Violence and mortality in West Darfur, Sudan (2003–04): epidemiological evidence from four surveys

Depoortere, Evelyn; Checchi, Francesco; Gerstl, Sibylle; Minetti, Andrea; Gayraud, Olivia; Briet, Virginie; Pahl, Jennifer; Defourny, Isabelle; Tatay, Mercedes; Brown, Vincent

doi:10.1016/s0140-6736(04)17187-0

Cited by 103 publications

(71 citation statements)

References 11 publications

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“…Their rapid transit to a more stable home environment probably led to their enjoying better conditions upon arrival than other IDPs in Africa. 15,17,[19][20][21][22][23] Mortality among adult IDPs was elevated compared with that of resident adults in 2008. While children are usually the most vulnerable group in complex emergencies in Africa, increased non-violence-related mortality among adults has been observed before during crises in more developed countries, such as Kosovo, where people with chronic diseases often go untreated due to lack of access to care.…”

Section: Discussionmentioning

confidence: 99%

“…15,17,19 To our knowledge, there has been no such finding in conflict situations in Africa, where most excess adult mortality is related to violence or acute infections rather than to chronic illnesses. 15,[19][20][21][22] Rates of HIV infection among IDPs and refugees in Africa can be high, although not necessarily higher than in the communities of origin [24][25][26][27][28] . In our analysis, the majority of adult IDP deaths were ascribed to HIV infection, which accounted for a larger proportion of deaths among IDPs than among DSS residents.…”

Section: Discussionmentioning

confidence: 99%

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Mortality and health among internally displaced persons in western Kenya following post-election violence, 2008: novel use of demographic surveillance

Feikin

Adazu

Obor

et al. 2010

Bull. World Health Organ.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Mortality and health among internally displaced persons in western Kenya following post-election violence, 2008: novel use of demographic surveillance

Feikin

Adazu

Obor

et al. 2010

Bull. World Health Organ.

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“…Spiegel & Salama, 2000;Depoortere et al, 2004;Coghlan et al, 2006). Cluster sampling offers substantial benefits relative to surveying alternatives such as simple random sampling (see Thompson, 2002, for an overview).…”

Section: Appendix a Cluster Sampling And The Epi Methodsmentioning

confidence: 99%

“…Spiegel & Salama, 2000;Depoortere et al, 2004;Coghlan et al, 2006). The experimental properties of this method, originally designed to measure vaccination coverage, are poorly understood at present.…”

Section: Appendix a Cluster Sampling And The Epi Methodsmentioning

confidence: 99%

“…As described by the Expanded Program on Immunization (EPI) sampling methodology (e.g. Spiegel & Salama, 2000;Depoortere et al, 2004;Coghlan et al, 2006), these studies often initiate the sampling process from some easily accessible geographical feature, such as the centre of a village, in order to economize resources and ensure staff safety. The stated procedures in Burnham et al (2006) call for selecting a 'constituent administrative unit' and then selecting a main street from 'a list of all main streets.…”

Section: Introductionmentioning

confidence: 99%

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Bias in Epidemiological Studies of Conflict Mortality

Johnson

Spagat

Gourley

et al. 2008

Journal of Peace Research

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Cluster sampling has recently been used to estimate the mortality in various conflicts around the world. The Burnham et al. study on Iraq employs a new variant of this cluster sampling methodology. The stated methodology of Burnham et al. is to (1) select a random main street, (2) choose a random cross street to this main street, and (3) select a random household on the cross street to start the process. The authors show that this new variant of the cluster sampling methodology can introduce an unexpected, yet substantial, bias into the resulting estimates, as such streets are a natural habitat for patrols, convoys, police stations, roadblocks, cafes, and street-markets. This bias comes about because the residents of households on cross-streets to the main streets are more likely to be exposed to violence than those living further away. Here, the authors develop a mathematical model to gauge the size of the bias and use the existing evidence to propose values for the parameters that underlie the model. The research suggests that the Burnham et al. study of conflict mortality in Iraq may represent a substantial overestimate of mortality. Indeed, the recently published Iraq Family Health Survey covered virtually the same time period as the Burnham et al. study, used census-based sampling techniques, and produced a central estimate for violent deaths that was one fourth of the Burnham et al. estimate. The authors provide a sensitivity analysis to help readers to tune their own judgements on the extent of this bias by varying the parameter values. Future progress on this subject would benefit from the release of high-resolution data by the authors of the Burnham et al. study.

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Association of Exposure to Violence and Potential Traumatic Events With Self-reported Physical and Mental Health Status in the Central African Republic

Vinck¹

2010

JAMA

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Context For decades, the Central African Republic (CAR) has experienced violence, economic stagnation, and institutional failure. The latest wave of violence erupted in 2001 and continues to this day in some areas. Yet there has been little attention to the conflict and even less research to document and quantify the conflict's human cost. Objective To study levels of violence in CAR, including mortality levels, and the association between exposure to violence and traumatic events with self-reported physical and mental health status. Design, Setting, and Participants Multistage stratified cluster random survey of 1879 adults 18 years or older in selected households conducted in 5 administrative units of CAR (3 in the south, which has been free from recent violence, and 2 in the north, in which violence continues) between October and December 2009. Main Outcome Measures Mortality, morbidity, exposure to potential traumatic events, sense of insecurity, and meeting of symptom criteria for depression and anxiety using the Hopkins Symptom Checklist-25 with a cutoff score of 1.75. Results The crude mortality rate (CMR) was 4.9 deaths (95% confidence interval [CI], 4.6-5.1) per 1000 population per month and self-reported CMR due to violence was 0.8 deaths (95% CI, 0.6-1.0) per 1000 population per month. Thirty-five percent reported their physical health status as being good or very good while 29% described it as bad or very bad. Respondents in northern prefectures reported higher rates of mortality, exposure to trauma, and insecurity and lower levels of physical health and access to health services compared with those in the south. The estimated prevalences of symptoms of depression and anxiety were 55.3% (95% CI, 51.6%-59.0%) and 52.5% (95% CI, 48.1%-56.8%), respectively. Exposure to violence and self-reported physical health were statistically associated with mental health outcomes (PϽ.001). Anxiety symptom scores were higher for respondents in the northern prefectures than those in the south (t=2.54, P=.01). Conclusion A high proportion of adult respondents in CAR reported witnessing or having personally experienced traumatic events over the course of the conflicts, and more than half met symptom criteria for depression and anxiety.

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Violence and mortality in West Darfur, Sudan (2003–04): epidemiological evidence from four surveys

Cited by 103 publications

References 11 publications

Mortality and health among internally displaced persons in western Kenya following post-election violence, 2008: novel use of demographic surveillance

Mortality and health among internally displaced persons in western Kenya following post-election violence, 2008: novel use of demographic surveillance

Bias in Epidemiological Studies of Conflict Mortality

Association of Exposure to Violence and Potential Traumatic Events With Self-reported Physical and Mental Health Status in the Central African Republic

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