13
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      The burden of unintentional drowning: global, regional and national estimates of mortality from the Global Burden of Disease 2017 Study

      research-article
      1 , 2 , 2 , 3 , 4 , 4 , 4 , 4 , 4 , 5 , 4 , 4 , 5 , 4 , 4 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 4 , 5 , 39 , 4 , 39 , 40 , 4 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 16 , 76 , 77 , 78 , 79 , 80 , 81 , 39 , 82 , 4 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 57 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 107 , 108 , 109 , 110 , 111 , 112 , 47 , 113 , 55 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , 122 , 123 , 124 , 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 , 133 , 134 , 135 , 136 , 137 , 138 , 139 , 140 , 141 , 142 , 143 , 144 , 145 , 146 , 147 , 148 , 33 , 149 , 150 , 4 ,
      Injury Prevention
      BMJ Publishing Group
      drowning, burden of disease, global

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Drowning is a leading cause of injury-related mortality globally. Unintentional drowning (International Classification of Diseases (ICD) 10 codes W65-74 and ICD9 E910) is one of the 30 mutually exclusive and collectively exhaustive causes of injury-related mortality in the Global Burden of Disease (GBD) study. This study’s objective is to describe unintentional drowning using GBD estimates from 1990 to 2017.

          Methods

          Unintentional drowning from GBD 2017 was estimated for cause-specific mortality and years of life lost (YLLs), age, sex, country, region, Socio-demographic Index (SDI) quintile, and trends from 1990 to 2017. GBD 2017 used standard GBD methods for estimating mortality from drowning.

          Results

          Globally, unintentional drowning mortality decreased by 44.5% between 1990 and 2017, from 531 956 (uncertainty interval (UI): 484 107 to 572 854) to 295 210 (284 493 to 306 187) deaths. Global age-standardised mortality rates decreased 57.4%, from 9.3 (8.5 to 10.0) in 1990 to 4.0 (3.8 to 4.1) per 100 000 per annum in 2017. Unintentional drowning-associated mortality was generally higher in children, males and in low-SDI to middle-SDI countries. China, India, Pakistan and Bangladesh accounted for 51.2% of all drowning deaths in 2017. Oceania was the region with the highest rate of age-standardised YLLs in 2017, with 45 434 (40 850 to 50 539) YLLs per 100 000 across both sexes.

          Conclusions

          There has been a decline in global drowning rates. This study shows that the decline was not consistent across countries. The results reinforce the need for continued and improved policy, prevention and research efforts, with a focus on low- and middle-income countries.

          Related collections

          Most cited references40

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

          Summary Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. Methods We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. Findings Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1–4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0–8·4) while the total sum of global YLDs increased from 562 million (421–723) to 853 million (642–1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6–9·2) for males and 6·5% (5·4–7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782–3252] per 100 000 in males vs s1400 [1279–1524] per 100 000 in females), transport injuries (3322 [3082–3583] vs 2336 [2154–2535]), and self-harm and interpersonal violence (3265 [2943–3630] vs 5643 [5057–6302]). Interpretation Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury. Funding Bill & Melinda Gates Foundation.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017

            Summary Background Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries—Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODEm), to generate cause fractions and cause-specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings At the broadest grouping of causes of death (Level 1), non-communicable diseases (NCDs) comprised the greatest fraction of deaths, contributing to 73·4% (95% uncertainty interval [UI] 72·5–74·1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 18·6% (17·9–19·6), and injuries 8·0% (7·7–8·2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22·7% (21·5–23·9), representing an additional 7·61 million (7·20–8·01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7·9% (7·0–8·8). The number of deaths for CMNN causes decreased by 22·2% (20·0–24·0) and the death rate by 31·8% (30·1–33·3). Total deaths from injuries increased by 2·3% (0·5–4·0) between 2007 and 2017, and the death rate from injuries decreased by 13·7% (12·2–15·1) to 57·9 deaths (55·9–59·2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000–289 000) globally in 2007 to 352 000 (334 000–363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118·0% (88·8–148·6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36·4% (32·2–40·6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33·6% (31·2–36·1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respiratory infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990—neonatal disorders, lower respiratory infections, and diarrhoeal diseases—were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. Funding Bill & Melinda Gates Foundation.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

