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Incidence and seasonal variation of injury in rural Vietnam: a community-based survey
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.ORCID iD: 0000-0001-5474-4361
2004 (English)In: Safety Science, ISSN 0925-7535, Vol. 42, no 8, 691-701 p.Article in journal (Refereed) Published
Abstract [en]

Study objective: To describe seasonal effects on injury incidence at the community level and to assess the relative merits of cross-sectional or longitudinal surveillance for injuries in such a setting.

Population and methods: This study took place in Bavi district, northern Vietnam, in the context of a longitudinal community surveillance site called FilaBavi. All non-fatal unintentional injuries which occurred in a sample of 24,776 people living in 5801 households were recorded during 2000. Four interview surveys per household were conducted continuously during 2000, each covering a 3-month period of recall. Injury morbidity data were analysed according to gender, age and circumstances of injury. Statistical analyses were based on monthly, quarterly and annual incidence rates with 95% confidence intervals. Significant differences between incidence rates were noted where the 95% confidence interval of the rate ratio excluded unity.

Results: There were 1917 persons who experienced a total of 2079 new non-fatal injuries during the period of observation, corresponding to an incidence of 89/1000 person-years. Seasonal variations were found in all types of injury. Overall, the highest incidence rates were observed in July and April, while the lowest monthly rates were found in May and November. Peaks were observed in February and April for traffic injuries, June for work-related injuries, July, August and October for home injuries. A significantly higher incidence rate was found in the third quarter survey (103/1000 person-years, p<0.05).

Conclusion: There can be interesting and significant seasonal variations in injury incidence within a community such as seen here in rural Vietnam and these variations have important implications for the design and planning of injury surveillance activities. Seasonal effects may cause invalid assessments of an injury problem if only cross-sectional household surveys are used, demonstrating the need for longitudinal approaches to injury incidence surveillance.

Place, publisher, year, edition, pages
2004. Vol. 42, no 8, 691-701 p.
Keyword [en]
Injury, Accidents, Seasonal variation, Surveillance, Community-based survey, Vietnam
National Category
Medical and Health Sciences
URN: urn:nbn:se:umu:diva-13613DOI: 10.1016/j.ssci.2003.12.001OAI: diva2:153284
Available from: 2007-05-11 Created: 2007-05-11 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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