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冲突时期(2003 - 2016年)伊拉克的事故

Accidents in Iraq during the period of conflict (2003-2016).

作者信息

Hussain Ashraf Ma, Lafta Riyadh K

机构信息

Department of Family and Community Medicine, College of Medicine, University of Babylon, Babil, Iraq.

Department of Family and Community Medicine, College of Medicine, Mustansiriya University, Baghdad, Iraq; Global Health Department, University of Washington, Seattle, USA.

出版信息

Qatar Med J. 2019 Dec 24;2019(3):14. doi: 10.5339/qmj.2019.14. eCollection 2019.

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 1 through to December 31, 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.

摘要

伤害日益被视为全球疾病负担的一个主要组成部分,因为它们主要影响年轻人,且通常会导致过早死亡或严重残疾。伊拉克长期的冲突导致了持续的暴力和动荡局势,这反过来又导致伤害发生率上升,卫生系统受损。描绘伊拉克在过去14年冲突期间(2003 - 2016年)平民中与冲突相关的非军事事故(道路交通事故[RTA]、跌倒、烧伤、火器伤、锐器袭击和性侵犯)的趋势。这项描述性研究于2017年1月1日至12月31日期间进行,使用了伊拉克卫生部已有的监测数据。该方法基于测量2003年至2016年期间每类事故的发生率,并将其随时间绘制图表。计算线性回归以估计疾病趋势。2003年至2016年期间,道路交通事故发生率显著上升,从每1000人1.85起增至2.9起(P≤0.01),意外跌倒尤其是2008年后(男性多于女性)也显著增加(P≤0.01)。相比之下,2011年达到峰值后,烧伤从每1000人4.19起显著降至3.42起,火器事故也从2007年的每1000人2.2起降至2016年的0.39起(P≤0.01),主要发生在男性中。锐器袭击也随时间下降至每1000人0.47起(P = 0.0001)。性侵犯随时间呈显著下降趋势,P = 0.037。事故仍然给已经恶化的伊拉克卫生系统增加负担。了解这一负担的影响对于更好地为未来可能有助于改善卫生服务质量的计划和干预措施做好准备至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b428/6929514/0d35443666eb/qmj-2019-014-g001.jpg

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