1887
Volume 2019, Issue 3
  • ISSN: 0253-8253
  •  E-ISSN:  Will be obtained soon 2227-0426

Abstract

Injuries are increasingly recognized as a major component of the global burden of disease, as they tend to affect mainly youth and are usually followed by premature death or severe disability. The longstanding conflict in Iraq has resulted in a situation of continuous violence and ongoing instability, which has in turn led to an increasing incidence of injuries and a crippled health system. To sketch a trend of non-military accidents in Iraq (road traffic accidents [RTA], falls, burns, firearm injuries, assaults by sharp objects and sexual assaults) among civilians during the last 14 years associated with the period of conflict (2003–2016). This descriptive study was conducted during the period from January 1st through to December 31st, 2017 using already available surveillance data from the Ministry of Health in Iraq. The methodology was based on measuring the incidence of each accident for the period from 2003 through 2016 and plotting it against time. Linear regression was computed to estimate the trends of the disease. The rate of RTAs significantly increased between 2003 and 2016, from 1.85 to 2.9 per 1000 ( ≤ 0.01), as did accidental falls especially after 2008 (males more than females) ( ≤ 0.01). By contrast, after a peak in 2011, burns dropped significantly from 4.19 to 3.42/1000, along with firearm accidents, which fell from 2.2/1000 in 2007 to 0.39 in 2016 ( ≤ 0.01), mostly among males. Assaults with sharp objects also decreased with time to a rate of 0.47/1000 ( = 0.0001). Sexual assaults showed a significant downward sloping trend over time to  = 0.037. Accidents still add a burden on the already deteriorated Iraqi health system. Understanding the impact of this burden is essential to better prepare for future plans and interventions that may help improve the quality of health services.

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2019.14
2019-12-24
2020-06-02
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2019/3/qmj.2019.14.html?itemId=/content/journals/10.5339/qmj.2019.14&mimeType=html&fmt=ahah

