Drowning in the Lake Victoria basin: A systematic review of prevalence, risk factors, and interventions in East Africa

What is already known on this topic - summarise the state of scientific knowledge on this subject before you did your study and why this study needed to be done. There is a significant body of research on drowning in low-middle-income countries with general knowledge of the demographic and behavioral risk factors and an emerging body of research on this topic specific to Uganda. This systematic review aims to gather the existing research for the Lake Victoria basin and highlight critical gaps in order to direct future research, policy, and interventions in the field. What this study adds - summarise what we now know because of this study that we did not know before Crucial gaps in content identified for the Lake Victoria basin included: studies with geographic focus in Kenya or Tanzania, studies of local populations, studies of direct drowning prevention interventions, studies on behavioral (non-demographic) risk factors such as alcohol use, and studies assessing community knowledge, attitudes, and beliefs related to drowning prevention and water safety. How might this study affect research, practice, or policy? Summarise the implications of this study. This study represents the first systematic review including both peer-reviewed and gray literature centered on the Lake Victoria basin, and indicates key gaps in knowledge that can direct future research efforts. BackgroundWith the highest number of drowning fatalities per square kilometer, Lake Victoria, the worlds second-largest body of fresh water, represents the most dangerous stretch of water. Despite the high burden of drowning in the region, data on drowning incidence and risk vary. This study aims to assess existing research on drowning risk, policy, and interventions in the Lake Victoria basin to identify key gaps and guide future research and policy recommendations. MethodsWe conducted a cumulative systematic review following Templier and Pares 2015 framework to collect all literature on drowning in Kenya, Uganda, and Tanzania. PubMed, Web of Science, Cochrane, Google Scholar, and EMBASE were searched from 1/1/1999 through 6/2/2025. Data on geographic scope and setting, community perspectives, and literature type were extracted, and articles were analyzed for content to determine emerging themes. ResultsWe identified 43 studies, including 37 peer-reviewed articles. There were eight global studies, seven multi-country, twenty in Uganda, three in Kenya, and five in Tanzania. 17.9% (n=5) of articles studied local populations, 67.9% (n=19) regional, and 14.3% (n= 4) national populations. 30.2% (n=13) mentioned community knowledge or attitudes. Over half of the studies focused on prevalence (23.2%, n=10) or risk factors (41.8%, n=18), and 13.9% (n=6) on direct interventions. ConclusionUnderstanding existing research on drowning in the Lake Victoria basin is crucial to identifying gaps and planning future research and interventions. Strengthening surveillance systems and evaluating culturally relevant prevention strategies are critical next steps to address this neglected public health issue.