Details:

Alternative Title:
Prehosp Disaster Med
Personal Author:
Nerlander, Maximilian P. ; Leidman, Eva ; Hassan, Ahmed ; Sultan, Abdul-Salam Saleh ; Hussain, Syed Jaffar ; ... More +
Nerlander, Maximilian P. ; Leidman, Eva ; Hassan, Ahmed ; Sultan, Abdul-Salam Saleh ; Hussain, Syed Jaffar ; Browne, Lauren B. ; Bilukha, Oleg O. Less -
Description:
Background

In Iraq, where Islamic State of Iraq and Syria (ISIS) and other groups have contributed to escalating violence in recent years, understanding the epidemiology of intentional firearm-related fatalities is essential for public health action.

Methods

The Iraqi Ministry of Health (MoH; Baghdad, Iraq) compiles surveillance of fatal injuries in eight of Iraq's 18 governorates (Baghdad, Al-Anbar, Basrah, Erbil, Kerbala, Maysan, Ninevah, and Al-Sulaimaniya). Information is collected from coroner's reports and interviews with family members. Analysis was performed on intentional firearm-related injuries, excluding injuries from intentional self-harm or negligent discharges, that occurred during 2010-2013, a subset of all fatal injuries, and compared to previously published explosive-related fatalities.

Results

Overall, the dataset included 7,985 firearm-related fatalities. Yearly fatalities were: 2010 = 1,706; 2011 = 1,642; 2012 = 1,662; and 2013 = 2,975. Among fatalities, 86.0% were men and 13.7% women; 83.4% were adults and 6.2% children <18 years of age. Where age and sex were both known, men aged 20-39 years accounted for 56.3% of fatalities. Three “high-burden” governorates had the highest fatality rate per 100,000 population—Baghdad (12.9), Ninevah (17.0), and Al-Anbar (14.6)—accounting for 85.9% of fatalities recorded in the eight governorates. Most fatalities occurred in the street (56.3%), followed by workplace (12.2%), home (11.3%), and farm/countryside (8.4%). Comparing the ratio of firearm-related fatalities to explosives-related fatalities revealed an overall ratio of 2.8:1. The ratio in Baghdad more than doubled from 2.9 in 2010 to 6.1 in 2013; the highest ratios were seen outside the high-burden governorates.

Conclusions

Firearm-related fatalities remained relatively stable throughout 2010-2012, and almost doubled in 2013, correlating with increased ISIS activity. Three governorates contributed the majority of fatalities and experienced the highest fatality rates; these saw high levels of conflict. Firearm-related fatalities disproportionately affected younger men, who historically are over-represented as victims and perpetrators of violence. More than one-half of fatalities occurred in the street, indicating this as a common environment for conflict involving firearms. Firearms appear to account for more fatalities in Iraq than explosives and largely accounted for escalating violence in Baghdad during the study period. The high ratio observed outside the high-burden governorates is reflective of very low numbers of explosives-related fatalities; thus, violence in these governorates is likely non-conflict-related. These observations provide valuable public health information for targeted intervention to prevent violence.


Subjects:
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Adolescent Adult Age Factors Article Child Fatal Outcome Female Firearms Humans Iraq Male Mortality Public Health Surveillance Population Surveillance Sex Factors Violence Wounds, Gunshot Wounds/injuries Young Adult
Source:
Prehosp Disaster Med. 32(5):548-555.
Pubmed ID:
28516826
Pubmed Central ID:
PMC5620119
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:713ac829dff648a385d75a5b76a2bcddd369cc90e9d45992e7253afe4c77d98e
Download URL:
https://stacks.cdc.gov/view/cdc/48448/cdc_48448_DS1.pdf
File Type:

Supporting Files

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