{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T01:15:00Z","timestamp":1794014100696,"version":"4.8.0"},"reference-count":24,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"unspecified","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100015763","name":"University of Szeged","doi-asserted-by":"crossref","award":["7336"],"award-info":[{"award-number":["7336"]}],"id":[{"id":"10.13039\/501100015763","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,10,3]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The highest childhood mortality rates are observed from external causes of death. Our study aims to investigate the trends in deaths from external causes among children aged 0\u201314 years between 2000 and 2022, comparing the pre-pandemic (2000\u20132019) and the COVID-19 pandemic (2020\u20132022) periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This is a population-based retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Settings<\/jats:title>\n                    <jats:p>From the \u2018Dissemination Database\u2019 of the Hungarian Central Statistical Office, we collected the monthly and annual mortality of all external causes (International Classification of Diseases, 10th Revision: V01\u2013Y89) and the two most common external causes (traffic accidents and drownings) for the period 2000\u20132022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Children aged under 15 years, and the relevant population, were available from this database by gender, 5-year age group and region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>The trends were characterised by the incidence rate ratio (IRR) and its 95%\u2009CI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During the study period, 1813 deaths (1142 boys and 671 girls) occurred. There was a significant decreasing trend in all external-cause mortality (IRR=0.94; 95%\u2009CI 0.93 to 0.95; p&lt;0.001). A similar trend was detected for mortality in traffic accidents and drownings. For external-cause mortality, significant seasonality was found in the pre-pandemic (July; p&lt;0.001) and pandemic (May; p=0.041) periods. Similar seasonality (July\u2013August) characterised mortality from traffic accidents and drownings. The highest mortality in the pre-pandemic period was observed in Northern Hungary and Southern Transdanubia regions. In contrast, these regions had the lowest external-cause mortality rates during the pandemic period, while the regions of the Northern Great Plains and the Southern Great Plains (HU33) had the highest external-cause mortality rates. The highest mortality rate from traffic accidents was found in the HU33 in both periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is a significant decreasing annual trend in childhood external-cause mortality in Hungary. Mortality from drowning was significantly higher around our larger natural water bodies in the summer months, while mortality from traffic accidents was the highest in the HU33.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-099074","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T07:01:09Z","timestamp":1761116469000},"page":"e099074","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Trends in childhood mortality from external causes of death in Hungary between 2000 and 2022: a retrospective cohort study of the nationwide population register data"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2650-406X","authenticated-orcid":false,"given":"Zsanett","family":"Urfi","sequence":"first","affiliation":[{"name":"Medical Physics and Informatics, University of Szeged Albert Szent-Gy\u00f6rgyi Faculty of Medicine, Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8900-6641","authenticated-orcid":false,"given":"Tibor Andr\u00e1s","family":"Ny\u00e1ri","sequence":"additional","affiliation":[{"name":"Medical Physics and Informatics, University of Szeged Albert Szent-Gy\u00f6rgyi Faculty of Medicine, Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5081-7313","authenticated-orcid":false,"given":"Tam\u00e1s","family":"Lantos","sequence":"additional","affiliation":[{"name":"University of Szeged, Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,10,21]]},"reference":[{"key":"2025120415073647000_15.10.e099074.1","unstructured":"Hungarian Central Statistical Office . International data - death rate [per thousand inhabitants]. 2024. Available: https:\/\/www.ksh.hu\/stadat_files\/nep\/en\/nep0056.html"},{"key":"2025120415073647000_15.10.e099074.2","unstructured":"Hungarian Central Statistical Office . Dissemination database. 2022. 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Road traffic injuries: children. 2023. Available: https:\/\/www.who.int\/news-room\/questions-and-answers\/item\/road-traffic-injuries-children [Accessed 02 Sep 2025]."},{"key":"2025120415073647000_15.10.e099074.8","doi-asserted-by":"crossref","unstructured":"Barnett AG , Dobson AJ . Analysing seasonal health data. 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