Short CommunicationDoes the number of injuries among elderly people in Kazakhstan increase during Ramadan?
Introduction
Injuries are a major public health problem associated with substantial healthcare expenditure, particularly in developing countries. Elderly people are at higher risk of trauma due to impaired motor and cognitive functions, and the increasing demands of modern society.1
Fasting during the holy month of Ramadan is one of the pillars of Islam, and more than 20% of the world's population fast during Ramadan every year. Previous studies have reported that fasting affects body physiology and daytime activities, and may increase the incidence of injuries.2 An increased number of traffic accidents during the holy month has been reported in Arab countries3, 4 and the UK.5 However, other studies have found no association.6, 7 Controversial findings may reflect true variations between the settings, warranting further research in other countries. No studies have been published on this topic from predominantly Muslim republics of the former Soviet Union.
Kazakhstan became an independent state in 1991. The mortality rate from external causes is considerably higher in Kazakhstan compared with Europe, at 102.5 deaths per 100,000 in 2011.8 Moreover, Kazakhstan has the highest mortality rate from traffic injuries in the world (30.6 per 100,000; for comparison, the rate in Norway is 5.0 per 100,000).9 The proportion of Muslim inhabitants in Kazakhstan has recently exceeded 70%, and this—in combination with a rapidly ageing population and high incidence of injuries—makes Kazakhstan a unique setting for studying health consequences of cultural and demographic transition.
This study assessed the effect of Ramadan on the daily injury count among elderly people in Kazakhstan, the largest country in Central Asia with a rapidly growing Muslim population.
Section snippets
Methods
This population-based ecological study was performed in the city of Semey, East Kazakhstan. Semey (former Semipalatinsk) is an industrial city known for being a test site for Soviet nuclear weapons until the early 1990s. The population of Semey was 335,400 in 2013. Daily injury counts for all injuries (International Classification of Disease codes S00–T98 and V01Y98) in individuals aged ≥60 years that occurred between 1 January 2010 to 31 December 2012 and required medical attention were
Results
In total, there were 6065 injuries during the study period (33% among men). The median age of injured subjects was 68 years for men and 71 years for women. Most injuries resulted from falls (82.2%), followed by exposure to inanimate (7.7%) and animate (4.6%) mechanical forces. Injuries from road traffic accidents and burns comprised 2.3% and 1.6% of all injuries, respectively. Sex-specific incidence rates by year, location and cause of trauma are presented in detail elsewhere.10
A crude analysis
Discussion
To the best of the authors' knowledge, this is the first study to assess whether the number of injuries increases during Ramadan in Central Asia. Several types of injuries were studied aside from those resulting from road traffic accidents.
The results suggest that after adjustment for year, month, day of the week and public holidays, the number of injuries during Ramadan is not significantly different from the corresponding numbers for other times of year. Point estimates suggest an increased
Ethical approval
The study was approved by the Ethical Committee of Semey State Medical University.
Funding
None declared.
Competing interests
None declared.
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