbidity and mortality have been steadily increasing in both developed and developing countries including India. The current study tried to assess the incidence of injury and identify the risk factors associated with injuries during the festival month in a selected urban area in Puducherry.

          Methods:

          It is a community-based cross-sectional survey conducted among the residents in the urban field practice area of a medical college in Puducherry. Participants were interviewed using a pretested questionnaire. Information on the incidence of injury and its associated factors were collected. Data were entered in EpiData and analyzed using Stata. Generalized linear models with Poisson distribution were used to identify the risk factors associated with the injuries.

          Results:

          Overall, 1380 participants from two selected clusters were interviewed. The incidence rate of injuries was 5.2% (95% CI: 4.0–6.4). In adjusted analysis male (RR 1.96, 95% CI: 1.15–3.37) and student (RR 2.91, 95% CI: 1.13–7.54) were independently associated with having an injury. Most of the injuries were unintentional and accidental.

          Conclusion:

          The reported incidence of at least one injury was 52 per 1000 population per month and the majority were accidental in nature. It was higher during the festival week. Public health strategies at the primary healthcare level targeting adult males and school children will be effective in the reduction and prevention of injury.

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          Most cited references17

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          Road traffic deaths, injuries and disabilities in India: current scenario.

          G Gururaj (2015)
          In 2005, road traffic injuries resulted in the death of an estimated 110,000 persons, 2.5 million hospitalizations, 8-9 million minor injuries and economic losses to the tune of 3% of the gross domestic product (GDP) in India. If the present trend continues, India will witness the deaths of 150,000 persons and hospitalization of 3 million people annually by 2010, increasing further to 200,000 deaths and more than 3.5 million hospitalizations annually by 2015. Nearly 10%-30% of hospital registrations are due to road traffic injuries and a majority of these people have varying levels of disabilities. A majority of victims of road traffic injuries are men in the age group of 15-44 years and belong to the poorer sections of society. Also, a vast majority of those killed and injured are pedestrians, motorcyclists and pillions riders, and bicyclists. A clearly defined road safety policy, a central coordinating agency, allocation of adequate resources, strict implementation of proven and effective interventions and reliable information systems are urgently required. Greater participation from health and other sectors based on an integrated, intersectoral and coordinated approach is essential. Health professionals can contribute in numerous ways and should take a lead role in reducing the burden of road traffic injuries in India.
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            Under-reporting of road traffic injuries to the police: results from two data sources in urban India.

            To report the magnitude of under-reporting of road traffic injury (RTI) to the police from population-based and hospital-based data in the urban population of Hyderabad, India. In a cross-sectional population-based survey, 10 459 participants aged 5-49 years (94.3% participation), selected using three-stage systematic cluster sampling, recalled the reporting of non-fatal RTIs to the police in the preceding 12 months and fatal RTIs in the preceding 3 years. In addition, 781 consecutive RTI cases presenting to the emergency department of five hospitals provided information on RTI reporting to the police. In the population-based study, of those who had non-fatal RTIs and sought outpatient or inpatient services, 2.3% (95% 1.1% to 3.5%) and 17.2% (95% CI 3.5% to 30.9%), respectively, reported the RTI to the police. Of the non-fatal consecutive RTI cases presenting to emergency departments, 24.6% (95% CI 21.3% to 27.8%) reported the RTI to the police. In the population-based study, 77.8% (95% CI 65.1% to 90.5%) of the fatal RTIs were reported to the police, and of the consecutive fatal RTI cases presenting to emergency departments, 98.1% (95% CI 95.5% to 100%) were reported to the police. The major reasons cited for not reporting RTIs to the police were "not necessary to report" and "hit and run case". As road safety policies are based on police data in India, these studies highlight serious limitations in estimating the true magnitude of RTIs from these data, indicating the need for better methods for such estimation.
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              Mortality due to road injuries in the states of India: the Global Burden of Disease Study 1990–2017

