Characterization of wound infections among patients injured during the 2011 Libyan conflict

Dau, Aghnaya A.; Tloba, S.; Daw, Mohamed A.

doi:10.26719/2013.19.4.356

Cited by 52 publications

(27 citation statements)

References 16 publications

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“…Such wounds are often exacerbated by infection with Acinetobacter and other highly resistant bacteria that are difficult to eradicate. 15,34 Armed conflicts and population displacement are complicated by the fact that neither are monolithic phenomena. 35 Indeed, one of the measures of the severity of a conflict, in addition to casualties and duration, is the extent to which people have been displaced from their communities.…”

Section: Discussionmentioning

confidence: 99%

“…15,18,19 The recruitment and data collection were conducted in the 14 provinces of the six regions affected by the conflict. The regions included in the study were: Eastward Coastal Region (ECR), Middle Coastal Region (MCR), Westward Coastal Region (WCR), West Mountain Region (WMR), Middle Mountain Region (MMR), and Southward Sahara Region (SWR).…”

Section: Methodsmentioning

confidence: 99%

“…Moreover, the war and its repercussions resulted in internal and external population displacement, on top of great human and economic cost. [15][16][17] There are no reliable data on the numbers involved and the objectives of this study were to estimate the number of deaths and injuries in the different regions of Libya and to examine population displacement in the Libyan community.…”

Section: Introductionmentioning

confidence: 99%

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Libyan armed conflict 2011: Mortality, injury and population displacement

Daw

El-Bouzedi

Dau

2015

African Journal of Emergency Medicine

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Background: Armed conflicts can negatively affect health services and cause injuries and death. The recent Arab uprising has been associated with considerable damage to infrastructure and loss of human lives. The aim of this study was to determine mortality, injuries and population displacement that occurred during the recent Libyan armed conflict. Methods: A systematic cross-sectional field survey and non-structured search was carried out over fourteen provinces in six Libyan regions, representing the primary sites of the armed conflict between February 2011 and February 2012. Thirty-five percent of the total area of Libya and 62.4% of the Libyan population were involved in the study. The mortality and injury rates were determined and the number of displaced people was calculated during the conflict period. Results: A total of 21,490 (0.5%) persons were killed, 19,700 (0.47%) injured and 435,000 (10.33%) displaced. The overall mortality rate was found to be 5.1 per 1000 per year (95% CI 4.1-7.4) and injury rate was found to be 4.7 per 1000 per year (95% CI 3.9-7.2) but varied by both region and time, reaching peak rates by JulyAugust 2011. Conclusion: The Libyan armed conflict resulted in great human loss and social damage mirrored by high rates of mortality, injury and human displacement. Such parameters peaked as the conflict escalated and differed according to the Libyan regions and provinces involved. National and international efforts should be combined to overcome the consequences of these conflicts. Pre´sentation: Les conflits arme´s peuvent affecter ne´gativement la sante´et provoquer des blessures et des de´ce`s. Le re´cent soule`vement arabe a e´te´associe´a`des dommages conside´rables aux infrastructures et a`la perte de vies humaines. L'objectif de cette e´tude e´tait de de´terminer le taux de mortalite´, de blessures et les de´placements de population pendant le re´cent conflit arme´en Libye. Me´thodes: Une e´tude de terrain transversale et syste´matique et une recherche non structure´e ont e´te´re´alise´es afin de couvrir six re´gions libyennes incluant 14 provinces, qui e´taient les principaux the´aˆtres du conflit arme´entre fe´vrier 2011 et fe´vrier 2012. Cette e´tude concernait trente-cinq pour cent de la surface totale de la Libye et 62,4 % de la population libyenne. Les taux de mortalite´et de blessures et le nombre de personnes de´place´es ont e´te´calcule´s sur la pe´riode du conflit.Re´sultats: Au total, 21,490 (0,5 %) personnes ont e´te´tue´es, 19,700 (0,47 %) personnes ont e´te´blesse´es et 435,000 (10,33 %) personnes ont e´te´de´place´es. Le taux de mortalite´global a e´te´estime´a`5,1 pour 1 000 par an (IC de 95 % ; 4,1 -7,4) et le taux de blessures global a e´te´estime´a`4,7 pour 1 000 par an (IC de 95 % ; 3,9 -7,2) ; ces taux variaient d'une re´gion a`l'autre. Ils ont varie´pe´riodiquement au cours du conflit et ont atteint un sommet en juillet-aouˆt 2011, la situation s'e´tant aggrave´e pour connaıˆtre ensuite un retour au calme vers la fin du conflit. Conclusion: Le conflit arme´li...

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Libyan armed conflict 2011: Mortality, injury and population displacement

Daw

El-Bouzedi

Dau

2015

African Journal of Emergency Medicine

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“…Although antimicrobial resistance has been infrequently noted among obligate anaerobes from combat-related infections (Calhoun et al, 2008; Dau et al, 2013; Kovaric et al, 1968; Sherwood et al, 2011; Wannamaker and Pulaski, 1958), it occurred in 73% of our initial isolates. Combat care guidelines recommend metronidazole, ertapenem, clindamycin or moxifloxacin as agents with activity against obligate anaerobes (Hospenthal et al, 2011).…”

Section: 0 Discussionmentioning

confidence: 76%

Epidemiology and antimicrobial susceptibilities of wound isolates of obligate anaerobes from combat casualties

White

Mende

Weintrob

et al. 2016

Diagnostic Microbiology and Infectious Disease

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Data from recent conflicts related to war wounds and obligate anaerobes are limited. We define the epidemiology and antimicrobial susceptibility of obligate anaerobes from Iraq and Afghanistan casualties (6/2009–12/2013), as well as their association with clinical outcomes. Susceptibility against eleven antibiotics (7 classes) was tested. Overall, 59 patients had 119 obligate anaerobes identified (83 were first isolates). Obligate anaerobes were isolated 7–13 days post-injury, primarily from lower extremity wounds (43%), and were largely Bacteroides spp. (42%) and Clostridium spp. (19%). Patients with pelvic wounds were more likely to have Bacteroides spp. and concomitant resistant gram-negative aerobes. Seventy-three percent of isolates were resistant to ≥1 antimicrobials. Bacteroides spp. demonstrated the most resistance (16% of first isolates). Patients with resistant isolates had similar outcomes to those with susceptible strains. Serial recovery of isolates occurred in 15% of patients and was significantly associated with isolation of Bacteroides spp., along with resistant gram-negative aerobes.

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“…many nationalities. Following the Libyan armed uprising in February 2011, foreign intervention, in the form of NATO airpower, supplied fighting groups with weapons and missiles to defeat the Libyan regime [13]. Since that time, there has been an increased incidence of the illegal use of firearms.…”

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confidence: 99%