The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #59220

Oleg O. Bilukha, MD, PhD, Muireann Brennan, MD, MPH, and Bradley A. Woodruff, MD, MPH. International Emergency and Refugee Health Branch, Centers for Disease Control, 4770 Buford Hwy, Mailstop F-48, Atlanta, GA 30341-3717, 770-488-7556, obb0@cdc.gov

Afghanistan is among the countries most affected by landmines and unexploded ordnance (UXO). Landmines/UXO injure or kill at least 1,200 Afghans per year. Surveillance of landmine/UXO injuries is critical to designing effective preventive and control programs. We evaluated surveillance of landmine/UXO injuries in Afghanistan. Clinic-based surveillance, which contributes about 90% of reported incidents, is operated by the International Committee of the Red Cross (ICRC). Non-clinic-based data come from community informants and mine-clearance teams. Data from both sources are compiled by the Mine Action Center for Afghanistan. The sensitivity of surveillance is low because only 390 (42%) of 828 health facilities likely to treat landmine/UXO victims submit reports. The case-fatality ratio of 9.4% is an underestimate because surveillance usually records those victims who survive long enough to reach health facilities. Different reporting agencies used different data-collection forms. However, the data that are submitted are of high quality (few missing or inconsistent data) and are collected in a timely fashion (75% of injuries are recorded within one week; 75% of records are entered into the database within 2 months). ICRC produces annual and semi-annual reports in a standardized format with little feedback from end-users (mine-clearance, mine-risk education, or victim assistance agencies), who report that programmatic use of the data is limited. Surveillance data should be summarized and reported to all interested partners on a regular basis in a format determined by end-users. Surveillance should expand its clinic-based and community-based components, use a uniform data reporting form, and improve data management and analysis.

Learning Objectives:

At the conclusion of the session, the participant in this session will be able to:
• Describe the main goals of surveillance system of landmine victims in emergencies
• List the three main programmatic areas in public health response to landmine problem
• Describe the major demographic characteristics of landmine victims in Afghanistan

Keywords: Landmines, Surveillance

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.