              Summary Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk–outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk–outcome pairs, and new data on risk exposure levels and risk–outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk–outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017. Findings In 2017, 34·1 million (95% uncertainty interval [UI] 33·3–35·0) deaths and 1·21 billion (1·14–1·28) DALYs were attributable to GBD risk factors. Globally, 61·0% (59·6–62·4) of deaths and 48·3% (46·3–50·2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10·4 million (9·39–11·5) deaths and 218 million (198–237) DALYs, followed by smoking (7·10 million [6·83–7·37] deaths and 182 million [173–193] DALYs), high fasting plasma glucose (6·53 million [5·23–8·23] deaths and 171 million [144–201] DALYs), high body-mass index (BMI; 4·72 million [2·99–6·70] deaths and 148 million [98·6–202] DALYs), and short gestation for birthweight (1·43 million [1·36–1·51] deaths and 139 million [131–147] DALYs). In total, risk-attributable DALYs declined by 4·9% (3·3–6·5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23·5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18·6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low. Interpretation By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning. Funding Bill & Melinda Gates Foundation.
                Bookmark

                Author and article information

                Journal
                Inj Prev
                Inj Prev
                injuryprev
                ip
                Injury Prevention
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                1353-8047
                1475-5785
                October 2020
                20 February 2020
                : 26
                : Suppl 1
                : i83-i95
                Affiliations
                [1 ] departmentCollege of Public Health, Medical and Veterinary Science , James Cook University , Douglas, Queensland, Australia
                [2 ] Royal Life Saving Society , Sydney, New South Wales, Australia
                [3 ] departmentSchool of Public Health and Community Medicine, Faculty of Medicine , University of New South Wales , Sydney, New South Wales, Australia
                [4 ] departmentInstitute for Health Metrics and Evaluation , University of Washington , Seattle, Washington, USA
                [5 ] departmentDepartment of Health Metrics Sciences, School of Medicine , University of Washington , Seattle, Washington, USA
                [6 ] departmentCollege of Medicine and Health Sciences, Department of Nursing , Adigrat University , Adigrat, Ethiopia
                [7 ] departmentDepartment of Public Health , Debre Berhan University , Debre Berhan, Ethiopia
                [8 ] departmentJames P Grant School of Public Health , BRAC University , Dhaka, Bangladesh
                [9 ] departmentHealth Systems and Population Studies Division , International Centre for Diarrhoeal Disease Research , Dhaka, Bangladesh
                [10 ] departmentEvidence Based Practice Center , Mayo Clinic Foundation for Medical Education and Research , Rochester, Minnesota, USA
                [11 ] Carol Davila University of Medicine and Pharmacy , Bucharest, Romania
                [12 ] departmentDepartment of Health Policy and Administration , University of the Philippines Manila , Manila, Philippines
                [13 ] departmentDepartment of Applied Social Sciences , Hong Kong Polytechnic University , Hong Kong, China
                [14 ] departmentHealth Management and Economics Research Center , Iran University of Medical Sciences , Tehran, Iran
                [15 ] departmentNursing Department , Wolaita Sodo University , Wolaita Sodo, Ethiopia
                [16 ] departmentDepartment of Forensic Science , Government Institute of Forensic Science , Nagpur, India
                [17 ] departmentDepartment of Forensic Medicine and Toxicology , Manipal Academy of Higher Education , Manipal, India
                [18 ] departmentDepartment of Hypertension , Medical University of Lodz , Lodz, Poland
                [19 ] Polish Mothers’ Memorial Hospital Research Institute , Lodz, Poland
                [20 ] departmentDepartment of Non-Communicable Diseases , Bangladesh University of Health Sciences (BUHS) , Dhaka, Bangladesh
                [21 ] departmentDepartment of Research , Public Health Perspective Nepal , Pokhara-Lekhnath Metropolitan City, Nepal
                [22 ] departmentSchool of Psychology , University of Auckland , Auckland, New Zealand
                [23 ] departmentOccupational Health Department , Kermanshah University of Medical Sciences , Kermanshah, Iran
                [24 ] departmentHealth Human Resources Research Center , Shiraz University of Medical Sciences , Shiraz, Iran
                [25 ] departmentDepartment of Community Medicine and Family Medicine , All India Institute of Medical Sciences , Jodhpur, India
                [26 ] departmentDepartment of Community Medicine, Datta Meghe Institute of Medical Sciences , Deemed University , Wardha, India
                [27 ] The George Institute for Global Health , New Delhi, India
