Haileselassie Mekonnen, Kahsay Hayelom, Teklemariam Tesfay, Gebretsadik Ataklti, Gessesse Ataklti, Desta Abraham Aregay, Kebede Haftamu, Mamo Nega, Negash Degnesh, Bahresilassie Mengish, Esayas Rieye, Haile Amanuel, Gebreegziabiher Gebremedhin, Kahsay Amaha, Gebregergs Gebremedhin Berhe, Amare Hagos, Mulugeta Afework
Tigray Health Research Institute, Tigray, Ethiopia.
Tigray Regional Health Bureau, Tigray, Ethiopia.
BMC Public Health. 2024 Dec 18;24(1):3413. doi: 10.1186/s12889-024-20932-9.
People in war-affected areas are more likely to experience excess mortality with hunger. However, information on the causes of death associated with hunger is often nonexistent. The purpose of this study was to verify and investigate hunger and hunger-related deaths after the Pretoria deal in Tigray, northern Ethiopia.
A cross-sectional study was conducted in nine districts and 53 IDP sites, which were randomly selected. All households with deceased family members were included and screened for perceived causes of death between November 2, 2022, and August 30, 2023. Suspected starvation deaths were further verified by the WHO-adapted verbal autopsy questionnaire to establish cause-specific mortality. Using a standardized cause-of-death list, three physicians assigned the causes of death, and disagreements over-diagnoses were settled by consensus. The Food and Nutrition Technical Assistance guidelines were also used to quantify household hunger status.
Verbal autopsies were conducted for 72.2% (1946/2694) of deaths. Of these deaths, 201 (7.5%) in under-five children and 1205 (44.7%) in females were recorded. Deaths increased from 8.6% in March to 16.4% in July. A total of 90.6% of deaths occurred at home. Starvation was the predominant cause of death across all ages (49.3%, n = 1329). About 94/155 (60.3%) in the IDP center and 1235/2539 (48.6%) in the community died due to starvation. Children under five had a higher risk of starvation-related deaths (OR = 1.7; 95% CI: 1.22-2.34). Females were also more likely to die by starvation than males. Large proportions of households (60.1%) had moderate or severe hunger.
Starvation was the leading cause of death across all ages in the study group. This reflects an expedited humanitarian response from aid agencies to prevent more deaths. Interventions, including the return of the displaced communities to their original homes, are needed to rescue those facing moderate to severe hunger.
受战争影响地区的人们因饥饿而面临更高的超额死亡率。然而，与饥饿相关的死亡原因信息往往并不存在。本研究的目的是核实和调查埃塞俄比亚北部提格雷地区达成比勒陀利亚协议后的饥饿及与饥饿相关的死亡情况。
在九个区和53个境内流离失所者安置点开展了一项横断面研究，这些地点是随机选取的。纳入所有有家庭成员死亡的家庭，并在2022年11月2日至2023年8月30日期间筛查死亡的可能原因。疑似饥饿死亡病例通过世界卫生组织改编的死因推断问卷进一步核实，以确定具体死因的死亡率。使用标准化的死亡原因清单，三名医生确定死亡原因，诊断分歧通过协商解决。还采用了食品和营养技术援助指南来量化家庭饥饿状况。
对72.2%（1946/2694）的死亡病例进行了死因推断。在这些死亡病例中，记录了5岁以下儿童死亡201例（7.5%），女性死亡1205例（44.7%）。死亡人数从3月的8.6%增至7月的16.4%。总共90.6%的死亡发生在家中。饥饿是所有年龄段死亡的主要原因（49.3%，n = 1329）。境内流离失所者安置中心约94/155（60.3%）的人以及社区1235/2539（48.6%）的人死于饥饿。5岁以下儿童饥饿相关死亡风险更高（比值比=1.7；95%置信区间：1.22 - 2.34）。女性因饥饿死亡的可能性也高于男性。很大比例的家庭（60.1%）存在中度或重度饥饿。
饥饿是研究组所有年龄段死亡的主要原因。这反映出援助机构加快了人道主义应对措施以防止更多人死亡。需要采取干预措施，包括让流离失所社区返回家园，以救助面临中度至重度饥饿的人群。
