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Epilepsy Research Nov 2019This systematic review of epilepsy mortality systematic reviews evaluates comparative risks, causes, and risk factors for all-cause mortality in people with epilepsy...
BACKGROUND
This systematic review of epilepsy mortality systematic reviews evaluates comparative risks, causes, and risk factors for all-cause mortality in people with epilepsy (PWE) to specifically establish the burden of epilepsy-related deaths.
METHODS
MEDLINE and Embase were searched from conception to 26/12/2018 for systematic reviews evaluating all-cause mortality in PWE of any age. Independent study selection, data extraction and quality assessment were performed. Deaths were separated into epilepsy-related and unrelated using a recently published classification system. Outcomes included standardized mortality ratio (SMR) and mortality rate (MR) in a primary analysis of comparative risks, causes, and risk factors for all-cause and epilepsy-related mortality. A narrative synthesis of review findings was used to present results, including from a secondary analysis of individual epilepsy-related death risk factors.
RESULTS
Six moderate or high-quality systematic reviews were included in the primary analysis, evaluating 103 observational studies. All-cause mortality remained similarly high between 1950 and present (median SMR range 2.2-3.4). Africa had the highest SMR (median 5.4, range 2.6-7.2). SMRs were also higher for children <18 years (median 7.5, range 3.1-22.4) than adults (median 2.6, range 1.3-8.7), and for epilepsy-related (median 3.8, range 0.0-82.4,) than unrelated causes (median 1.7, range 0.7-17.6). Structural brain disease conferred the greatest risk for all-cause mortality (SMR range 24.0-41.5). Common epilepsy-related causes included alcohol, drowning, pneumonia, and suicide. In secondary analysis of nine additional systematic reviews, epilepsy-related death risk factors were reported for sudden unexpected death in epilepsy (SUDEP), drowning and suicide.
CONCLUSIONS
Premature all-cause mortality remains a major problem in PWE globally, particularly in children and young adults, with most being epilepsy-related and potentially preventable. SUDEP is only one of several other common and important epilepsy-related causes of death.
Topics: Cause of Death; Death, Sudden; Epilepsy; Humans
PubMed: 31526975
DOI: 10.1016/j.eplepsyres.2019.106192 -
Epilepsy & Behavior : E&B Oct 2018We conducted a systematic review to ascertain the overall mortality and causes of premature mortality in epilepsy.
BACKGROUND
We conducted a systematic review to ascertain the overall mortality and causes of premature mortality in epilepsy.
METHODOLOGY
We searched PubMed and Embase to identify relevant articles reporting mortality in epilepsy. An assessment of the methodological quality and overall quality of evidence of the identified studies was done using appropriate checklists. We extracted data from these studies reporting measures of overall and cause-specific mortality in epilepsy.
RESULTS
Sixty-three articles from fifty-six cohorts met the eligibility criteria, thirty-three population- or community-based and twenty-three hospital- or institutional-based studies. The majority of studies are from high-income countries (HIC). These studies reported overall excess mortality for people with epilepsy, with wide variability reported for population- or community-based studies and from low- and middle-income countries (LMIC). Twenty-seven articles from twenty-three cohorts reported measures of mortality for cause-specific mortality in epilepsy. People with epilepsy from HIC and LMIC have a higher risk of dying from various causes compared with the general population. Those in LMIC, however, have a particularly high chance of dying from external causes such as drowning and suicide. We observed a decrement over time in measures of overall and cause-specific mortality in cohorts.
CONCLUSIONS
Despite the heterogeneity in reports, our findings support the suggestions that people with epilepsy have an increased risk of premature mortality from various causes. Further work is needed to elucidate the mechanisms, to determine biomarkers for predicting those at risk, and to understand the implications of counseling and preventive strategies.
Topics: Epilepsy; Humans; Income; Mortality, Premature; Poverty; Prospective Studies; Retrospective Studies
PubMed: 30154056
DOI: 10.1016/j.yebeh.2018.07.017 -
PloS One 2018Drowning claims 7% of the global burden of injury-related deaths. Lifejackets are routinely recommended as a drowning prevention strategy; however, a review of related... (Review)
Review
OBJECTIVE
Drowning claims 7% of the global burden of injury-related deaths. Lifejackets are routinely recommended as a drowning prevention strategy; however, a review of related factors regarding lifejacket wear has not previously been investigated.
METHODS
This systematic review examined literature published from inception to December 2016 in English and German languages. The personal, social, and environmental factors associated with lifejacket wear among adults and children were investigated, a quantitative evaluation of the results undertaken, and gaps in the literature identified.
