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  • 1.
    Mosleh, Marwan
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Dalal, Koustuv
    Örebro Univ, Örebro; Al Farabi Kazakh Natl Univ, Alma Ata, Kazakhstan.
    Aljeesh, Yousef
    Islamic Univ Gaza, Gaza Strip, Palestine.
    Svanström, Leif
    Karolinska Inst, Stockholm.
    The burden of war-injury in the Palestinian health care sector in Gaza Strip2018In: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 18, no 1, article id 28Article in journal (Refereed)
    Abstract [en]

    Background: War-related injury is a major public health concern, and a leading cause of mortality, morbidity, and disability globally, particularly in low and middle-income countries such as Palestine. Little is known about the burden of war-related injury in the Palestinian context. The objective of this study was to characterize the incidence and pattern of injuries, associated with war in Gaza Strip, from July 8 to August 26, 2014.

    Methods: This was a descriptive study based on an injury registry at hospital facilities in the Gaza Strip. A total of 420 victims records from 2014 Gaza war injuries were randomly selected, proportionate to the size of the study population estimated across five Gaza governorates. Simple descriptive statistics were calculated to explore the frequency and percentage distribution of study variables and injury data. A chi-square test (X-2) was used. The significance level was derived at p < 0.05. The data were analyzed by IBM SPSS software, version 23.

    Results: Males (75.5%) have experienced more war-related injuries than females (24.5%), constituting a male: female ratio of 3.1: 1. Almost half (49.5%) of the injured victims were of the age group 20-39, followed by children and adolescents (< 20 years), accounting for 31.4%. More than half of victims were single (53.6%), 44.3% were married and the rest were widowed or divorced. The overall number of injuries was 6.4 per 1000 population, though it varied among regions. North Gaza reported the highest number of injuries (9.0) and Rafah the lowest (4.7) per 1000 population. Blast and explosion were found to be the most common causes of war injuries (72.9%). The highest proportion of injuries were reported in the upper body. Multiple body shrapnel wounds and burns (39.3%) were most frequent. Other types of injuries were multiple organ injury (24.3%), fractures (13.6%), internal organ injury and bleeding (9.8%), amputation (4.5%), abrasions / lacerations and contusions (4.8%), vision or hearing loss or both (1.9%) and respiratory problems (1.9%). The highest percentage of injuries were classified as mild (46.9%), and the rest ranged from moderate-to-severe. Almost 26% of individuals had sustained disability, and most of them had physical/motor impairment.

    Conclusion: War-related injuries constitute a major problem to public health discipline and clinical medicine as well. A better surveillance system using ICD codes, and development of a comprehensive electronic data network are necessary to make future research easier and more timely.

  • 2.
    Yahaya, Ismael
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. London Sch Hyg & Trop Med, London WC1, England.
    Uthman, O
    Univ Liverpool, Liverpool Sch Trop Med, Int Hlth Grp, Liverpool L3 5QA, Merseyside, England.
    Soares, Joaquim
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Karolinska Inst, Dept Publ Hlth Fdn Sci, Div Social Med, Stockholm, Sweden.
    Macassa, Gloria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Karolinska Inst, Dept Publ Hlth Fdn Sci, Div Social Med, Stockholm, Sweden.
    Social disorganization and history of child sexual abuse against girls in Sub-Saharan Africa: A multilevel analysis2013In: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 13, no 33Article in journal (Refereed)
    Abstract [en]

    Background

    Child sexual abuse (CSA) is a considerable public health problem. Less focus has been paid to the role of community level factors associated with CSA. The aim of this study was to examine the association between neighbourhood-level measures of social disorganization and child sexual abuse CSA.

    Methods

    We applied multiple multilevel logistic regression analysis on Demographic and Health Survey data for 6,351 adolescents from six countries in sub-Saharan Africa between 2006 and 2008.

    Results

    The percentage of adolescents that had experienced CSA ranged from 1.04% to 5.84%. There was a significant variation in the odds of reporting CSA across the communities, suggesting 18% of the variation in CSA could be attributed to community level factors. Respondents currently employed were more likely to have reported CSA than those who were unemployed (odds ratio [OR] = 2.05, 95% confidence interval [CI] 1.48 to 2.83). Respondents from communities with a high family disruption rate were 57% more likely to have reported CSA (OR=1.57, 95% CI 1.14 to 2.16).

    Conclusion

    We found that exposure to CSA was associated with high community level of family disruption, thus suggesting that neighbourhoods may indeed have significant important effects on exposure to CSA. Further studies are needed to explore pathways that connect the individual and neighbourhood levels, that is, means through which deleterious neighbourhood effects are transmitted to individuals.

  • 3.
    Zacarias, AE
    et al.
    Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm SE-17176, Sweden.
    Macassa, Gloria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Svanström, L
    Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm SE-17176, Sweden.
    Soares, Joaquim J. F.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Antai, D
    Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm SE-17176, Sweden.
    Intimate partner violence against women in Maputo city, Mozambique2012In: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 12, no 1, p. Art. no. 35-Article in journal (Refereed)
    Abstract [en]

    Background

    There is limited research about IPV against women and associated factors in Sub-Saharan Africa, not least Mozambique. The objective of this study was to examine the occurrence, severity, chronicity and "predictors" of IPV against women in Maputo City (Mozambique).

    Methods

    Data were collected during a 12 month-period (consecutive cases, with each woman seen only once) from 1,442 women aged 15--49 years old seeking help for abuse by an intimate partner at the Forensic Services at the Maputo Central Hospital, Maputo City, Mozambique. Interviews were conducted by trained female interviewers, and data collected included demographics and lifestyle variables, violence (using the previously validated Revised Conflict Tactics Scale (CTS2), and control (using the Controlling Behaviour Scale Revised (CBS-R). The data were analysed using bivariate and multivariate methods.

    Results

    The overall experienced IPV during the past 12 months across severity (one or more types, minor and severe) was 70.2% (chronicity, 85.8 +/- 120.9).a Severe IPV varied between 26.3-45.9% and chronicity between 3.1 +/- 9.1-12.8 +/- 26.9, depending on IPV type. Severity and chronicity figures were higher in psychological aggression than in the other IPV types. Further, 26.8% (chronicity, 55.3 +/- 117.6) of women experienced all IPV types across severity. The experience of other composite IPV types across severity (4 combinations of 3 types of IPV) varied between 27.1-42.6% and chronicity between 35.7 +/- 80.3-64.9 +/- 110.9, depending on the type of combination. The combination psychological aggression, physical assault and sexual coercion had the highest figures compared with the other combinations.. The multiple regressions showed that controlling behaviours, own perpetration and co-occurring victimization were more important in "explaining" the experience of IPV than other variables (e.g. abuse as a child).

    Conclusions

    In our study, controlling behaviours over/by partner, own perpetration, co-occurring victimization and childhood abuse were more important factors in "explaining" sustained IPV. More investigation into women's IPV exposure and its "predictors" is warranted in Sub-Saharan Africa, particularly Mozambique.

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