| Titre : | Population-based survey methods to quantify associations between human rights violations and health outcomes among internally displaced persons in eastern Burma. (2007) |
| Auteurs : | Luke-C MULLANY ; Chris BEYRER ; Catherine-I LEE ; Thomas-J LEE ; Mahn MAHN ; Cynthia MAUNG ; RICHARDS (Adam-K) : USA. Department of Family & Social Medicine. Montefiore Medical Center. Albert Einstein College of Medicine. Bronx. NY. ; Voravit SUWANVANICHKIJ ; Backpack Health Worker Team. Mae Sot Tak. THA ; Center for Public Health and Human Rights. Bloomberg School of Public Health. Baltimore. MD. USA ; Global Health Access Program. Mae Sot Tak. THA |
| Type de document : | Article |
| Dans : | Journal of epidemiology and community health (vol. 61, n° 10, 2007) |
| Pagination : | 908-914 |
| Langues: | Anglais |
| Mots-clés : | Population ; Méthodologie ; Méthode ; Association ; Pronostic ; Evolution ; Migrant ; Homme ; Asie ; Birmanie ; Droits fondamentaux |
| Résumé : | [BDSP. Notice produite par INIST-CNRS YTR0xlRV. Diffusion soumise à autorisation]. Background : Case reports of human rights violations have focused on individuals'experiences. Population-based quantification of associations between rights indicators and health outcomes is rare and has not been documented in eastern Burma. Objective : We describe the association between mortality and morbidity and the household-level experience of human rights violations among internally displaced persons in eastern Burma. Methods : Mobile health workers in conflict zones of eastern Burma conducted 1834 retrospective household surveys in 2004. Workers recorded data on vital events, mid-upper arm circumference of young children, malaria parasitaemia status of respondents and household experience of various human rights violations during the previous 12 months. Results : Under-5 mortality was 218 (95% confidence interval 135 to 301) per 1000 live births. Almost one-third of households reported forced labour (32.6%). Forced displacement (8.9% of households) was associated with increased child mortality (odds ratio=2.80), child malnutrition (odds ratio=3.22) and landmine injury (odds ratio=3.89). Theft or destruction of the food supply (reported by 25.2% of households) was associated with increased crude mortality (odds ratio=1.58), malaria parasitaemia (odds ratio=1.82), child malnutrition (odds ratio=1.94) and landmine injury (odds ratio=4.55). Multiple rights violations (14.4% of households) increased the risk of child (incidence rate ratio=2.18) and crude (incidence rate ratio=1.75) mortality and the odds of landmine injury (odds ratio=19.8). Child mortality risk was increased more than fivefold (incidence rate ratio=5.23) among families reporting three or more rights violations. Conclusions : Widespread human rights violations in conflict zones in eastern Burma are associated with significantly increased morbidity and mortality. Population-level associations can be quantified using standard epidemiological methods. This approach requires further validation and refinement elsewhere. |
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