Article Text

Download PDFPDF

Fatal drowning in the Western Cape, South Africa: a 7-year retrospective, epidemiological study
  1. Colleen Jayne Saunders1,
  2. Robyn Adriaanse2,3,
  3. Abigail Simons2,3,
  4. Ashley van Niekerk2,3
  1. 1 Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa
  2. 2 Violence, Injury and Peace Research Unit, South African Medical Research Council-University of South Africa, Cape Town, South Africa
  3. 3 Institute for Social and Health Sciences, University of South Africa, Cape Town, South Africa
  1. Correspondence to Dr Colleen Jayne Saunders, Division of Emergency Medicine, University of Cape Town, Cape Town 7925, South Africa; c.saunders{at}


Introduction Drowning is a neglected public health threat in low-income and middle-income countries where the greatest drowning burden is observed. There is a paucity of drowning surveillance data from low-resource settings, particularly in Africa. Understanding local epidemiological factors will enable the development of context-specific drowning prevention initiatives and the appropriate allocation of resources.

Aim The primary aim of this study was to describe the epidemiology of fatal drowning in the Western Cape, South Africa.

Method This retrospective study describes fatal drowning incidents captured in the Western Cape vital registration system between 2010 and 2016. Data were obtained from the Forensic Pathology Services of the Western Cape Government. One-way analysis of variance was performed to detect a trend in mean drowning mortality rates between 2010 and 2016. χ2 tests for independence were performed to detect differences in the distribution of variables between groups.

Results A total of 1391 fatal drownings occurred in the Western Cape between 2010 and 2016, with an age-adjusted drowning mortality rate of 3.2 per 100 000 population. Rates were fourfold higher in men compared with women. Children, particularly young children aged 0–4 years, and young adult men between 20 and 34 years of age were identified to be at high risk of fatal drowning. Drowning occurred predominantly in large, open bodies of water with concentrations in summer and public holidays.

Conclusions The Western Cape drowning prevention strategy should prioritise interventions to reduce drowning in children and young adult men, with a targeted focus on festive periods such as public holidays.

  • drowning
  • injury prevention
  • water safety
  • South Africa

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

View Full Text

Statistics from


  • Contributors CJS conceptualised the study and was responsible for data collection and analysis, as well as preparation of the manuscript for submission. AS and RA drafted the manuscript. AVN provided project oversight. All authors contributed to interpretation of the findings and critical revision of manuscript drafts. All authors reviewed and approved the final manuscript.

  • Funding This study was undertaken as part of a broader project aimed at developing a drowning prevention framework for the Western Cape. This project was commissioned and funded by the Western Cape Government: Directorate for Disaster Management. RA was funded by the Department of Science and Technology-National Research Foundation of South Africa’s internship programme.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Approval for this study was obtained from the University of Cape Town Human Research Ethics Committee (HREC 590/2017) and the Western Cape Government: Department of Health.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data presented here were formally requested from the Western Cape Government: Department of Health: Forensic Pathology Services. Study proposals that have been approved by a formally recognised South African ethical review board may similarly request access to the same data.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.