RESULTS
Twenty studies, with sample sizes of studies ranging between 20 and 482,331, were identified. Fifty-five percent were cross-sectional studies. All studies were scored IV or V on the Australian National Health and Medical Research Council (NHMRC) grading system indicating mostly descriptive and cross-sectional levels of evidence. Factors associated with increased wear included age (mostly children), gender (mostly female), boat type (non-motorised), boat size (small boats), role modelling (children influenced by adult lifejacket wear), and activity (water-skiing, fishing). Factors not associated or inconsistent with lifejacket wear included education, household income, ethnicity, boating ability, confidence in lifejackets, waterway type, and weather and water conditions. Factors associated with reduced lifejacket wear included adults, males, discomfort, cost and accessibility, consumption of alcohol, and swimming ability. Three studies evaluated the impact of interventions.
CONCLUSION
This review identified factors associated with both increased and decreased lifejacket wear. Future research should address the motivational factors associated with individuals' decisions to wear or not wear lifejackets. This, combined with further research on the evaluation of interventions designed to increase lifejacket wear, will enhance the evidence base to support future drowning prevention interventions.
Topics: Adolescent; Adult; Child; Drowning; Emergencies; Female; Humans; Male; Ships; Swimming; Young Adult
PubMed: 29718971
DOI: 10.1371/journal.pone.0196421 -
International Journal of Environmental... May 2022Children between the ages of 4-6 years represent the population most affected by drowning accidents, while their early involvement in physical activity, and more... (Review)
Review
Children between the ages of 4-6 years represent the population most affected by drowning accidents, while their early involvement in physical activity, and more specifically in aquatic activities is a key factor in their future physical life journey. The systematic review's purpose was to identify aspects in the intervention's studies with children and/or their parents that had a significant impact on the Aquatic Literacy (AL) dimensions mentioned as motor, psychological, affective, and cognitive. The PICO method was used to define the research question and PRISMA checklist searched for articles in nine databases: Cochrane, Embase, ERIC, ProQuest, PsychInfo, PubMed, Scopus, SportDiscus, and Web of Science. Eligibility criteria were: (1) English language, (2) primary research, (3) population of 4-6 year old children or their parents, (4) intervention study design, and (5) results related to at least one of the AL domains. The strength of evidence and the risk of bias were assessed. Results showed relatively poor number of studies for such a vulnerable population regarding the drowning risk ( = 8 for parents and = 14 for children intervention). Studies did not show a consensus on which educational approach was more beneficial than others. Concerning parental education, results were rather homogeneous, especially concerning the theoretical frameworks employed and the relevancy to include parents in swimming programs. The development of pedagogical tools for promotion and evaluation, based on the AL theoretical framework, could help to clarify the question of "how to teach" children to prevent drowning and engage young children in long-term physical activities.
Topics: Child; Child, Preschool; Drowning; Humans; Language; Literacy; Swimming
PubMed: 35627720
DOI: 10.3390/ijerph19106180 -
Injury Prevention : Journal of the... Jun 2018Drowning is a global public health issue and prevention poses an ongoing challenge for all countries. Many nations are experiencing ageing populations, and little is...
PURPOSE
Drowning is a global public health issue and prevention poses an ongoing challenge for all countries. Many nations are experiencing ageing populations, and little is known about the epidemiology, risk factors and prevention of drowning deaths among older people. This paper reports on a systematic review of literature published on drowning among older people.
METHODS
A systematic literature review was undertaken using English-language, Portuguese-language and Spanish-language papers published between 1980 and 2015. The review explores gaps in the literature with a focus on the epidemiology, risk factors and strategies for the prevention of unintentional fatal drowning among people 50 years and over.
RESULTS
Thirty-eight papers were deemed relevant to the study design, including 18 (47%) on epidemiology, 19 (50%) on risk factors and 9 (24%) on strategies for prevention. Risk factors identified included male gender, ethnicity, rurality and increasing age. Prevention strategies commonly proposed were education and wearing life jackets. Gaps identified in the published literature include a lack of consistency around age groupings used for epidemiological studies; a lack of consensus on risk factors; a lack of total population, country-level analysis; and the need for older age-specific prevention strategies that have been implemented and their effectiveness evaluated.
CONCLUSION
This review identified drowning deaths among older people as a global issue. Further work is required to reduce drowning in this cohort. High-quality epidemiological studies identifying risk factors using standardised age groupings to allow for international comparisons are required, as are implementation and evaluation of older age-specific prevention strategies.