              Summary Background A systematic understanding of population-level trends in deaths due to road injuries at the subnational level over time for India's 1·4 billion people, by age, sex, and type of road user is not readily available; we aimed to fill this knowledge gap. Methods As part of the Global Burden of Diseases, Injuries, and Risk Factors Study, we estimated the rate of deaths due to road injuries in each state of India from 1990 to 2017 based on several verbal autopsy data sources. We calculated the number of deaths and death rate for road injuries by type of road user, and assessed the age and sex distribution of these deaths over time. Based on the trends of the age-standardised death rate from 1990 to 2017, we projected the age-standardised death rate to 2030 to assess if the states of India would meet the Sustainable Development Goal (SDG) target to halve the death rate for road injuries from 2015 by 2020 or 2030. We calculated 95% uncertainty intervals (UIs) for the point estimates. Findings In 2017, 218 876 deaths (95% UI 201 734 to 231 141) due to road injuries occurred in India, with an age-standardised death rate for road injuries of 17·2 deaths (15·7 to 18·1) per 100 000 population, which was much higher in males (25·7 deaths [23·5 to 27·4] per 100 000) than in females (8·5 deaths [7·2 to 9·1] per 100 000). The number of deaths due to road injuries in India increased by 58·7% (43·6 to 74·7) from 1990 to 2017, but the age-standardised death rate decreased slightly, by 9·2% (0·6 to 18·3). In 2017, pedestrians accounted for 76 729 (35·1%) of all deaths due to road injuries, motorcyclists accounted for 67 524 (30·9%), motor vehicle occupants accounted for 57 802 (26·4%), and cyclists accounted for 15 324 (7·0%). India had a higher age-standardised death rate for road injury among motorcyclists (4·9 deaths [3·9–5·4] per 100 000 population) and cyclists (1·2 deaths [0·9–1·4] per 100 000 population) than the global average. Road injury was the leading cause of death in males aged 15 to 39 years in India in 2017, and the second leading cause in this age group for both sexes combined. The overall age-standardised death rate for road injuries varied by up to 2·6 times between states in 2017. Wide variations were seen between the states in the percentage change in age-standardised death rate for road injuries from 1990 to 2017, ranging from a reduction of 38·2% (22·3 to 51·7) in Delhi to an increase of 17·0% (0·6 to 34·7) in Odisha. If the trends estimated up to 2017 were to continue, no state in India or India overall would achieve the SDG 2020 target in 2020 or even in 2030. Interpretation India's contribution to the global number of deaths due to road injuries is increasing, and the country is unlikely to meet the SDG targets if the trends up to 2017 continue. India needs to implement evidence-based road safety interventions, promote strong policies and traffic law enforcement, have better road and vehicle design, and improve care for road injuries at the state level to meet the SDG goal. Funding Bill & Melinda Gates Foundation and Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.
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                Author and article information

                Journal
                J Family Med Prim Care
                J Family Med Prim Care
                JFMPC
                Journal of Family Medicine and Primary Care
                Wolters Kluwer - Medknow (India )
                2249-4863
                2278-7135
                December 2020
                31 December 2020
                : 9
                : 12
                : 6041-6045
                Affiliations
                [1 ] Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital (SMVMCH), Puducherry, India
                [2 ] International Union Against Lung Diseases, New Delhi, India
                [3 ] Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
                [4 ] Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medicine and Research (JIPMER), Puducherry, India
                Author notes
                Address for correspondence: Dr. Swaroop Kumar Sahu, Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medicine and Research (JIPMER), Puducherry - 605006, India. E-mail: swaroop.sahu@ 123456gmail.com
                Article
                JFMPC-9-6041
                10.4103/jfmpc.jfmpc_1105_20
                7928127
                84f1ea19-3a42-47e0-b5d6-98da2928f890
                Copyright: © 2020 Journal of Family Medicine and Primary Care

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 06 June 2020
                : 09 September 2020
                : 02 October 2020
                Categories
                Original Article

                accidents,festivals,injuries,urban slums,wounds
                accidents, festivals, injuries, urban slums, wounds

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