Peer-reviewed article
Survival analysis of post-war mortality in conflict-affected communities of Laelay Maichew Woreda, Tigray Region, Ethiopia.
Gebretensae YA, Fissuh YH ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study analyzed mortality patterns in 303 war-affected individuals from Laelay Maichew Woreda in Tigray, Ethiopia between November 2020 and March 2024. The conflict caused a 44.55% mortality rate, with children aged 14 and younger representing the majority of deaths, mainly from direct combat. Children, young adults, males, and those with poor health status or acute/chronic illnesses had significantly higher risks of death. The findings highlight how armed conflict disrupts survival outcomes for vulnerable populations, particularly children.
Key points
- Overall mortality rate of 44.55% in conflict-affected groups, with children ≤14 years constituting the majority of deaths
- Direct combat was the major cause of death (72%), with median survival time of 17 weeks
- Children had 2.06 times higher hazard of mortality compared to other age groups
- Young adults and males showed 3.15 and 1.68 times higher mortality hazards respectively
- Those with chronic illness and poor health status had 3.28 times higher hazard of mortality
Limitations
The study is observational and cannot establish causality or distinguish between direct effects of combat and indirect effects of health system collapse. The analysis covers only a defined period in one woreda and may not be generalizable to other conflict-affected regions.
Abstract
Objectives The Tigray war devastated Laelay Maichew Woreda in terms of death and displacement, health care disruption, and food insecurity. This study analyzes the mortality trend with associated determinants and provides evidence that strengthens healthcare resilience. Methods The study analyzed 303 war-affected individuals from November 2020 to March 2024, utilizing Kaplan-Meier survival analysis, log-rank tests, Cox proportional hazards, parametric, and accelerated failure time models to identify possible factors impacting survival. Results This study revealed a mortality rate of 44.55% in conflict-affected vulnerable groups, where children aged ≤14 years constituted the majority of registered deaths. Direct combat was identified as the major cause of death (72%), with a median survival time of 17 weeks. The Gompertz model indicated that children (hazardratio[HR]=2.06,P=0.044), young adults (HR=3.15,P=0.007) , males (HR=1.68,p=0.011) , individuals with poor health status ( HR=2.68,P=0.001 ), those with acute health problems (HR=1.56,P=0.018) , and individuals with chronic illness and poor overall health status (HR=3.28,P=0.002) had significantly higher hazards of mortality, while disease outbreaks, lack of medicines and health facilities, and access to health care were associated with reduced hazards of mortality. Conclusion Post-conflict mortality risks in Laelay Maichew Woreda are higher for children, young adults, males, and those exposed to direct combat, disease outbreaks, or a lack of healthcare access. The long-term impact of war on survival necessitates targeted interventions and policies.