Topics: Accident Prevention; Drowning; Humans; Internationality; Middle Aged; Risk Factors; Swimming
PubMed: 28774894
DOI: 10.1136/injuryprev-2017-042351 -
Mycoses Feb 2024Scedosporium/Lomentospora species exist as saprophytic moulds that can potentially lead to serious infections in patients who have experienced near-drowning incidents.... (Review)
Review
Scedosporium/Lomentospora species exist as saprophytic moulds that can potentially lead to serious infections in patients who have experienced near-drowning incidents. Scedosporium species are distributed across different regions of the world while Lomentospora prolificans has quite a restricted geographic distribution. We aimed to systematically review scedosporiosis cases after near-drowning, their clinical manifestations, underlying diseases, treatments, outcomes and its impact through disability-adjusted life years (DALYs). Five available sources were searched from 1 January 2007, to 20 April 2022. Thirty-eight studies, including 41 patients, were evaluated. Mean age was 33.6 ± 18.6 years (range 1-68), and 28 were male (68.3%). Central nervous system (CNS) dissemination predominated (36/41; 87.8%), presenting mainly as multiple brain abscesses (26/41; 63.4%), followed by lung involvement (22/41; 56.4%). Scedosporium apiospermum species complex was the most causative agent (38/41; 92.7%). Overall mortality was 51.2%. Half of the patients (18/37) were cured after receiving proper treatment, and in most cases, voriconazole alone or in combination with surgery or other antifungals caused survival. The mean survival time was 123 ± 27 days. Mean DALYs in 1980-2022 were 46.110 ± 3.318 (39.607-52.612). Time to diagnosis was estimated to be 120 days, and there was no association between time to diagnosis and outcome. Voriconazole is a potentially effective therapy, and combination of surgery and antifungal treatment may lead to more favourable outcome. Advances in early diagnosis and appropriate antifungal therapy may have contributed to reducing its mortality.
Topics: Humans; Male; Infant; Child, Preschool; Child; Adolescent; Young Adult; Adult; Middle Aged; Aged; Female; Antifungal Agents; Voriconazole; Scedosporium; Disability-Adjusted Life Years; Near Drowning; Ascomycota; Invasive Fungal Infections
PubMed: 38345265
DOI: 10.1111/myc.13703 -
Journal of Water and Health Feb 2018Therapeutic use of spring waters has a recorded history dating back to at least 1550 BC and includes both bathing in and drinking such waters for their healing... (Review)
Review
Therapeutic use of spring waters has a recorded history dating back to at least 1550 BC and includes both bathing in and drinking such waters for their healing properties. In Australia and New Zealand the use of therapeutic spring waters is a much more recent phenomenon, becoming a source of health tourism from the late 1800s. We conducted a systematic review aimed at determining the potential health outcomes relating to exposure to Australian or New Zealand natural spring water. We found only low-level evidence of adverse health outcomes relating to this spring water exposure, including fatalities from hydrogen sulphide poisoning, drowning and primary amoebic meningoencephalitis. We found no studies that investigated the therapeutic use of these waters, compared with similar treatment with other types of water. From the broader literature, recommendations have been made, including fencing potentially harmful spring water, and having signage and media messages to highlight the potential harms from spring water exposure and how to mitigate the risks (e.g. not putting your head under water from geothermal springs). Sound research into the potential health benefits of Australian and New Zealand spring waters could provide an evidence base for the growing wellness tourism industry.
Topics: Australia; Environmental Monitoring; Humans; Medical Tourism; Natural Springs; New Zealand; Water Microbiology; Water Pollutants, Chemical
PubMed: 29424713
DOI: 10.2166/wh.2017.209 -
Health Promotion International Oct 2023Little is known about unintentional drowning deaths in Indonesia, the world's fourth most populous and largest archipelagic country. This study aimed to describe the... (Review)
Review
Little is known about unintentional drowning deaths in Indonesia, the world's fourth most populous and largest archipelagic country. This study aimed to describe the epidemiology and risk factors of unintentional drowning in Indonesia and explore existing health promotion and drowning prevention approaches in Indonesia within a socio-ecological health promotion framework. A scoping review, guided by PRISMA-ScR, was conducted to locate peer-reviewed studies and government reports/policy documents published until May 2023, in English or Indonesian language, using MEDLINE (Ovid), CINAHL, Informit, PsycINFO (ProQuest), Scopus, SafetyLit, BioMed Central and Google Scholar, Indonesian journal databases (Sinta, Garuda) and government agencies websites around the terms: drown, swim, flood, hurricane, cyclone, disaster, water rescue and maritime/boat safety. This review identified 32 papers. However, a paucity of information on unintentional drowning rates, risk factors and prevention in Indonesia was noted. The unavailability of a coordinated national drowning data collection system in Indonesia, from which national and subnational subcategory data can be collected, underlines the possibility of under-representation of drowning mortality. The association between various exposures and drowning incidents has not been fully investigated. An over-reliance on individual-focused, behaviour-based, preventive measures was observed. These findings highlight the need for improving drowning surveillance to ensure the availability and reliability of drowning data; and strengthening research to understand the risk factors for drowning and delivery of drowning prevention programs. Further policy development and research focusing on health promotion approaches that reflect a socio-ecological approach to drowning prevention in Indonesia is imperative.
