Conflict-related intentional injuries in Baghdad, Iraq, 2003-2014: A modeling study and proposed method for calculating burden of injury in conflict

COVID-19 in Baghdad, Iraq: adaptive and emotional findings in a household cluster survey

Purpose

The objective of this study was to assess the impact of COVID-19 infection on households in Baghdad, Iraq.

Methods

A cross-sectional household survey was conducted in early 2022; 41 clusters were selected proportional to population size from the districts of the Baghdad governorate. Households were randomly selected for inclusion. The head of household or senior female member present was interviewed to obtain a listing of COVID-19 infections, deaths, and vaccinations among members of the household and to understand if social and economic changes occurred during the pandemic. All analyses incorporated the complex survey design and sample weights for clustering.

Findings

The findings revealed that there were 1,464 cases of COVID-19 (37.1%) and 34 reported fatalities among the 927 households enrolled in this study. One or more COVID-19 immunizations were received by 50.9% of household members. Preventive measures against COVID-19 were widely reported to be being practiced but were not more commonly reported in households having reported a clinical case of infection. While some households where infections had occurred stated that their household expenses were increased, overall, infections were not associated with significantly increased household costs. In households where COVID-19 had occurred, senior members reported a substantial increase in emotional and psychological problems compared with uninfected households.

Implications

COVID-19 deaths were rare, though infections were common, suggesting an effect of vaccination and other efforts. The household economic implications were minimal in houses with and without COVID-19-infected members. COVID-19 had mental health consequences on affected and unaffected populations alike. It is conceivable that the fear and uncertainty generated by the pandemic had an effect on senior household members which was out of keeping with the other effects in the households sampled. This suggests that there may be a persisting need for mental health services for a protracted period to manage the consequences of mental health needs arising from the pandemic.

The Casualties of War: An Excess Mortality Estimate of Lives Lost in the 2020 Nagorno-Karabakh Conflict

Who and how many died in the 2020 Karabakh War? With limited evidence provided by authorities, media outlets, and human rights organizations, still little is known about the death toll caused by the 44-day conflict in and around Nagorno-Karabakh. This paper provides a first assessment of the human cost of the war. Using age-sex vital registration data from Armenia, Azerbaijan, and the de facto Republic of Artsakh/Nagorno-Karabakh, we difference the 2020 observed mortality values from expected deaths based on trends in mortality between 2015 and 2019 to offer sensible estimates of excess mortality resulting from the conflict. We compare and contrast our findings with neighboring peaceful countries with similar mortality patterns and socio-cultural background and discuss them against the backdrop of the concurrent first wave of Covid-19. We estimate that the war led to almost 6,500 excess deaths among people aged 15-49. Nearly 2,800 excess losses occurred in Armenia, 3,400 in Azerbaijan, and 310 in de facto Artsakh. Deaths were highly concentrated among late adolescent and young adult males, suggesting that most excess mortality was directly related to combat. Beyond the human tragedy, for small countries like Armenia and Azerbaijan, such loss of young men represents a considerable long-term cost for future demographic, economic, and social development.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11113-023-09790-2.