Risk factors for unsafe behaviors toward grenades among rural populations affected by explosive devices in Colombia

Abstract

BackgroundFollowing decades of armed conflict, Colombia remains highly affected by explosive device (ED) contamination, especially in rural areas. Many victims are injured by EDs despite knowing their dangers. Determining risk factors for unsafe behaviors toward EDs, including grenades, is critical for preventing injuries.MethodsIn 2012, CDC assisted Colombian partners in conducting a multi-stage knowledge, attitudes, and practices survey in rural ED-affected areas. Within each of 40 clusters, 28 households were selected, and participants aged 10 years or older were asked about behaviors toward EDs. Participants reported actual behaviors toward past EDs encountered and theoretical behaviors toward EDs not encountered. Behaviors were a priori classified as unsafe or safe. This analysis focuses on behaviors toward the most commonly encountered device, grenades.ResultsOf 928 adult and 562 child participants, 488 (52.5%) adults and 249 (43.9%) children encountered ED, while 121 (13.7%) adults and 148 (26.9%) children received mine risk education (MRE). Among the 430 (46.7%) adults who encountered grenades, 113 (25.7%) reported unsafe behaviors; multivariable analysis showed that unsafe behavior was associated with working outdoors (adjusted odds ratio [aOR]: 1.7, 95% confidence interval [CI]: 1.1–2.7). Among the 429 (46.5%) adults who did not encounter ED, 61 (14.6%) described unsafe theoretical behaviors toward grenades; multivariable analysis showed that unsafe behavior was associated with older age (aOR: 1.02, 95% confidence limit [CL]: 1.00–1.05) and black or Afro-Colombian identity (aOR: 2.5, 95% CI 1.3–5.1). Among the 181 (32.0%) children who encountered grenades, 41 (23.8%) reported unsafe behaviors, while among the 311 (55.9%) children who did not encounter ED, 30 (10.2%) reported unsafe behavior. In both groups of children, multivariable analysis showed that unsafe behavior was associated with lower mean score on knowledge of ED, with aOR: 0.7, 95% CL: 0.6–0.9, and aOR: 0.8, 95% CL: 0.6–0.98, respectively.ConclusionsParticipants reported frequent ED exposure but low receipt of MRE. Our findings should guide MRE improvement in ED-affected areas by strengthening the connection between ED knowledge and avoiding unsafe behavior, with a particular focus on people working outdoors. MRE should promote knowledge of ED risks but should also recognize socioeconomic factors that lead to engaging in unsafe behaviors.

Hand grenade blast injuries in the Eastern Democratic Republic of Congo: a case series of 38 patients

“…This subpopulation is more likely to be affected by HGBIs because young adult males are often involved in armed conflicts [ 12 ]. When they are not participating in the conflict, young adults can still be exposed to HGBIs if they have an outdoor occupation [ 17 ]. This is especially true if they are from a low socioeconomic background.…”

“…Five of the Congolese HGBI patients were minors. Children are more likely to exhibit unsafe behavior around hand grenades, including approaching, touching, and playing with hand grenades [ 17 , 19 ]. This at-risk behavior equally increases their chances of severe injury.…”