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Johns Hopkins International Injury Research Unit

A World Health Organization Collaborating Center for Injuries, Violence and Accident Prevention

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Keyword: olakunle alonge

On May 21 and 22, 2014, the Johns Hopkins International Injury Research Unit (JH-IIRU), along with the Institute for International Programs (IIP) and USAID co-hosted a meeting on child injury at the Johns Hopkins Bloomberg School of Public Health. The meeting brought together members of the injury prevention field in an effort to reduce the global burden on childhood injuries, with a focus on low- and-middle-income countries (LMICs), where more than 95% of both intentional and unintentional child deaths occur.

International Health professor and director of IIP, Bob Black opened the meeting, which was conducted as part of the Health Research Challenge for Impact Program, funded by the United States Agency for International Development with JH-IIRU director, Adnan Hyder discussing the prospects and challenges of child injuries. Olakunle Alonge, JH-IIRU faculty member who is leading the Unit’s work on Saving of Lives from Drowning in Bangladesh (SoLiD) project, discussed effective interventions for child injury and quality of data sources, as well as provided a summary and next steps for the meeting. Also participating from JH-IIRU was Dr. Ricardo Pérez-Núñez, currently a postdoctoral fellow with the Unit.

Child injury group
JH-IIRU, IIP and USAID child injury meeting participants

Other presenters included Dr. Neal Brandes from USAID and Torine Creppy from SafeKids. Several JH-IIRU collaborators participated in the meeting, including Dr. Junaid Razzak from Aga Khan University, Dr. Olive Kobusingye from Makerere University, Dr. Dr. Shams El Arifeen, from icddr,b as well as current and past Global Road Safety Program collaborators, Martha Hijar, former director of Entornos Foundaçion, Mexico and Marieannette Otero, from the Association for Safe International Road Travel (ASIRT).

The World Health Organization (WHO) reports that the five most common unintentional injuries among children are from road traffic injuries, falls, burns, drowning and poisoning.

JH-IIRU is committed to reducing the global burden of childhood unintentional injuries. From our assessment of the potential of child injury prevention in "Saving 1000 children a day: The potential of child and adolescent injury prevention" (accessed here) to our Global Road Safety Program work in low- and middle-income countries that focuses on interventions like seatbelts and child restraints, JH-IIRU is dedicated to using reliable data to assess risks and introduce effective interventions. We have analyzed hospital data on pediatric burn injuries in South Africa, examined child road safety education programs in Malaysia and done extensive home injury risk assessment work in Pakistan.

Every day, more than 32 children between the ages of 1-4 die in Bangladesh due to drowning. That's more than 12,000 children a year. In fact, while the mortality rates of childhood diseases like diarrhea or malaria have decreased, in large part due to disease prevention and nutritional interventions, the rate of child drowning has increased, especially in low-income countries like Bangladesh, because there has not been a similar investment in prevention. It's not surprising, then, that drowning is the leading cause of death for this age group in the country. But drowning, like most unintentional injuries, is a preventable cause of death.

The Johns Hopkins International Injury Research Unit (JH-IIRU) is committed to reducing the burden of child injuries around the world. That's why, on February 27, 2014, JH-IIRU joined Bloomberg Philanthropies in Dhaka, Bangladesh, to launch the Drowning Prevention Project, a $10 million initiative aimed at identifying scalable drowning interventions in this low-lying South Asian country.

As part of this project, JH-IIRU will work in collaboration with the International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b) and the Center for Injury Prevention and Research Bangladesh (CIPRB), to initiate the Saving of Lives from Drowning (SoLiD) in Bangladesh. SoLiD is an implementation study that has been established to test the effectiveness of two interventions to prevent and reduce the burden of childhood drowning in Bangladesh. The interventions will be implemented along with family education and community awareness on drowning prevention.

Adnan A. Hyder, MD, MPH, PhD, director of JH-IIRU, will lead a team that will directly address two major factors in preventable child drowning deaths in a country where 7% of its surface is covered in water-lack of supervision and easy access to water. The project will test two interventions: community daycare centers (sometimes referred to as "crèches" or "anchals") playpens. Attendance in crèches during the period when drowning injury is most likely to occur reduces the risk of drowning by both supervising the child and removing the child from the hazard. Similarly, playpens, which will be locally manufactured, restrict child mobility, thus creating a barrier between the child and the hazard. They are also an aid to adult supervision, which, in turn, minimizes exposure to the risk of drowning.

The goal of the project is to monitor and evaluate the effectiveness of these interventions for 80,000 children, 1-4 years of age over a two-year period.

"The rate of drowning for young children in Bangladesh is alarming," said Hyder. "It is imperative that we explore the feasibility of appropriate and cost-effective drowning prevention interventions for child survival."

"This project represents a tremendous opportunity for continuing to improve child health care in Bangladesh and is a strong commitment to injury research," said Olakunle Alonge, assistant scientist in JH-IIRU and program manager for SoLiD.

Bloomberg Philanthropies is also supporting the World Health Organization (WHO) to publish an evidence-based global report on drowning prevention later this year and provide expert guidance on effective strategies to combat this burgeoning epidemic and save thousands of lives.

More information here

Over the last 20 years, child deaths from communicable diseases like respiratory infections, diarrheal disease and neonatal disorders have decreased significantly, yet deaths from childhood injuries have remained steady. The global burden of disease studies (GBD) suggest that of the estimated 5.1 million deaths due to injuries in 2010, 12% are attributed to children ages 1-19 years. Despite these high numbers, childhood unintentional injuries have not received much attention.

In a recent publication, JH-IIRU assistant scientist, Olakunle Alonge, MD, PhD, MPH and director, Adnan Hyder, MD, MPH, PhD, use data from GBD 2010 to describe the burden of unintentional childhood injuries, provide an overview of intervention options and examine the policy framework for reducing the burden, especially in low- and middle-income countries (LMICs), where the rate of injuries is disproportionately high.

“Reducing the global burden of childhood unintentional injuries,” published in the November 2013 issue of the Archives of Disease in Childhood, outlines the most common causes of death, including road traffic injuries, drowning and burns, and suggests possible solutions to these childhood injuries. Potential interventions include road traffic injury preventions, such as child restraints and helmet use that have been found effective in high income countries (HICs); barrier methods for drowning prevention, such as playpens fence construction, as well as other engineering methods to reduce water hazards; and safer stoves, lamps and lighting sources as possible short-term solutions for burn injuries.

The paper emphasizes the need for multi-sector cooperation and collaboration, including disciplines of law, engineering, medicine and social sciences for solutions to be truly effective.

To read the entire paper, click here

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