Epidemiology of fatal and non-fatal unintentional childhood drowning in Malaysia-analyses of hospital-based registry data from 2000 to 2022.

Childhood drowning is a major cause of morbidity and mortality with significant economic and social implications, especially in low- and middle-income countries. Despite this, there is a lack of good-quality epidemiological data on childhood drowning. We report the epidemiology of fatal and non-fatal unintentional childhood drowning in Malaysia between the years 2000 and 2022. Data about childhood drowning were obtained from a hospital-based registry gathered by the National Health Informatics Centre, the Ministry of Health, Malaysia. Child population data were downloaded from the Malaysian Census. Overall incidence rates (IRs), case fatality rates (CFRs), and IR and CFR by age, sex, race, and region were calculated. Binary logistic regression was used to determine the factors associated with fatality. Between the years 2000 and 2022, a total of 4247 cases of drowning were reported. IR was significantly higher among children aged 0-9, boys, Bumiputera, and the East Coast and Borneo regions. Overall CFR was 3.7%. Age, year of hospitalization, and Bumiputera were associated with CFR. The site of drowning was unspecified in 84% of cases, while for those recorded, natural water sources and swimming pools accounted for most sites. While the annual incidence of drowning has remained nearly constant throughout the years, the fatality rate has increased between 2010 and 2022. Our report provides leads for further research data requirements to understand childhood drowning epidemiology better and improve preventive measures.