Mortality in Iraq associated with the 2003-2011 war and occupation: findings from a national cluster sample survey by the university collaborative Iraq Mortality Study.

<h4>Background</h4>Previous estimates of mortality in Iraq attributable to the 2003 invasion have been heterogeneous and controversial, and none were produced after 2006. The purpose of this research was to estimate direct and indirect deaths attributable to the war in Iraq between 2003...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Amy Hagopian, Abraham D Flaxman, Tim K Takaro, Sahar A Esa Al Shatari, Julie Rajaratnam, Stan Becker, Alison Levin-Rector, Lindsay Galway, Berq J Hadi Al-Yasseri, William M Weiss, Christopher J Murray, Gilbert Burnham
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/8c18fe8a6b8b4e6c9de9d55c69c9ccea
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:8c18fe8a6b8b4e6c9de9d55c69c9ccea
record_format	dspace
spelling	oai:doaj.org-article:8c18fe8a6b8b4e6c9de9d55c69c9ccea2021-11-18T05:43:06ZMortality in Iraq associated with the 2003-2011 war and occupation: findings from a national cluster sample survey by the university collaborative Iraq Mortality Study.1549-12771549-167610.1371/journal.pmed.1001533https://doaj.org/article/8c18fe8a6b8b4e6c9de9d55c69c9ccea2013-10-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24143140/pdf/?tool=EBIhttps://doaj.org/toc/1549-1277https://doaj.org/toc/1549-1676<h4>Background</h4>Previous estimates of mortality in Iraq attributable to the 2003 invasion have been heterogeneous and controversial, and none were produced after 2006. The purpose of this research was to estimate direct and indirect deaths attributable to the war in Iraq between 2003 and 2011.<h4>Methods and findings</h4>We conducted a survey of 2,000 randomly selected households throughout Iraq, using a two-stage cluster sampling method to ensure the sample of households was nationally representative. We asked every household head about births and deaths since 2001, and all household adults about mortality among their siblings. We used secondary data sources to correct for out-migration. From March 1, 2003, to June 30, 2011, the crude death rate in Iraq was 4.55 per 1,000 person-years (95% uncertainty interval 3.74-5.27), more than 0.5 times higher than the death rate during the 26-mo period preceding the war, resulting in approximately 405,000 (95% uncertainty interval 48,000-751,000) excess deaths attributable to the conflict. Among adults, the risk of death rose 0.7 times higher for women and 2.9 times higher for men between the pre-war period (January 1, 2001, to February 28, 2003) and the peak of the war (2005-2006). We estimate that more than 60% of excess deaths were directly attributable to violence, with the rest associated with the collapse of infrastructure and other indirect, but war-related, causes. We used secondary sources to estimate rates of death among emigrants. Those estimates suggest we missed at least 55,000 deaths that would have been reported by households had the households remained behind in Iraq, but which instead had migrated away. Only 24 households refused to participate in the study. An additional five households were not interviewed because of hostile or threatening behavior, for a 98.55% response rate. The reliance on outdated census data and the long recall period required of participants are limitations of our study.<h4>Conclusions</h4>Beyond expected rates, most mortality increases in Iraq can be attributed to direct violence, but about a third are attributable to indirect causes (such as from failures of health, sanitation, transportation, communication, and other systems). Approximately a half million deaths in Iraq could be attributable to the war. Please see later in the article for the Editors' Summary.Amy HagopianAbraham D FlaxmanTim K TakaroSahar A Esa Al ShatariJulie RajaratnamStan BeckerAlison Levin-RectorLindsay GalwayBerq J Hadi Al-YasseriWilliam M WeissChristopher J MurrayGilbert BurnhamPublic Library of Science (PLoS)articleMedicineRENPLoS Medicine, Vol 10, Iss 10, p e1001533 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Amy Hagopian Abraham D Flaxman Tim K Takaro Sahar A Esa Al Shatari Julie Rajaratnam Stan Becker Alison Levin-Rector Lindsay Galway Berq J Hadi Al-Yasseri William M Weiss Christopher J Murray Gilbert Burnham Mortality in Iraq associated with the 2003-2011 war and occupation: findings from a national cluster sample survey by the university collaborative Iraq Mortality Study.
description	<h4>Background</h4>Previous estimates of mortality in Iraq attributable to the 2003 invasion have been heterogeneous and controversial, and none were produced after 2006. The purpose of this research was to estimate direct and indirect deaths attributable to the war in Iraq between 2003 and 2011.