Epidemiological Study on Injury and Violence in Nepal

Abstract

Background: Non-communicable disease contributes to severe disability and morbidity than communicable disease which directly affect on nation’s development. Especially burden of injuries are rising throughout world with more than 90% of deaths in South East Asian Region. Nepal being part of South-East Asia region therefore can’t be isolated from injury burden. Assessing magnitude of injury can therefore be used as useful tool to quantify burden of morbidity due to injury which further will be a scientific evidence for the review, amendments and implementation of already formulated draft national action plan for injury prevention. Methods: The study was retrospective descriptive in nature. The time period of the study was from mid-July 2008 to mid-June 2009 (fiscal year 2065/66 BS). Data were collected from five regions of Nepal including at least two tertiary care centers from each region. A format was developed to enter the data according to name, address, age, sex, cause of injury and diagnosis. Similar format was developed in MS Excel for the hospitals where the data were stored in electronic version. The collected data were, then, entered into Microsoft Excel. The data were transferred to SPSS 13 after the completion of data editing and cleaning. Analysis was done using SPSS version 13.0. Results: Total number of injury recorded in selected tertiary care centers of Nepal from mid-July 2008 to mid-June 2009 was 37973. Unintentional injuries is seem to be nearly 3 times higher than the intentional injury of which road traffic accident and fall related injuries contribute higher percentage. In terms of cause of injury, road traffic accident (RTA) is the major cause of injury in Nepal with more than 28 % followed by falls (26.5 %) and interpersonal violence (21.8 %). Male populations are mostly affected in every injury related events in Nepal except in poisoning (47% Vs 53%). Central region has the highest proportion of injury which is approximately 50% of total injury case in the country. It shows that there is high burden of injury among the age group 15-44 years, which is the economically active group. The prevalence of injury is found to be 15 per 10,000 populations at national level. Road traffic accident is highly common in 15-29 year age group which accounts 44 % of the total injuries. Central and eastern development region is reported to have the highest distributions of interpersonal violence which account for 33% in each region. Fire related cause is most common in male than in female and most affected age group is 15- 29 years. Conclusions: Injury is one of the major public health problems in Nepal which till now is a neglected problem from policy as well as program perspective. The prevalence of injury is 15 percent at national level which is only the tip of iceberg. Keywords: drowning; injury; intentional; poisoning; prevalence; road traffic accidents; unintentional; violence.