Topics: Humans; Drowning; Indonesia; Reproducibility of Results; Risk Factors; Health Promotion
PubMed: 37851464
DOI: 10.1093/heapro/daad130 -
Journal of Community Health Apr 2016Globally, drowning is one of the ten leading causes of child mortality. Children aged <5 years are particularly at risk, and children and young people continue to be... (Review)
Review
Globally, drowning is one of the ten leading causes of child mortality. Children aged <5 years are particularly at risk, and children and young people continue to be overrepresented in drowning statistics. Accordingly, evidence informed interventions to prevent children drowning are of global importance. This review aimed to identify, assess and analyse public health interventions to reduce child drowning and investigate the use of behavioural theories and evaluation frameworks to guide child drowning prevention. Thirteen databases were searched for relevant peer reviewed articles. The systematic review was guided by the PRISMA criteria and registered with PROSPERO. Fifteen articles were included in the final review. Studies were delivered in high, middle and low income countries. Intervention designs varied, one-third of studies targeted children under five. Almost half of the studies relied on education and information to reduce drowning deaths, only three studies used a multi-strategy approach. Minimal use of behavioural theories and/or frameworks was found and just one-third of the studies described formative evaluation. This review reveals an over reliance on education and information as a strategy to prevent drowning, despite evidence for comprehensive multi-strategy approaches. Accordingly, interventions must be supported that use a range of strategies, are shaped by theory and planning and evaluation frameworks, and are robust in intervention design, delivery and evaluation methodology. This approach will provide sound evidence that can be disseminated to inform future practice and policy for drowning prevention.
Topics: Adolescent; Child; Developed Countries; Developing Countries; Drowning; Humans; Young Adult
PubMed: 26499822
DOI: 10.1007/s10900-015-0105-2 -
BMC Public Health Feb 2024Drowning is a public health problem in Türkiye, as in the rest of the world. This study aims to systematically review the literature on drowning in Türkiye with a...
INTRODUCTION
Drowning is a public health problem in Türkiye, as in the rest of the world. This study aims to systematically review the literature on drowning in Türkiye with a focus on data sources, epidemiology, risk factors and prevention strategies.
METHODS
Literature searches were conducted using PubMed, SPORTSDiscus, Scopus, Web of Science, Turk MEDLINE, Google Scholar and Google Akademik (Turkish language). Studies (limited to original research written in English and Turkish) reporting drowning (unintentional and intentional; fatal and non-fatal) of residents and tourists in Türkiye were independently dual screened at the title and abstract and full text stages. Study quality was assessed using JBI checklists and evidence level assessed based on study design.
RESULTS
From a total of 917 studies, 49 met the inclusion criteria. Most (51%) focused on unintentional fatal drowning. Included studies were most commonly analytical cross-sectional studies (n = 23) and case series (n = 20) meaning the evidence level was low or very low for 48 (98%) studies. Fifteen studies examined drowning at the national level, while sub-national studies (n = 30) focused on urban areas across three provinces: Antalya (n = 6), Istanbul (n = 6), Izmir (n = 4). There was little consensus on risk factors beyond male drowning risk, and no data reported on implemented or evaluated drowning prevention interventions.
DISCUSSION
There is a need for more national-level studies to identify the causes of drowning and to guide intervention implementation and evaluation to inform policy makers and donors. Currently official data is limited in its detail, providing age and gender data only, hampering efforts to identify, and thus address, causal factors for drowning.
PRACTICAL APPLICATIONS
There is currently very little evidence to inform investment in effective drowning prevention interventions in Türkiye. To improve this, data collection systems on drowning in Türkiye need to be strengthened via the development a national drowning registry.
TRIAL REGISTRATION
#CRD42022382615.
Topics: Humans; Male; Drowning; Cross-Sectional Studies; Turkey; Risk Factors; Public Health
PubMed: 38378496
DOI: 10.1186/s12889-024-18032-9