<h4>Methods and findings</h4>We conducted a survey of 2,000 randomly selected households throughout Iraq, using a two-stage cluster sampling method to ensure the sample of households was nationally representative. We asked every household head about births and deaths since 2001, and all household adults about mortality among their siblings. We used secondary data sources to correct for out-migration. From March 1, 2003, to June 30, 2011, the crude death rate in Iraq was 4.55 per 1,000 person-years (95% uncertainty interval 3.74-5.27), more than 0.5 times higher than the death rate during the 26-mo period preceding the war, resulting in approximately 405,000 (95% uncertainty interval 48,000-751,000) excess deaths attributable to the conflict. Among adults, the risk of death rose 0.7 times higher for women and 2.9 times higher for men between the pre-war period (January 1, 2001, to February 28, 2003) and the peak of the war (2005-2006). We estimate that more than 60% of excess deaths were directly attributable to violence, with the rest associated with the collapse of infrastructure and other indirect, but war-related, causes. We used secondary sources to estimate rates of death among emigrants. Those estimates suggest we missed at least 55,000 deaths that would have been reported by households had the households remained behind in Iraq, but which instead had migrated away. Only 24 households refused to participate in the study. An additional five households were not interviewed because of hostile or threatening behavior, for a 98.55% response rate. The reliance on outdated census data and the long recall period required of participants are limitations of our study.<h4>Conclusions</h4>Beyond expected rates, most mortality increases in Iraq can be attributed to direct violence, but about a third are attributable to indirect causes (such as from failures of health, sanitation, transportation, communication, and other systems). Approximately a half million deaths in Iraq could be attributable to the war. Please see later in the article for the Editors' Summary.
format	article
author	Amy Hagopian Abraham D Flaxman Tim K Takaro Sahar A Esa Al Shatari Julie Rajaratnam Stan Becker Alison Levin-Rector Lindsay Galway Berq J Hadi Al-Yasseri William M Weiss Christopher J Murray Gilbert Burnham
author_facet	Amy Hagopian Abraham D Flaxman Tim K Takaro Sahar A Esa Al Shatari Julie Rajaratnam Stan Becker Alison Levin-Rector Lindsay Galway Berq J Hadi Al-Yasseri William M Weiss Christopher J Murray Gilbert Burnham
author_sort	Amy Hagopian
title	Mortality in Iraq associated with the 2003-2011 war and occupation: findings from a national cluster sample survey by the university collaborative Iraq Mortality Study.
title_short	Mortality in Iraq associated with the 2003-2011 war and occupation: findings from a national cluster sample survey by the university collaborative Iraq Mortality Study.
title_full	Mortality in Iraq associated with the 2003-2011 war and occupation: findings from a national cluster sample survey by the university collaborative Iraq Mortality Study.
title_fullStr	Mortality in Iraq associated with the 2003-2011 war and occupation: findings from a national cluster sample survey by the university collaborative Iraq Mortality Study.
title_full_unstemmed	Mortality in Iraq associated with the 2003-2011 war and occupation: findings from a national cluster sample survey by the university collaborative Iraq Mortality Study.
title_sort	mortality in iraq associated with the 2003-2011 war and occupation: findings from a national cluster sample survey by the university collaborative iraq mortality study.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/8c18fe8a6b8b4e6c9de9d55c69c9ccea
work_keys_str_mv	AT amyhagopian mortalityiniraqassociatedwiththe20032011warandoccupationfindingsfromanationalclustersamplesurveybytheuniversitycollaborativeiraqmortalitystudy AT abrahamdflaxman mortalityiniraqassociatedwiththe20032011warandoccupationfindingsfromanationalclustersamplesurveybytheuniversitycollaborativeiraqmortalitystudy AT timktakaro mortalityiniraqassociatedwiththe20032011warandoccupationfindingsfromanationalclustersamplesurveybytheuniversitycollaborativeiraqmortalitystudy AT saharaesaalshatari mortalityiniraqassociatedwiththe20032011warandoccupationfindingsfromanationalclustersamplesurveybytheuniversitycollaborativeiraqmortalitystudy AT julierajaratnam mortalityiniraqassociatedwiththe20032011warandoccupationfindingsfromanationalclustersamplesurveybytheuniversitycollaborativeiraqmortalitystudy AT stanbecker mortalityiniraqassociatedwiththe20032011warandoccupationfindingsfromanationalclustersamplesurveybytheuniversitycollaborativeiraqmortalitystudy AT alisonlevinrector mortalityiniraqassociatedwiththe20032011warandoccupationfindingsfromanationalclustersamplesurveybytheuniversitycollaborativeiraqmortalitystudy AT lindsaygalway mortalityiniraqassociatedwiththe20032011warandoccupationfindingsfromanationalclustersamplesurveybytheuniversitycollaborativeiraqmortalitystudy AT berqjhadialyasseri mortalityiniraqassociatedwiththe20032011warandoccupationfindingsfromanationalclustersamplesurveybytheuniversitycollaborativeiraqmortalitystudy AT williammweiss mortalityiniraqassociatedwiththe20032011warandoccupationfindingsfromanationalclustersamplesurveybytheuniversitycollaborativeiraqmortalitystudy AT christopherjmurray mortalityiniraqassociatedwiththe20032011warandoccupationfindingsfromanationalclustersamplesurveybytheuniversitycollaborativeiraqmortalitystudy AT gilbertburnham mortalityiniraqassociatedwiththe20032011warandoccupationfindingsfromanationalclustersamplesurveybytheuniversitycollaborativeiraqmortalitystudy
_version_	1718424799149031424

Mortality in Iraq associated with the 2003-2011 war and occupation: findings from a national cluster sample survey by the university collaborative Iraq Mortality Study.

Ejemplares similares