Does the number of injuries among elderly increase during Ramadan in Kazakhstan?

INTRODUCTION:  Several studies reported that Ramadan affects daytime activities and may alter performance in mental physical and social domains including an increase in the incidence of traffic incidence.  Kazakhstan is a former Soviet republic in Central Asia with high traffic mortality and with steadily increasing Muslim population. Effects of Ramadan of health in the former Soviet republics of Central Asia have not been studied. We assessed the effect of Ramadan on daily counts of injuries among elderly in an urban Kazakhstani setting.

METHODS:  Daily counts of injuries (ICD codes S00-T98 and V01-Y98) in individuals aged 60 years or older in 2010-2012 were obtained from the medical records. Differences between the numbers of injuries per day during Ramadan vs. other days were studied using multiple Poisson regression. Weekly, monthly and annual variations in injuries were modelled using days of the week, public holidays, months and year as binary dummy variables. Results are presented as percent difference with 95% confidence intervals (CI) calculated using robust standard errors. Analyses were performed separately by gender.

RESULTS:  Altogether, there were 6065 injuries (4065 of them among women) during the three years. After adjustment for year-to-year, seasonal and weekly variations as well as size of the population and public holidays the number of injuries during Ramadan became on average 10.7% lower (95% CI: -37.2; -15.8)  among men and 2.7% lower (95% CI: -20.3; 14.8) among women compared to other days.

CONCLUSIONS:  Contrary to a few other settings, there is no evidence of the increased number of traffic accidents among elderly during Ramadan in 2010-2012 in Semey, Kazakhstan. This can be partly explained by ethnic, religious and cultural heterogeneity of the Kazakhstani population and older age in our study compared to other studies. Other factors behind our findings will be discussed.