                [28 ] departmentCentre for Global Child Health , University of Toronto , Toronto, Ontario, Canada
                [29 ] departmentCentre of Excellence in Women and Child Health , Aga Khan University , Karachi, Pakistan
                [30 ] departmentSocial Determinants of Health Research Center , Babol University of Medical Sciences , Babol, Iran
                [31 ] departmentDepartment of Internal Medicine , Manipal Academy of Higher Education , Mangalore, India
                [32 ] departmentResearch Unit on Applied Molecular Biosciences (UCIBIO) , University of Porto , Porto, Portugal
                [33 ] departmentMaternal and Child Health Division , International Centre for Diarrhoeal Disease Research , Dhaka, Bangladesh
                [34 ] departmentDepartment of Epidemiology and Biostatistics , University of South Carolina , Columbia, South Carolina, USA
                [35 ] departmentFaculty of Biology , Hanoi National University of Education , Hanoi, Vietnam
                [36 ] departmentResearch School of Population Health , Australian National University , Action, Australian Capital Territory, Australia
                [37 ] departmentEnvironmental and Occupational Health and Safety , University of Gondar , Gondar, Ethiopia
                [38 ] departmentDepartment of Human Physiology , University of Gondar , Gondar, Ethiopia
                [39 ] Public Health Foundation of India , Gurugram, India
                [40 ] departmentToxoplasmosis Research Center , Mazandaran University of Medical Sciences , Sari, Iran
                [41 ] departmentDepartment of Community Medicine , University of Peradeniya , Peradeniya, Sri Lanka
                [42 ] Tehran University of Medical Sciences , Tehran, Iran
                [43 ] departmentCenter of Excellence in Public Health Nutrition , Nguyen Tat Thanh University , Ho Chi Minh City, Vietnam
                [44 ] departmentSydney School of Public Health , University of Sydney , Sydney, New South Wales, Australia
                [45 ] departmentDepartment of Global Health and Social Medicine , Harvard University , Boston, Massachusetts, USA
                [46 ] departmentDepartment of Social Services , Tufts Medical Center , Boston, Massachusetts, USA
                [47 ] departmentDepartment of Public Health Sciences , Karolinska Institutet , Stockholm, Sweden
                [48 ] departmentWorld Health Programme , Université du Québec en Abitibi-Témiscamingue , Rouyn-Noranda, Québec, Canada
                [49 ] departmentREQUIMTE/LAQV , University of Porto , Porto, Portugal
                [50 ] departmentPsychiatry Department , Kaiser Permanente , Fontana, California, USA
                [51 ] departmentSchool of Health Sciences , A.T. Still University , Arizona, Missouri, USA
                [52 ] departmentDepartment of Population Medicine and Health Services Research , Bielefeld University , Bielefeld, Germany
                [53 ] departmentPublic Health Department , Haramaya University , Harar, Ethiopia
                [54 ] departmentNon-Communicable Diseases (NCD) , World Health Organization (WHO) , New Delhi, India
                [55 ] departmentDepartment of Public Health , Erasmus University Medical Center , Rotterdam, Netherlands
                [56 ] departmentCentre for International Health and Section for Ethics and Health Economics , University of Bergen , Bergen, Norway
                [57 ] departmentSchool of Public Health , Curtin University , Perth, Western Australia, Australia
                [58 ] departmentCenter of Excellence in Behavioral Medicine , Nguyen Tat Thanh University , Ho Chi Minh City, Vietnam
                [59 ] departmentDepartment of Pediatrics, Dell Medical School , University of Texas Austin , Austin, Texas, USA
                [60 ] departmentKasturba Medical College , Manipal Academy of Higher Education , Manipal, India
                [61 ] departmentDepartment of Legal Medicine and Bioethics , Carol Davila University of Medicine and Pharmacy , Bucharest, Romania
                [62 ] departmentClinical Legal Medicine Department , National Institute of Legal Medicine Mina Minovici , Bucharest, Romania
                [63 ] departmentDivision of Information and Computing Technology, College of Science and Engineering , Hamad Bin Khalifa University , Doha, Qatar
                [64 ] departmentQatar Foundation for Education , Science, and Community Development , Doha, Qatar
                [65 ] departmentDepartment of Community Medicine , University of Ibadan , Ibadan, Nigeria
                [66 ] departmentDepartment of Family Medicine , Bangalore Baptist Hospital , Bangalore, India
                [67 ] departmentResearch Institute for Endocrine Sciences , Shahid Beheshti University of Medical Sciences , Tehran, Iran
                [68 ] departmentSchool of Psychology and Public Health , La Trobe University , Melbourne, Victoria, Australia
                [69 ] departmentSchool of Public Health and Community Medicine , University of New South Wales , Sydney, New South Wales, Australia
                [70 ] departmentInstitute of Medicine , University of Colombo , Colombo, Sri Lanka
                [71 ] departmentFaculty of Graduate Studies , University of Colombo , Colombo, Sri Lanka
