(1/280) Effect of type and transfer of conventional weapons on civilian injuries: retrospective analysis of prospective data from Red Cross hospitals.

OBJECTIVE: To examine the link between different weapons used in modern wars and their potential to injury civilians. DESIGN: Retrospective analysis of prospectively collected data about hospital admissions. SETTING: Hospitals of the International Committee of the Red Cross. SUBJECTS: 18 877 people wounded by bullets, fragmentation munitions, or mines. Of these, 2012 had been admitted to the hospital in Kabul within six hours of injury. MAIN OUTCOME MEASURES: Age and sex of wounded people according to cause of injury and whether they were civilians (women and girls, boys under 16 years old, or men of 50 or more). RESULTS: 18.7% of those injured by bullets, 34.1% of those injured by fragments, and 30.8% of those injured by mines were civilians. Of those admitted to the Red Cross hospital in Kabul within six hours of injury, 39.1% of those injured by bullets, 60.6% of those injured by fragments, and 55.0% of those injured by mines were civilians. CONCLUSIONS: The proportion of civilians injured differs between weapon systems. The higher proportion injured by fragments and mines is explicable in terms of the military efficiency of weapons, the distance between user and victim, and the effect that the kind of weapon has on the psychology of the user.  (+info)

(2/280) 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.  (+info)

(3/280) Outbreak of poliomyelitis--Kunduz, Afghanistan, 1999.

Since May 10, 1999, 26 cases of acute flaccid paralysis (AFP), including five cases with isolation of wild poliovirus type 1 and one with type 3, have been reported from Kunduz province in northern Afghanistan. Fifteen (54%) case-patients resided in Kunduz city, and the remaining patients resided in the districts surrounding Kunduz. Although the exact causes for the outbreak are not known, the discontinuation of polio vaccination activities in mid-1997 in northern Afghanistan because of ongoing civil conflict may have facilitated the outbreak.  (+info)

(4/280) Progress toward poliomyelitis eradication--Afghanistan, 1994-1999.

In 1988, the World Health Assembly adopted a resolution to eradicate poliomyelitis globally by 2000. During the same year, the Regional Committee, Eastern Mediterranean Region (EMR) of the World Health Organization (WHO) resolved to eradicate polio from the region by 2000. Substantial progress in reaching this goal has been made globally and in countries of EMR. This report describes the current status of polio eradication in Afghanistan, a country in EMR with ongoing civil conflict where eradication efforts began in late 1994.  (+info)

(5/280) Eradication of poliomyelitis in countries affected by conflict.

The global initiative to eradicate poliomyelitis is focusing on a small number of countries in Africa (Angola, Democratic Republic of the Congo, Liberia, Sierra Leone, Somalia, Sudan) and Asia (Afghanistan, Tajikistan), where progress has been hindered by armed conflict. In these countries the disintegration of health systems and difficulties of access are major obstacles to the immunization and surveillance strategies necessary for polio eradication. In such circumstances, eradication requires special endeavours, such as the negotiation of ceasefires and truces and the winning of increased direct involvement by communities. Transmission of poliovirus was interrupted during conflicts in Cambodia, Colombia, El Salvador, Peru, the Philippines, and Sri Lanka. Efforts to achieve eradication in areas of conflict have led to extra health benefits: equity in access to immunization, brought about because every child has to be reached; the revitalization and strengthening of routine immunization services through additional externally provided resources; and the establishment of disease surveillance systems. The goal of polio eradication by the end of 2000 remains attainable if supplementary immunization and surveillance can be accelerated in countries affected by conflict.  (+info)

(6/280) Mine blast injuries: ocular and social aspects.

