Understanding the burden of injuries in Nepal: A systematic review of published studies

Background: The population of Nepal are vulnerable to injuries from natural disasters as well as those occurring in the home, at work and on the roads. Aim: To collate and synthesise the published literature reporting injuries to people of any age resident in Nepal. Method: We searched five electronic databases using an inclusive search strategy. Potentially eligible citations were screened by title and abstract and full texts of studies obtained. Data were extracted by two researchers. Synthesis was reported narratively by injury type and study design. Results: We identified 186 publications reporting 176 unique studies. Most studies used designs likely to underestimate the true burden of disease, including 144 case series and 36 cross-sectional studies. No trials were identified. The largest number of publications were related to poisoning and self-harm with only 22 focussing on road traffic injuries. There was minimal exploration of inequalities in injury occurrence other than descriptive reporting by age and gender. Conclusions: There is limited research using study designs at low risk of bias on injuries occurring to residents of Nepal, even on areas of concern such as road traffic injuries. The findings indicate a lack of robust epidemiological evidence to inform strategic approaches to injury prevention and suggest a need for capacity strengthening for injury prevention research.