| Titre : | Mortality patterns during a war in Guinea-Bissau 1998-99 : changes in risk factors ? Commentary. (2006) |
| Auteurs : | Jens NIELSEN ; Peter Aaby ; Per-Kragh ANDERSEN ; GARFIELD (Richard) / disc. : USA. Columbia University. New York. NY. ; Henrik JENSEN ; Statens Serum Institut. Danish Epidemiology Science Centre. DNK ; University of Copenhagen. Department of Biostatistics. DNK |
| Type de document : | Article |
| Dans : | International journal of epidemiology (vol. 35, n° 2, 2006) |
| Pagination : | 438-446 |
| Langues: | Anglais |
| Mots-clés : | Mortalité ; Guerre ; Facteur risque ; Epidémiologie ; Guinée Bissau ; Afrique ; Homme |
| Résumé : | [BDSP. Notice produite par INIST-CNRS R0xxlVt2. Diffusion soumise à autorisation]. Background : The crude mortality rate of the whole population and the mortality of children<5 years of age are the common indicators of the severity of a complex emergency situation. However, these indicators rarely take account of differences in socioeconomic conditions and vulnerability. Methods : We followed a population in Guinea-Bissau, which fled when fighting took place in the capital during the war in 1998-99. The population stayed close to the area of conflict and returned as soon as a cease-fire was negotiated. A peace treaty was signed after half-a-year. The following 6 months was a period of returning and re-settlement, even though two outbreaks of fighting occurred. Results In the first half-year the mortality rate was 78% [mortality ratio (MR)=1.78 ; 95% CI 1.61-1.97] increased and mortality for children<5 years of age doubled (MR=2.07 ; 95% CI 1.79-2.38). In the last 6 months of the war, mortality was slightly increased for children and not at all for the total population. In the first half-year, households living in better houses and having members with schooling were less affected. In the're-settlement'period two inequalities emerged ; the largest ethnic group, Pepel, continued to have high mortality when the mortality of other groups declined ; likewise girls continued to have an elevated mortality whereas mortality of boys declined. Conclusion : Whereas specific'free'interventions reduced social inequalities for the groups affected, for the total population health-inequalities were slightly amplified during the war. Once the population returned to their urban homes, mortality fell to pre-war levels even though some fighting continued, limited humanitarian aid was available and the pre-war infra-structure had not been re-established. |
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