BACKGROUND/AIMS: Landmines have long been used in conventional warfare. These are antipersonnel mines which continue to injure people long after a ceasefire without differentiating between friend or foe, soldier or civilian, women or children. This study focuses on Afghan non-combatants engaged in mine clearing operations in Afghanistan in the aftermath of the Russo-Afghan war. The patterns and types of injuries seen are described and experiences in their management, ways, and means to prevent them, and recommendations for the rehabilitation of the affected individuals are given. METHODS: It is a retrospective and analytical study of 84 patients aged 19-56 years who sustained mine blast injuries during mine clearing operations in Afghanistan from November 1992 to January 1996. The study was carried out at a military hospital with tertiary care facilities. The patients were divided into three groups on the basis of their injuries. Group 1 required only general surgical attention, group 2 sustained only ocular injuries, while group 3 had combined ocular and general injuries. Patients in groups 2 and 3 were treated in two phases. The first phase aimed at immediate restoration of the anatomy, while restoration of function wherever possible was done in subsequent surgical procedures in the second phase. RESULTS: It was observed that 51 out of 84 patients (60.7%) had sustained ocular trauma of a variable degree as a result of the blasts. The mean age of the victims was 29 years and they were all male. A total of 91 eyes of 51 patients (89.2%) had been damaged. Bilaterality of damage was seen in 40 (78.4%) patients. Most, 34 (37.3%), eyes became totally blind (NPL). Only a few escaped with injury mild enough not to impair vision. Foreign bodies, small and multiple, were found in the majority of eyes; most, however, were found in the anterior segment, and posterior segment injuries were proportionally less. CONCLUSIONS: The prevalence of blindness caused by mine blast injuries is quite high. The resulting psychosocial trauma to the patients and their families is tremendous and has not been adequately highlighted. These injuries are a great drain on the country's resources. Enforcement of preventive measures and the use of protective gear and sophisticated equipment by the mine clearing personnel would prove to be far more economical in terms of human life as well as medical and economic resources. There is also need for greater attention towards the establishment of support groups and rehabilitation programmes for these individuals.  (+info)

(7/280) Heterogeneous geographic patterns of nucleotide sequence diversity between two alcohol dehydrogenase genes in wild barley (Hordeum vulgare subspecies spontaneum).

Patterns of nucleotide sequence diversity in the predominantly self-fertilizing species Hordeum vulgare subspecies spontaneum (wild barley) are compared between the putative alcohol dehydrogenase 3 locus (denoted "adh3") and alcohol dehydrogenase 1 (adh1), two related but unlinked loci. The data consist of a sequence sample of 1,873 bp of "adh3" drawn from 25 accessions that span the species range. There were 104 polymorphic sites in the sequenced region of "adh3." The data reveal a strong geographic pattern of diversity at "adh3" despite geographic uniformity at adh1. Moreover, levels of nucleotide sequence diversity differ by nearly an order of magnitude between the two loci. Genealogical analysis resolved two distinct clusters of "adh3" alleles (dimorphic sequence types) that coalesce roughly 3 million years ago. One type consists of accessions from the Middle East, and the other consists of accessions predominantly from the Near East. The two "adh3" sequence types are characterized by a high level of differentiation between clusters ( approximately 2.2%), which induces an overall excess of intermediate frequency variants in the pooled sample. Finally, there is evidence of intralocus recombination in the "adh3" data, despite the high level of self-fertilization characteristic of wild barley.  (+info)

(8/280) Progress toward poliomyelitis eradication--Afghanistan, 1999-2000.

In 1988, the World Health Assembly of the World Health Organization (WHO) resolved to eradicate poliomyelitis globally by 2000. During the same year, the Eastern Mediterranean Region (EMR) of WHO passed a resolution to join the global initiative. Since then, substantial progress has been made worldwide and in EMR member countries. Afghanistan, with ongoing civil conflict, initiated polio eradication activities in 1994. Since then, a countrywide surveillance system for acute flaccid paralysis (AFP) was established and National Immunization Days (NIDs) were implemented. This report summarizes the achievements toward polio eradication in Afghanistan during 1999-2000.  (+info)