References

  1. Murray CJL, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al.  Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012; 380:9859:21972223.
    [Google Scholar]
  2. Norouzi V, Feizi I, Vatankhah S, Pourshaikhian M. Calculation of the Probability of Survival for Trauma Patients Based on Trauma Score and the Injury Severity Score Model in Fatemi Hospital in Ardabil. Arch Trauma Res. 2013; 2:1:3035.
    [Google Scholar]
  3. World Health Organization. Falls. Fact sheet 2018; March 22 2018 [Internet]. Geneva: Switzerland, World Health Organization; 2018. Available from: http://www.who.int/mediacentre/factsheets/fs344/en .
  4. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al.  Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012; 380:9859:20952128.
    [Google Scholar]
  5. World Health Organization. Injuries. Health topics 2018 [Internet]. Geneva: Switzerland, World Health Organization; 2018. Available from: http://www.who.int/topics/injuries/about/en .
  6. World Health Organization. Injuries and violence. The Facts 2014 [Internet]. Geneva: Switzerland, World Health Organization; 2018. Available from: http://www.who.int/violence_injury_prevention/media/news/2015/Injury_violence_facts_2014/en .
  7. Global Burden of Disease Study. Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2015; 388:1005:1545602.
    [Google Scholar]
  8. World Health Organization. Road traffic injuries. Fact sheet 2018 [Internet]. Geneva: Switzerland, World Health Organization; 2018. Available from: http://www.who.int/mediacentre/factsheets/fs358/en/ .
  9. World Health Organization. Facts on road safety 2018 [Internet]. Geneva: Switzerland, World Health Organization; 2018. Available from: http://www.who.int/features/factfiles/roadsafety/en .
  10. World Health Organization. Injuries and violence: the facts [Internet]. Geneva: Switzerland: World Health Organization 2010.
  11. Atiyeh BS, Gunn SW, Hayek SN. Military and civilian burn injuries during armed conflicts. Ann Burns Fire Disasters. 2007; 20:4:203215.
    [Google Scholar]
  12. Webster PC. Iraq's growing health crisis. Lancet. 2014; 384:9938:119120.
    [Google Scholar]
  13. Lafta R, Al-Shatari S, Cherewick M, Galway L, Mock C, Hagopian A, et al.  Injuries, death, and disability associated with 11 years of conflict in Baghdad, Iraq: A randomized household cluster survey. Plos One. 2015; 10:8:e0131834.
    [Google Scholar]
  14. Lancet Editor. Iraq's neglected health and humanitarian crisis. Lancet. 2015; 385:9985:2324.
    [Google Scholar]
  15. UNAMI/OHCHR. United Nations Assistance Mission for Iraq/Office of the High Commissioner for Human Rights. Report on the Rights of Persons with Disabilities in Iraq, December 2016 [Internet]. Available from: http://www.uniraq.org/index.php?option = com_k2&view = item&task = download&id = 2118_ba29368d4a62b7b36938b845a174394d&lang = en .
  16. World Health Organization. Violence Info. Homicide, WHO Global Health Estimates (2015 update) [Internet]. Geneva: Switzerland, World Health Organization; 2018. Available from: http://apps.who.int/violence-info/homicide/.
  17. World Health Organization. Violence Info. Country Profiles, Iraq [Internet]. Geneva: Switzerland, World Health Organization; 2015. Available from: http://apps.who.int/violence-info/country/IQ .
  18. GBD. Mortality and Causes of Death Collaborators Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: A systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2015; 388:1005:1459.
    [Google Scholar]
  19. Mandil A, Chaaya M, Saab D. Health status, epidemiological profile and prospects: eastern Mediterranean region. Int J Epidemiol. 2013; 42:2:616626.
    [Google Scholar]
  20. Olawale OA, Owoaje ET. Incidence and pattern of injuries among residents of a rural area in South Western Nigeria: a community-based study. BMC Public Health. 2007; 7::246.
    [Google Scholar]
  21. Cardona M, Joshi R, Ivers RQ, Iyengar S, Chow CK, Colman S, et al.  The burden of fatal and non-fatal injury in rural India. Inj Prev. 2008; 14:4:232237.
    [Google Scholar]
  22. Navaratne KV, Fonseka P, Rajapakshe L, Somatunga L, Ameratunga S, Ivers R, et al.  Population based estimates of injuries in Sri Lanka. Inj Prev. 2009; 15:3:170175.
    [Google Scholar]
  23. Stewart KA, Groen RS, Kamara TB, Farahzad MM, Samai M, Cassidy LD, et al.  Traumatic injuries in developing countries: report from a nationwide cross-sectional survey of Sierra Leone. JAMA Surg. 2013; 148:5:463469.
    [Google Scholar]
  24. El Tayeb SE, Abdalla S, Mørkve O, Heuch I, Van den Bergh G. Injuries in Khartoum state, the Sudan: a household survey of incidence and risk factors. Int J Inj Control Saf Promot. 2014; 21:2:144153.
    [Google Scholar]
  25. Petroze RT, Joharifard S, Groen RS, Niyonkuru F, Ntaganda E, Kushner AL, et al.  Injury, disability and access to care in Rwanda: results of a nationwide cross-sectional population study. World J Surg. 2015; 39:1:6269.
    [Google Scholar]
  26. Haagsma JA, Graetz N, Bolliger I, Naghavi M, Higashi H, Mullany EC, et al.  The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013. Inj Prev. 2016; 22:1:318.
    [Google Scholar]
  27. Mahran DG, Farouk O, Qayed MH, Berraud A. Pattern and trend of injuries among Trauma Unit Attendants in Upper Egypt. Trauma Mon. 2016; 21:2:e20967.
    [Google Scholar]
  28. Khaji A, Ghodsi SM, Eftekhar B, Karbakhsh M. Trauma research in Iran: a report of the Sina trauma data bank. Arch Iran Med. 2010; 13:1:1720.
    [Google Scholar]
  29. Leidman E, Maliniak M, Sultan AS, Hassan A, Hussain SJ, Bilukha OO. Road traffic fatalities in selected governorates of Iraq from 2010 to 2013: prospective surveillance. Confl Health. 2016; 10:2:2.
    [Google Scholar]
  30. World Health Organization. Global status report on road safety [Internet]. Geneva: Switzerland: World Health Organization 2015.
  31. World Health Organization. Violence and injury prevention/road safety status. Ctry Profiles, Iraq [Internet]. Geneva: Switzerland: World Health Organization 2018.
  32. Stewart BT, Lafta R, Cherewick M, Esa Al Shatari SA, Flaxman AD, Hagopian A, et al.  Road traffic injuries in Baghdad from 2003 to 2014: results of a randomised household cluster survey. Inj Prev. 2016; 22:5:321327.
    [Google Scholar]
  33. Bener A, Abdul Rahman YS, Abdel Aleem EY, Khalid MK. Trends and characteristics of injuries in the State of Qatar: hospital-based study. Int J Inj Control Saf Promot. 2012; 19:4:368372.
    [Google Scholar]
  34. Stewart BT, Lafta R, Esa Al Shatari SA, Cherewick M, Flaxman A, Hagopian A, et al.  Fall injuries in Baghdād from 2003 to 2014: results of a randomized household cluster survey. Injury. 2016; 47:1:244249.
    [Google Scholar]
  35. Rybarczyk MM, Schafer JM, Elm CM, Sarvepalli S, Vaswani PA, Balhara KS, et al.  A systematic review of burn injuries in low- and middle-income countries: epidemiology in the WHO-defined African Region. Afr J Emerg Med. 2017; 7:1:3037.
    [Google Scholar]
  36. Othman N, Kendrick D. Epidemiology of burn injuries in the east Mediterranean Region: a systematic review. BMC Public Health. 2010; 10::83.
    [Google Scholar]
  37. Stewart B, Lafta RK, Al Shatari SA, Cherewick M, Burnham G, Hagopian A, et al.  Burns in Baghda¯d from 2003-2014: results of a randomized household cluster survey. Burns J Int Soc Burn Inj. 2016; 42:1:4855.
    [Google Scholar]
  38. Lafta R, Aflouk NA, Dhiaa S, Lyles E, Burnham G. Needs of internally displaced women and children in Baghdad. Karbala, and Kirkuk, Iraq. Plos Curr. 2016;8.
    [Google Scholar]
  39. Bataineh ZA, Al Quran TM, Al Balas H, Khammash MR. Pattern of burn injury at north of Jordan. Int J Burns Trauma. 2018; 8:1:15.
    [Google Scholar]
  40. Golshan A, Patel C, Hyder AA. A systematic review of the epidemiology of unintentional burn injuries in South Asia. J Public Health. 2013; 35:3:384396.
    [Google Scholar]
  41. World Health Organization. Conflict and humanitarian crisis in Iraq. Public health risk assessment and interventions [Internet]. Geneva: Switzerland, World Health Organization; 2014. Available from: http://who.int/hac/crises/irq/iraq_phra_24october2014.pdf .
  42. Human Rights Watch. Escapees describe systematic rape. Yezidi survivors in need of urgent Care 2015. Iraq: institute of strategic and international studies [Internet]. Available from: https://www.hrw.org/news/2015/04/14/iraq-isis-escapees-describe-systematic-rape.
http://instance.metastore.ingenta.com/content/journals/10.5339/qmj.2019.14
Loading
/content/journals/10.5339/qmj.2019.14
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): accidents , conflict , injuries , Iraq and trend
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error