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Threat of Melee-related Terrorist Attacks: A Retrospective Analysis of Patterns, Mortality, and Public Health Impact

Vadym Shapovalov1, Isabella Lagunzad2, Nolan Abdelsayed2

  • 1Emergency Medicine, https://ror.org/00sf92s91Lehigh Valley Health Network, Allentown, PA, United States.

Disaster Medicine and Public Health Preparedness
|May 29, 2026
PubMed
Abstract

Insights

Melee-based terrorist attacks, using weapons like knives, cause significant global casualties. The African region shows a higher death rate, with knives being the most frequent weapon.

Area of Science:

  • Global security studies
  • Terrorism research
  • Public health and epidemiology

Background:

  • Melee-based terrorism involves attacks with non-projectile weapons like knives or blunt objects.
  • This study investigates the prevalence, injury patterns, and mortality of such attacks.

Purpose of the Study:

  • To analyze the global characteristics of melee-based terrorist attacks.
  • To identify injury patterns and mortality rates associated with these attacks.
  • To determine predictors of mortality in melee-related terrorism.

Main Methods:

  • Retrospective analysis of the Global Terrorism Database (1970-2020).
  • Inclusion criteria: melee weapons as primary assault mode, resulting in injuries or death.
  • Descriptive statistics and negative binomial regression for casualty and mortality analysis.

Main Results:

  • 1,505 melee-related attacks identified, causing 5,528 injuries and 5,110 fatalities.
  • Average 3.40 deaths and 3.67 injuries per attack.
  • African Region had the highest death ratio (14.54 deaths/attack, IRR=18.33); knives were predominant weapons (58.63%, IRR=10.32 for death).

Conclusions:

  • Melee-based terrorist attacks pose a persistent and growing global threat.
  • These attacks result in a substantial burden of mortality and injuries worldwide.
  • Understanding attack patterns is crucial for developing effective counter-terrorism strategies.
Keywords:
Meleeattackmortalityterroristwound

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