Population trends related to injury from explosive munitions in Lao PDR (1964-2008): a retrospective analysis
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Hundessa, Samuel
Verghis, Vinu
Griffin, Mark
Durham, Jo
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Background: The presence of landmines and explosive remnants of war (ERW) including unexploded ordnance (UXO) poses a serious public health risk for populations living in conflict-affected and contaminated areas. Current analysis, however, provides only a partial view of the burden. In this study, we examined the multivariable relationship between year of injury, activity at the time of the incident, case fatalities and casualty rates in order to provide decision-makers with a more fine-grained understanding of landmines and ERW injuries in the Lao PDR. Methods: Using data from a retrospective, national household survey, frequency tables, logistic and Poisson regressions were performed using STATA 13 to predict the case fatality and population-standardized incidence rates for ERW casualties. Results: The findings indicated that most casualties were male (86.75%), with the majority of incidents (74.7%) occurring during the conflict period (1964-1979). The odds of death for the conflict period was 1.5 times that of the post-conflict period (1980-2008). The highest odds of death during the conflict period was associated with big bombs (OR = 1.38, 95% CI: 1.243-1.522, p < 0.01), and landmine injuries were more common during conflict compared to the post-conflict period (IRR = 1.42, 95% CI: 1.368-1.477, p < 0.01). Post conflict, cluster munitions had the highest incidence rate for death or injury (IRR = 1.07, 95%CI: 1.006-1.143, p = 0.03). Scrap collection which is often the target of mine risk education and thought to be one of the main activities at time of injury had the second lowest incidence rate of the activities related to incident during post-conflict period. Conclusions: As the first study of this nature in Lao PDR, this research provides information essential for planning services and prevention. This study suggests more effort needs to be directed towards addressing the geographical regions and population subgroups experiencing increased casualty numbers and odds of death. Further research is required to improve the documentation and understanding of the health and socio-economic consequences of landmine and ERW injuries.
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Conflict and Health
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12
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1
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© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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Health services and systems
Public health
Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Landmines
Explosive remnants of war
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Pizzino, SE; Hundessa, S; Verghis, V; Griffin, M; Durham, J, Population trends related to injury from explosive munitions in Lao PDR (1964-2008): a retrospective analysis, Conflict and Health, 2018, 12 (1), pp. 36:1-36:13