ABSTRACT
Injuries are responsible for more than five million deaths each year, roughly equal to the number of deaths from HIV/AIDS, malaria, and tuberculosis combined (Gosselin et al. 2009). Low- and middle-income countries account for 91 percent of deaths due to unintentional injuries. When compared with high-income countries, the death rate is nearly double in low and middle income countries (65 versus 35 per 100,000), and the rate for disability-adjusted life-years (DALYs) is more than triple (2398 versus 774 per 100,000; Chandran et al. 2010). These low- and middle-income countries have higher injury rates, suffer more non-fatal, negative health outcomes, and die more often due to these injuries. Morbidity and mortality rates vary significantly by region. Southeast Asia consistently experiences the highest injury rates, due in large part to the sizeable number of low-income countries in that region and stronger health surveillance systems which can more accurately report injury data. Low- and middle-income countries in southeast Asia contribute over 34 percent of the global unintentional injury deaths (Chandran et al. 2010). While deaths due to injury are more often reported, and therefore studied, non-fatal injuries provide a more realistic picture of the overall burden of injuries because many of the most common injuries, such as burns and falls, do not lead to death. While two-thirds of the world's injuries occur in developing countries there is very little research on the prevalence and causes of injury morbidity in these regions (Smith and Barss 1991). This chapter explores the burden of accidental injuries among adults in Matlab, Bangladesh. The population of Matlab has participated in a comprehensive health and demographic surveillance system since the 1960's so that information on unintentional injuries is available. The study not only investigates the prevalence of injuries but also population characteristics associated with accidental injuries, in particular the relationship with socio-economic status. Socioeconomic status is measured for all people living in the study area through a comprehensive household-level survey of assets. The chapter provides a review of the literature on injuries in Bangladesh and other developing countries and describes the results of a survey in which non-fatal accidental injuries were systematically identified in an area with an ongoing health and demographic surveillance system.
