Infant mortality from acute respiratory infections and armed conflict: an exploratory analysis
Mortalidad infantil por infecciones respiratorias agudas y conflicto armado: un análisis exploratorio
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AbstractObjectives Considering the consequences generated by armed conflict in terms of public health, especially those related to communicable diseases, we aimed to explore infant mortality from acute respiratory infections (ARI) and its relationship with the armed conflict in Colombia. Methods We retrospectively conducted a descriptive analysis. Mortality data were extracted from death certificates of the National Administrative Department of Statistics, using ICD-10 codes related to ARI. We estimated municipality mortality rates related to IRA (MR-IRA) by sex, in children under-five. Also, we calculated for 1998-2003, 2004-2009 and 2010-2015 the average annual mortality rate by quintiles of armed conflict intensity (ACI) at municipal level, following the ACI index built by the National Institute of Health of Colombia. Rate ratios were estimated to evaluate relative gaps between the MR-ARI of quintiles with greater ACI index and the MR-ARI of those ones with less intensity. Results MR-ARI in children under-five were higher in boys than in girls, for all the analyzed periods. Excluding the first ACI quintile (because this one showed a paradoxical relationship between ACI and MR-ARI), we observed a gradient pattern between the ACI quintiles and the MR-ARI, with higher mortality rates in the quintiles with the greatest impact due to the conflict. For 1998-2003, in boys, the MR-ARI related to the quintile with the highest ACI was 1.34 times greater than the rate of quintile 2. For 2010-2015, this gap increased to 1.5 times. In girls, for 1998-2003 the relative difference was 1.36 and for 2010-2015 there was no change in this gap. Conclusions Our estimations suggest that, with exception of quintile 1, the MR-ARI was higher in the quintiles with greater armed conflict, as we can expect. Additionally, relative gaps by sex increased in boys and remained constant in girls.