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

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

4045.0: Tuesday, November 18, 2003 - 8:30 AM

Abstract #59220

Surveillance of landmine victims during emergencies: Lessons learned from evaluation in Afghanistan

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,

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:

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.

Injury Surveillance

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