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Community-based assessment of unintentional injuries: a pilot study in rural Vietnam
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.ORCID iD: 0000-0001-5474-4361
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2003 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 31, no Supplement 62, 38-44 p.Article in journal (Refereed) Published
Abstract [en]

AIMS: Although unintentional injuries are recognised as a major public health problem globally, little is known about their patterns and rates at the community level in most low-income countries. Rapid social development, leading to increased traffic and industrialization, may be changing patterns of injury. Injuries within the home environment have not so far been recognized to the same extent as traffic and work-related injuries in Vietnam, largely because they have not been effectively counted. This study took place in northern Vietnam, in the context of a longitudinal community surveillance site called FilaBavi, as a pilot project aiming to determine the community incidence of unintentional injury and to explore appropriate methods for community-based injury surveillance. METHODS: An initial study population of 23,807 was identified and asked about their experience of injury in the preceding three months. RESULTS: Overall 450 new injuries were detected over 5,952 person-years, a rate of 76 per 1,000 person-years. Males were injured at 1.6 times the rate of females, and home and road traffic accidents were most common. Most injuries occurred during unpaid household tasks. Cutting and crushing injuries occurred most frequently. Of 221 deaths from all causes in the FilaBavi population during 1999 among 43,444 person-years, 25 were attributed to unintentional injuries and two to suicide. Unintentional injury was the third leading cause of death in this community, with a case-fatality rate of 0.8%. DISCUSSION: The findings suggest that greater attention needs to be directed toward the prevention of injuries occurring in the home in rural Vietnam. On the basis of this pilot study, a one-year study using the same approach is under way to characterize the patterns of unintentional injury in more detail, including any seasonal variation.

Place, publisher, year, edition, pages
2003. Vol. 31, no Supplement 62, 38-44 p.
Keyword [en]
community-based, surveillance, unintentional injury, Vietnam
National Category
Medical and Health Sciences
URN: urn:nbn:se:umu:diva-4121DOI: 10.1080/14034950310015095PubMedID: 14578075OAI: diva2:143095
Available from: 2004-09-24 Created: 2004-09-24 Last updated: 2015-04-29Bibliographically approved
In thesis
1. Epidemiology of unintentional injuries in rural Vietnam
Open this publication in new window or tab >>Epidemiology of unintentional injuries in rural Vietnam
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The main objective of this epidemiological study was to assess the incidence of unintentional non-fatal injuries, together with their determinants and consequences, in a defined Vietnamese population, thus providing a basis for future prevention. A one-year follow-up survey involved four quarterly cross-sectional household injury interviews during 2000. This cohort study was based within a demographic surveillance site in Bavi district, northern Vietnam, which provides detailed, longitudinal information in a continuous and systematic way. Findings relate to three phases of the injury process: before, during and after injury.

The study showed that unintentional non-fatal injuries were an important health problem in rural Vietnam. The high incidence rate of 89/1000 pyar reflected almost one tenth of the population being injured every year. Home injuries were found to be most common, often due to a lack of proper kitchens and dangerous surroundings in the home. Road traffic injuries were less common but tended to be more severe, with longer periods of disability and higher unit costs compared with other types of injury. The leading mechanisms of injury were impacts with other objects, falls, cuts and crushing. Males had higher injury incidence rates than females except among the elderly. Elderly females were often injured due to falls in the home. Being male or elderly were significant risk factors for injury. Poverty was a risk factor for injuries in general and specifically for home and work related injuries, but not for road traffic injuries. The middle income group was at higher risk of traffic injuries, possibly due to their greater mobility.

Injuries not only affected people’s health, but were also a great financial burden. The cost of an injury, on average, corresponded to approximately 1.3 months of earned income, increasing to 7 months for a severe injury. Ninety percent of the economic burden of injury fell on households, only 8% on government and 2% on health insurance agencies. Self-treatment was the most common way of treating injuries (51.7%), even in some cases of severe injury. There was a low rate of use of public health services (23.2%) among injury patients, similar to private healthcare (22.4%). High cost, long distances, residence in mountains, being female and coming from ethnic minorities were barriers for seeking health services. People with health insurance sought care more, but the coverage of health insurance was very low.

Some prevention strategies might include education and raising awareness about the possible dangers of injury and the importance of seeking appropriate care following injury. To avoid household hazards, several strategies could be used: better light in the evening, making gravel paths around the house, clearing moss to avoid slipping, wearing protective clothing when using electrical equipment and improving kitchens. Similarly, improving road surfaces, having separate paths for pedestrians and cyclists and better driver training could reduce road accidents.

In Vietnam, and especially in a rural district without any injury register system, a community-based survey of unintentional injuries has been shown to be a feasible approach to injury assessment. It gave more complete results than could have been obtained from facility-based studies and led to the definition of possible prevention strategies.

Place, publisher, year, edition, pages
Umeå: Folkhälsa och klinisk medicin, 2004. 67 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 914
Public health, unintentional injury, community-based, surveillance, Vietnam, Folkhälsomedicin
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
urn:nbn:se:umu:diva-322 (URN)91-7305-723-1 (ISBN)
Public defence
2004-10-15, 135, 9A, Norrlands universitetssjukhus, Umeå, 09:00 (English)
Available from: 2004-09-24 Created: 2004-09-24 Last updated: 2010-05-07Bibliographically approved

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