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Estimating drowning mortality in Tanzania: a systematic review and meta-analysis of existing data sources
  1. Sophie Sarrassat1,
  2. Sigilbert Mrema2,
  3. Kassimu Tani2,
  4. Thomas Mecrow3,
  5. Dan Ryan3,
  6. Simon Cousens1
  1. 1 Centre for Maternal Adolescent Reproductive and Child Health (MARCH), London School of Hygiene and Tropical Medicine, London, UK
  2. 2 Ifakara Health Institute, Dar Es Salaam, Tanzania
  3. 3 Royal National Lifeboat Institution, Poole, UK
  1. Correspondence to Dr Sophie Sarrassat, Centre for Maternal Adolescent Reproductive and Child Health (MARCH), London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; sophie.sarrassat{at}lshtm.ac.uk

Abstract

Background The WHO advocates a 7-step process to enable countries to develop and implement drowning prevention strategies. We sought to assess, using existing data sources, the drowning situation in Tanzania as a first step in this process.

Methods We searched for data on causes of death in Tanzania by reviewing existing literature and global datasets and by in-country networking. Authors and institutions were then contacted to request aggregate data on drowning mortality. Site-specific drowning estimates were combined using a random effects meta-analytic approach. We also tested for evidence of variations in drowning estimates by sex and by age group.

Results We acquired partial or complete information on drowning deaths for 13 data sources. We found strong evidence for substantial variations between study sites (p<0.001). Combining population-based data, we estimated an average of 5.1 drowning deaths per 100 000 persons per year (95% CI 3.8 to 6.3). The proportions of deaths due to drowning were 0.72% (95% CI 0.55 to 0.88) and 0.94% (95% CI 0.09 to 1.78) combining population-based data and hospital-based data, respectively. Males were at greater risk than females, while both under-five children and adults aged 45 years or more were at greater risk than those aged 5–44 years.

Conclusion Our estimates of drowning burden are broadly in line with the 2016 Global Burden of Disease and the 2015 WHO Global Health Estimates. While this exercise was useful in raising the burden of drowning in Tanzania with policy makers, planning drowning prevention strategies in this country will require a better understanding of which subpopulations are at high risk.

  • drowning
  • metanalysis
  • mortality
  • systematic review
  • community

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: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors SS, SM, KT, TM, DR and SC developed the framework for data identification and acquisition. SS and SC conducted the literature search. SM, KT and TM conducted the in-country networking for identification of other possible data sources and organised workshops with relevant stakeholders. SS and SC analysed the data and wrote the initial draft of the manuscript. All authors reviewed, made inputs to and approved the final paper. SC is the overall guarantor and SS is the corresponding author.

  • Funding This work was supported by the Royal National Lifeboat Institution.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Ethical approval was obtained from the LSHTM ethics committee for the acquisition of unpublished data (reference 13845). In Tanzania, ethical approval was obtained from both the IHI (reference IHI/IRB/No:005-2017) and the national (reference NIMR/HQ/R.8a/Vol.IX/2508) ethics committees.

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