Incidence of weapon injuries not related to interfactional combat in Afghanistan in 1996: prospective cohort study.

OBJECTIVE

To examine the descriptive epidemiology of weapon injuries not directly attributable to combat during armed conflict.

DESIGN

Prospective cohort study.

SETTING

Nangarhar region of Afghanistan, which experienced effective peace, intense fighting, and then peace over six months in 1996.

SUBJECTS

608 people admitted to Jalalabad hospital because of weapon injuries.

MAIN OUTCOME MEASURES

Estimated incidence of injuries from combat or otherwise (non-combat injury) before, during, and after the fall of Kabul.

RESULTS

Incidence of non-combat injury was initially 65 per 100 000. During the intense military campaign for Kabul the incidence declined dramatically, and then differentially increased dependent on injury subcategory-that is, whether injuries were accidental or intentional and whether they were inflicted by firearms or fragmenting munitions. Non-combat injuries accounted for 51% of weapon injuries observed over the study period. Civilians were more likely to have non-combat injuries than combat injuries.

CONCLUSIONS

Weapon injuries that are not attributable to combat are common. Social changes accompanying conflict and widespread availability of weapons may be predictive of use of weapons that persists independently of conflict.