3/26/2023 0 Comments Boko haram insurgencyIn Niger, clinical data related to the management of casualties from the Boko Haram conflict in the Lake Chad Basin are poorly reported. In Nigeria, several studies have reported injuries and socio-psychological consequences of the Boko Haram-led war 4, 10– 12. This hospital, supported by the International Committee of the Red Cross (ICRC) in taking care of war victims, also receives patients from Nigeria. The Regional Hospital Center (CHR) of Diffa located in South-East of Niger is the regional reference hospital. More than 100,000 survivors of Boko Haram attacks in Nigeria have fled to the Diffa region in Niger Republic, bordering Nigeria the health centers in this region are at the forefront of caring for the wounded in the conflict 15. There are more than 2.5 million refugees and displaced persons, while others have witnessed horrible massacres of their loved ones 14, 15. According to the journal of the Office for the Coordination of Humanitarian Affairs (OCHA Niger), the insurrection of the Jihadist group Boko Haram has caused the deaths of more than 25,000 people since 2009 in the Lake Chad Basin which includes the borders between Cameroon, Niger, Nigeria, and Chad. In Africa, the Sahelo-Saharan belt has long been an area of instability and insecurity 4, 8 however, violence became more pronounced in the 2000s with the birth of armed jihadist groups like Boko Haram (BH), AQIM, and MOUJAO and the consequences of the Libyan revolution 4, 8– 113. Recently, insecurity due to the use of firearms has become endemic and epidemic worldwide, leading to serious injuries and deaths which affect both military and civilian populations 1, 3, 6– 9. Injuries resulting from insurgency continue to be on the rise it is a serious public health challenge worldwide, accounting for significant physical, psychological, social and economic costs 1– 5. Predictors of death after injuries of Boko Haram terrorism in this study included: being civilian patients (OR = 3.38, p=0.018), injuries to head, neck, trunk or spine (OR 3.45, p= 0.001) or the presence of polytrauma on admission (OR = 17.30, p<0.0001). Postoperative follow-up was uneventful in 460 (80.28%) of cases there were 29 deaths, giving a mortality rate of 5.1%. The main surgical management included wound debridement in 409 (71.4%), external bone fixation in 38 (6.6%), laparotomy in 30 (5.2%), thoracic drainage in 27 (4.7%), and major limb amputations in 13 (2.3%) cases. Injuries to limbs accounted for 361(63%) of cases and polytrauma in 65(11.34%). Firearms and explosives accounted for injuries in 489 (85.3%) and 7(1.2%) of patients respectively 42 (7.3%) suffered injuries from a variety of traditional weapons. Civilian victims accounted for 379 (66.1%) while Nigerien soldiers accounted for 160(27.9%) and 34 (5.9%) were Boko Haram fighters. The mean age was 30,94(SD24,91) years (range 1 to 97 years). The majority, 513(89.5%), were males while females constituted 60(10.5%) with a male/female ratio of 8.55. In the period of this study, 573 injuries from Boko Haram insurgency were managed at the Regional Hospital at Diffa.
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