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Potential Risk Estimation Drowning Index for Children (PREDIC): a pilot study from Matlab, Bangladesh
N N Borse1, A A Hyder2, D Bishai3
1Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA(1); Public Health Sciences Division, The International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Insights
Childhood drowning is a significant public health issue. A new index, PREDIC, was developed to identify children at high risk, aiding targeted drowning prevention programs in Bangladesh.
Area of Science:
- Public Health
- Epidemiology
- Child Safety
Background:
- Childhood drowning is a critical public health concern, particularly in low- and middle-income countries.
- In rural Bangladesh, drowning accounts for over 40% of child deaths aged 1-4 years.
Purpose of the Study:
- To develop and evaluate a novel childhood drowning risk prediction index.
- To create a practical tool for identifying high-risk children for targeted interventions.
Main Methods:
- Literature review to identify drowning risk factors in Bangladesh.
- Adaptation of the Newacheck model to construct the Potential Risk Estimation Drowning Index for Children (PREDIC).
- Application of the PREDIC index to drowning deaths and a comparison group in Matlab, Bangladesh, using t-tests and ROC curve analysis.
Main Results:
- The PREDIC index showed statistically significant higher mean scores in drowned children (6.01) compared to the comparison group (5.26).
- 68% of drowning cases had a PREDIC score of 6 or more, versus 43% in the comparison group (p<0.001).
- The Receiver Operating Characteristic curve yielded an area under the curve of 0.662.
Conclusions:
- The PREDIC index is scientifically plausible, complete, accurate, and practical for identifying children at high risk of drowning.
- The index can guide the implementation of targeted drowning prevention programs.
- Further validation of the PREDIC index's accuracy, feasibility, and effectiveness in Bangladesh and other countries is recommended.
Unlabelled:
Childhood drowning is a major public health problem that has been neglected in many low- and middle-income countries. In Matlab, rural Bangladesh, more than 40% of child deaths aged 1-4 years are due to drowning.
Aim:
The main objective of this paper was to develop and evaluate a childhood drowning risk prediction index.
Methodology:
A literature review was carried out to document risk factors identified for childhood drowning in Bangladesh. The Newacheck model for special health care needs for children was adapted and applied to construct a childhood drowning risk index called "Potential Risk Estimation Drowning Index for Children" (PREDIC). Finally, the proposed PREDIC Index was applied to childhood drowning deaths and compared with the comparison group from children living in Matlab, Bangladesh. This pilot study used t-tests and Receiver Operating Characteristic (ROC) curve to analyze the results.
Results:
The PREDIC index was applied to 302 drowning deaths and 624 children 0-4 years old living in Matlab. The results of t-test indicate that the drowned children had a statistically (t=-8.58, p=0.0001) significant higher mean PREDIC score (6.01) than those in comparison group (5.26). Drowning cases had a PREDIC score of 6 or more for 68% of the children however, the comparison group had 43% of the children with score of 6 or more which was statistically significant (t=-7.36, p<0.001). The area under the curve for the Receiver Operating Characteristic curve was 0.662.
Conclusion:
Index score construction was scientifically plausible; and the index is relatively complete, fairly accurate, and practical. The risk index can help identify and target high risk children with drowning prevention programs. PREDIC index needs to be further tested for its accuracy, feasibility and effectiveness in drowning risk reduction in Bangladesh and other countries.
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