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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.

Accident; Analysis and Prevention

|August 9, 2011

Summary

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.

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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.