                [72 ] departmentGastrointestinal and Liver Disease Research Center , Guilan University of Medical Sciences , Rasht, Iran
                [73 ] Social Determinants of Health Research Center , Qazvin, Iran
                [74 ] departmentHealth Services Management Department , Qazvin University of Medical Sciences , Qazvin, Iran
                [75 ] departmentDepartment of Forensic Medicine and Toxicology , All India Institute of Medical Sciences , Jodhpur, India
                [76 ] departmentHematology-Oncology and Stem Cell Transplantation Research Center , Tehran University of Medical Sciences , Tehran, Iran
                [77 ] departmentPars Advanced and Minimally Invasive Medical Manners Research Center , Iran University of Medical Sciences , Tehran, Iran
                [78 ] departmentEpidemiology Department, Faculty of Public Health and Tropical Medicine , Jazan University , Jazan, Saudi Arabia
                [79 ] departmentEpidemiology and Biostatistics Department , Health Services Academy , Islamabad, Pakistan
                [80 ] departmentDepartment of Nutrition and Health Science , Ball State University , Muncie, Indiana, USA
                [81 ] departmentDepartment of Anthropology , Panjab University , Chandigarh, India
                [82 ] departmentInstitute of Clinical Physiology , National Research Council , Pisa, Italy
                [83 ] University of Melbourne , Melbourne, Victoria, Australia
                [84 ] departmentPathology Department, College of Medicine , Imam Abdulrahman Bin Faisal University , Dammam, Saudi Arabia
                [85 ] departmentDepartment of Public Health , Trnava University , Trnava, Slovakia
                [86 ] departmentHealth Education and Research Department , SDM College of Medical Sciences & Hospital , Dharwad, India
                [87 ] departmentHealth University , Rajiv Gandhi University of Health Sciences , Bangalore, India
                [88 ] departmentOphthalmology Department , Iran University of Medical Sciences , Tehran, Iran
                [89 ] departmentOphthalmology Department , University of Manitoba , Winnipeg, Manitoba, Canada
                [90 ] departmentPlastic Surgery Department , Iran University of Medical Sciences , Tehran, Iran
                [91 ] departmentDepartment of Health Services Research and Policy , London School of Hygiene & Tropical Medicine , London, UK
                [92 ] Mekelle University , Mekelle, Ethiopia
                [93 ] departmentForensic Medicine Division , Imam Abdulrahman Bin Faisal University , Dammam, Saudi Arabia
                [94 ] departmentBreast Surgery Unit , Helsinki University Hospital , Helsinki, Finland
                [95 ] University of Helsinki , Helsinki, Finland
                [96 ] Pacific Institute for Research & Evaluation , Calverton, Maryland, USA
                [97 ] departmentCommunity Medicine , Manipal Academy of Higher Education , Mangalore, India
                [98 ] departmentDepartment of Epidemiology and Biostatistics , Shahrekord University of Medical Sciences , Shahrekord, Iran
                [99 ] departmentDepartment of Nursing , Shahroud University of Medical Sciences , Shahroud, Iran
                [100 ] departmentNon-Communicable Diseases Research Center , Tehran University of Medical Sciences , Tehran, Iran
                [101 ] departmentIran National Institute of Health Research , Tehran University of Medical Sciences , Tehran, Iran
                [102 ] departmentFaculty of Life Sciences and Medicine , King’s College London , London, UK
                [103 ] departmentDepartment of Pediatric Medicine , Nishtar Medical University , Multan, Pakistan
                [104 ] departmentDepartment of Pediatrics & Pediatric Pulmonology , Institute of Mother & Child Care , Multan, Pakistan
                [105 ] departmentGeneral Surgery Department , Carol Davila University of Medicine and Pharmacy , Bucharest, Romania
                [106 ] departmentGeneral Surgery Department , Emergency Hospital of Bucharest , Bucharest, Romania
                [107 ] departmentInstitute for Global Health Innovations , Duy Tan University , Hanoi, Vietnam
                [108 ] departmentDepartment of Psychiatry and Behavioural Neurosciences , McMaster University , Hamilton, Ontario, Canada
                [109 ] departmentDepartment of Psychiatry , University of Lagos , Lagos, Nigeria
                [110 ] departmentDepartment of Pathology and Molecular Medicine , McMaster University , Hamilton, Ontario, Canada
                [111 ] departmentDepartment of Forensic Medicine, Kasturba Medical College , Manipal Academy of Higher Education , Manipal, India
                [112 ] departmentParasitology and Mycology , Shiraz University of Medical Sciences , Shiraz, Iran
                [113 ] departmentDepartment of Pediatrics , RD Gardi Medical College , Ujjain, India
                [114 ] departmentHealth Sciences Department , Muhammadiyah University of Surakarta , Sukoharjo, Indonesia
                [115 ] departmentDepartment of Chemistry , Sharif University of Technology , Tehran, Iran
