Child injuries have been neglected for many years, and are largely absent from child survival initiatives presently on the Indian agenda. We assessed the epidemiology of injury deaths in children in a population-based study in the Indian state of Bihar using verbal autopsy. Interviews were conducted using the Population Health Metrics Research Consortium shortened verbal autopsy questionnaire for deaths in 1–14 years children that occurred from January 2012 to March 2014 in 1 09 689 households in 1017 clusters representative of the state with a participation rate 87.1%. Cause of death was assigned using the SmartVA automated algorithm. The annualized overall, unintentional and intentional injury mortality incidence by sex and place of residence were estimated.The survey covered 2 24 077 children aged 1–14 years and identified 749 deaths from all causes in this age group. Injury deaths accounted for 12.4%, 29.9% and 26.1% of deaths in 1–4, 5–9 and 10–14 years age groups, respectively. Injury deaths accounted for 28% of all deaths in urban areas and 23.1% of all deaths among boys. The adjusted annualized incidence of injury mortality among children aged 1–14 years in Bihar was 31.3 (95% CI 30.8–31.9) per 1 00 000 children. This rate was significantly higher in 5–9 years (37.4, 95% CI 36.4 to 38.4) as compared with other ages. The unintentional injury mortality rate was 29.7 (95% CI 29.2 to 30.2) and intentional injury mortality rate was 1.6 (95% CI 1.5 to 1.8). Drowning mortality accounted for the most injury mortality (10.9, 95% CI 10.6 to 11.2) followed by bite of a venomous animal (9.3, 95% CI 9.0 to 9.6). The magnitude of and variations in injury mortality among children from this large representative sample from Bihar state can provide crucial inputs for more specific planning of targeted interventions which needed to address the injury risk in children.
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