A multi-country epidemiological analysis of mortality from landmines and other explosive ordnance

Explosive ordnance including landmines, improvised explosive devices and explosive remnants of war are known to contaminate at least fifty-eight countries, threatening the health of affected communities across generations. Despite the scale of this problem, mortality estimates pertaining to these weapons are limited in scope. This study addresses this knowledge gap by conducting a multi-country epidemiological study on explosive weapons casualties in low-resource settings.

A retrospective analysis of secondary data was conducted with data sourced from mine action authorities and centres, and international non-government organisations from across 17 countries. Casualty information contained included demographics, mortality, injury data, and incident details. Univariate and multivariate logistic regression models were used to assess which characteristics were associated with mortality and survival.

Here we show one of the largest epidemiological analyses, to date, of explosive weapons casualties. The overall case fatality rate was 38.8% and females have an elevated risk of fatal outcomes. Overall, children experience lower odds of death compared to adults; and, improvised explosive devices have the highest lethality of the weapons examined.

This research highlights the lethality of explosive weapons among local casualties, with a case fatality rate significantly higher than that observed in high-resource civilian or military trauma systems, illustrating the deadliness and indiscriminate nature of these devices. The findings of this analysis can inform injury prevention and trauma care initiatives targeting preventable death and disability for casualties of explosive ordnance.