Factors Affecting Childhood Drowning: An Evidence-based Study in Bangladesh

Abstract Introduction: Drowning is the leading cause of death among children aged 1–17 years in rural Bangladesh. Despite substantial progress in reducing infectious disease mortality–from 54 per 100,000 in 2011 to 23.62 per 100,000 in 2021–child drowning remains overlooked. This study aims to identify risk factors associated with childhood drowning deaths in two geographically distinct regions: the northern mainland and Sandwip Island. Methods: A cross-sectional study was conducted between January and March 2024. A total of 322 households were selected using purposive sampling. Face-to-face interviews were conducted, and data were analyzed using logistic regression models to examine sociodemographic, environmental, and caregiving risk factors associated with childhood drowning deaths. Results: Children in Sandwip Island had a higher risk of drowning death compared to those in the northern mainland (odds ratio [OR] = 2.10). Among drowning victims, 75.16% were under 4 years old. Children under grandparental care had 2.12 times higher odds of drowning death. Boys were more likely to experience drowning incidents, yet mortality was higher among girls (66.10% vs. 60.78%). Higher parental education levels were associated with lower drowning mortality. Households using open water as a usual showering place had lower drowning deaths than those using tubewells or indoor washrooms (OR = 0.50). Conclusion: Findings highlight the need for targeted interventions, including improved supervision in high-risk areas, enhanced water safety measures, and caregiver education programs.