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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
3213.0: Monday, December 12, 2005 - 12:45 PM

Abstract #121117

Public health and conflict in the Democratic Republic of Congo – Sustained elevations of mortality after 6 years of war

Ben Coghlan, MBBS, MPH1, Richard Brennan, MBBS, MPH2, Pascal Ngoy, MD2, David Dafora, MD2, Brad Otto, BA1, Mark Clements, BSc, PhD3, and Tony Stewart, MBBS, MAppEpid1. (1) Centre for International Health, Burnet Institute, GPO Box 2284, Melbourne, VIC 3001, Australia, (2) International Rescue Committee, 122 East 42nd Street, New York, NY 10168, ++ 1-212-551-3019, irc@theirc.org, (3) The Australian National University, Building 62, National Centre for Epidemiology and Population Health, Canberra, ACT 0200, Australia

The war in Democratic Republic of the Congo (DRC) commenced in 1998. A series of mortality surveys has demonstrated that between 1998 and 2002, an estimated 3.3 million people have died, making it the world's most deadly conflict since World War II. The aims of this study were to determine the crude and under-5 mortality rates since January 2003, to identify trends in mortality, to assess for regional differences in mortality, and to estimate the total number of excess deaths since January 2003. Methods: DRC was divided into two strata along the 2001 line of military control: “east” and “west”. Each stratum was surveyed using a three-stage, household-based cluster sampling technique. Results: 19,500 households were visited. The national crude mortality rate (CMR) of 2.1 deaths/1,000/month (95%CI 1.6-2.6) is 40% higher than that reported for sub-Saharan Africa (1.5). This translates into more than 600,000 excess deaths over the recall period. The CMR in the East (2.4) was significantly higher than the West (1.8). The majority of deaths were due to easily preventable and treatable diseases. There was a significant association between violence and deaths from all causes. When combined with the results of three previous surveys, we estimate that 3.9 million people have died as a result of the Congolese conflict. Conclusion: Sustained elevations of mortality in DRC since 1998 have resulted in a death toll in excess of 3.9 million persons. Increased and sustained political and humanitarian interventions are required to reduce the human toll of this oft-forgotten conflict.

Learning Objectives:

Keywords: War, International Health

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

[ Recorded presentation ] Recorded presentation

War and Public Health

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA