Abstract
BackgroundNepal is one of the post-conflict countries affected by violence from explosive devices. We undertook this study to assess the magnitude of injuries due to intentional explosions in Nepal during 2008-2011 and to describe time trends and epidemiologic patterns for these events.MethodsWe analyzed surveillance data on fatal and non-fatal injuries due to intentional explosions in Nepal that occurred between 1 January 2008 and 31 December 2011. The case definition included casualties injured or killed by explosive devices knowingly activated by an individual or a group of individuals with the intent to harm, hurt or terrorize. Data were collected through media-based and active community-based surveillance.ResultsAnalysis included 437 casualties injured or killed in 131 intentional explosion incidents. A decrease in the number of incidents and casualties between January 2008 and June 2009 was followed by a pronounced increase between July 2010 and June 2011. Eighty-four (19.2%) casualties were among females and 40 (9.2%) were among children under 18 years of age. Fifty-nine (45.3%) incidents involved one casualty, 47 (35.9%) involved 2 to 4 casualties, and 6 involved more than 10 casualties. The overall case-fatality ratio was 7.8%. The highest numbers of incidents occurred in streets or at crossroads, in victims’ homes, and in shops or markets. Incidents on buses and near stadiums claimed the highest numbers of casualties per incident. Socket, sutali, and pressure cooker bombs caused the highest numbers of incidents.ConclusionsIntentional explosion incidents still pose a threat to the civilian population of Nepal. Most incidents are caused by small homemade explosive devices and occur in public places, and males aged 20 to 39 account for a plurality of casualties. Stakeholders addressing the explosive device problem in Nepal should continue to use surveillance data to plan interventions.
Highlights
Nepal is one of the post-conflict countries affected by violence from explosive devices
341 (78.0%) injuries were among males and 84 (19.2%) were among females; the sex of 12 (2.7%) casualties was unknown. 286 (65.4%) casualties were adults, 40 (9.2%) were children, and the age of 111 casualties (25.4%) was unknown (Table 2)
Of 138 children injured in intentional explosions in Israel during a 15-month period in 2000-2001, 54% were injured in incidents on the road and 36% were injured in incidents in public or commercial buildings [12]
Summary
Nepal is one of the post-conflict countries affected by violence from explosive devices. Explosive devices continue to maim, kill, and terrorize civilian populations worldwide despite new and continuing efforts to prevent injury and assist victims, increasing attention from various global actors, and novel prohibitions and limitations in formal and customary humanitarian law [1]. Nepal is one among many post-conflict countries affected by violence from explosive devices. Persistent post-conflict explosive violence perpetrated with the intent to kill, maim, and terrorize is attributed to multiple factors, including political instability, proliferation of politically and criminally motivated armed groups, increased access to explosive devices, discrimination based on ethnicity and religion, poverty, unemployment, and poor security [7,8,9]
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