                [116 ] departmentCollege of Medicine , University of Central Florida , Orlando, Florida, USA
                [117 ] departmentCollege of Graduate Health Sciences , A.T. Still University , Mesa, Arizona, USA
                [118 ] departmentUniversity Institute of Public Health , University of Lahore , Lahore, Pakistan
                [119 ] departmentPublic Health Department , University of Health Sciences , Lahore, Pakistan
                [120 ] departmentSurgery Department , University of Minnesota , Minneapolis, Minnesota, USA
                [121 ] departmentSurgery Department , University Teaching Hospital of Kigali , Kigali, Rwanda
                [122 ] departmentEmergency Department , Shahid Beheshti University of Medical Sciences , Tehran, Iran
                [123 ] departmentSina Trauma and Surgery Research Center , Tehran University of Medical Sciences , Tehran, Iran
                [124 ] departmentDepartment of Entomology , Ain Shams University , Cairo, Egypt
                [125 ] departmentHealth Economics , Bangladesh Institute of Development Studies (BIDS) , Dhaka, Bangladesh
                [126 ] departmentDepartment of Psychology , University of Alabama at Birmingham , Birmingham, Alabama, USA
                [127 ] departmentEmergency Department , Manian Medical Centre , Erode, India
                [128 ] departmentDepartment of Health Promotion and Education , Alborz University of Medical Sciences , Karaj, Iran
                [129 ] Independent Consultant , Karachi, Pakistan
                [130 ] departmentCollege of Medicine , Yonsei University , Seodaemun-gu, South Korea
                [131 ] departmentDivision of Cardiology , Emory University , Atlanta, Georgia, USA
                [132 ] departmentDepartment of Forensic Medicine , Kathmandu University , Dhulikhel, Nepal
                [133 ] departmentMedical Surgical Nursing Department , Urmia University of Medical Science , Urmia, Iran
                [134 ] departmentEmergency Nursing Department , Semnan University of Medical Sciences , Semnan, Iran
                [135 ] departmentDepartment of Psychology , Deakin University , Burwood, Victoria, Australia
                [136 ] departmentDepartment of Agriculture and Food Systems , University of Melbourne , Melbourne, Victoria, Australia
                [137 ] departmentCenter for Health Resource and Services Research and Development , National Institute of Health Research & Development , Jakarta, Indonesia
                [138 ] departmentDepartment of Pediatrics , King Saud University , Riyadh, Saudi Arabia
                [139 ] departmentCollege of Medicine , Alfaisal University , Riyadh, Saudi Arabia
                [140 ] departmentDepartment of Public Health , Adigrat University , Adigrat, Ethiopia
                [141 ] Argentine Society of Medicine , Buenos Aires, Argentina
                [142 ] Velez Sarsfield Hospital , Buenos Aires, Argentina
                [143 ] departmentPsychosocial Injuries Research Center , Ilam University of Medical Sciences , Ilam, Iran
                [144 ] departmentDivision of Injury Prevention and Mental Health Improvement , National Center for Chronic and Non-Communicable Disease Control, Chinese Center for Disease Control and Prevention , Beijing, China
                [145 ] departmentDepartment of Psychopharmacology , National Center of Neurology and Psychiatry , Tokyo, Japan
                [146 ] departmentDepartment of Epidemiology and Biostatistics , Wuhan University , Wuhan, China
                [147 ] departmentGlobal Health Institute , Wuhan University , Wuhan, China
                [148 ] departmentDepartment of Health Economics and Management , Urmia University of Medical Science , Urmia, Iran
                [149 ] departmentDepartment of Medicine, School of Clinical Sciences at Monash Health , Monash University , Melbourne, Victoria, Australia
                [150 ] departmentDepartment of Preventive Medicine , Wuhan University , Wuhan, China
                Author notes
                [Correspondence to ] Dr Spencer L James, Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98121, USA; spencj@ 123456uw.edu
                Author information
                http://orcid.org/0000-0003-1864-4552
                http://orcid.org/0000-0002-6424-1511
                http://orcid.org/0000-0003-4653-2507
                Article
                injuryprev-2019-043484
                10.1136/injuryprev-2019-043484
                7571364
                32079663
                793513d6-e081-43c0-90ec-8a536d1b3304
                © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

                History
                : 19 September 2019
                : 04 December 2019
                : 06 December 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100000865, Bill and Melinda Gates Foundation;
                Award ID: OPP1152504
                Categories
                Original Research
                1506
                Custom metadata
                unlocked

                Medicine
                drowning,burden of disease,global
                Medicine
                drowning, burden of disease, global

                Comments

                Comment on this article