Theses (MSc. Public Health)

Objectives: This dissertation studied the time trends and distribution of fatal and non-fatal childhood drowning in Malaysia by demographic and spatial factors between 2000 and 2022. The difference in annual incidence between 2000-2011 and 2012-2022 was also identified. Methods: The drowning data reported to the national Health Informatics Centre (HIC) for 18 years old and below, from hospitalised cases of child drowning incidents and drowning deaths, were analysed. Data from the Department of Statistics Malaysia (DOSM) were also retrieved. These data were then used to calculate annual incidence, annual rates of change in drowning, and case fatality rates. Also, binary logistic regression analyses identified the socio-demographic and spatial factors associated with drowning. The outcome or the dependent variables were fatal and non-fatal, while age, year, sex, race, and region acted as independent variables. Results: A total of 4,191 reports of childhood drowning incidents and 155 drowning fatalities were reported to HIC. Drowning incidence rate was higher in 2000-2011 (IR 21.83) than in 2012-2022 (IR 17.65). Drowning incidence were significantly higher among the aged 0-4 years, boys, Bumiputera, and children living in urban areas (p<0.001). In contrast, the case fatality rate was higher in 2012-2022 (CFR 4.88) than in 2000-2011 (CFR 2.75). Children aged 0-9 years (p<0.001), children living in the Klang Valley region (p=0.049), and urban areas (p=0.034) were significant in fatal drowning. The time trends analysis for annual rates of change increased by 0.0001 for drowning incidents and 0.0003 for drowning fatalities. The east coast region significantly demonstrates 2.19 times (95% CI 1.03-4.65) higher than other regions (p=0.0041). Conclusions: This study provided more detail analyses of available childhood drowning data. The null hypothesis was rejected as there was a difference of drowning incidents in 2000-2011 and 2012-2022. The findings also suggested that preventive measures should be targeted towards children aged 0-9 years, boys, and children living in urban areas.