Journal Article

Crippling Violence: Conflict and Incident Polio in Afghanistan

Curtis, Andrew, Bourdeaux, Margaret, Norris, Alison, Hachey, Kevin

2016

Overview

Designing effective public health campaigns in areas of armed conflict requires a nuanced understanding of how violence impacts the epidemiology of the disease in question. We examine the geographical relationship between violence (represented by the location of detonated Improvised Explosive Devices) and polio incidence by generating maps of IEDs and polio incidence during 2010, and by comparing the mean number of IED detonations in polio high-risk districts with non polio high-risk districts during 2004-2009. We demonstrate a geographic relationship between IED violence and incident polio. Districts that have high-risk for polio have highly statistically significantly greater mean numbers of IEDs than non polio high-risk districts (p-values 0.0010-0.0404). The geographic relationship between armed conflict and polio incidence provides valuable insights as to how to plan a vaccination campaign in violent contexts, and allows us to anticipate incident polio in the regions of armed conflict. Such information permits vaccination planners to engage interested armed combatants to co-develop strategies to mitigate the effects of violence on polio.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Afghanistan - epidemiology / Aggression / Biology and Life Sciences / Care and treatment / Complications and side effects / Conflict, Psychological / Detonation / Disabilities / Epidemics / Epidemiology / Explosive Agents / Explosive devices / Explosives / Geography / Health aspects / Health promotion / Humans / Incidence / Infectious diseases / Internet / Medicine / Medicine and Health Sciences / People and Places / Poliomyelitis / Poliomyelitis - epidemiology / Poliomyelitis - prevention & control / Poliovirus / Poliovirus Vaccines - immunology / Public health / Risk / Risk Factors / Vaccination / Vaccines / Violence