INJURIES OF BOKO HARAM INSURGENCY IN SOUTH-EAST NIGER REPUBLIC
Sani R1, Adamou H2*, Daddy H3 , Amadou Magagi I2, Abdoulaye MB4 , James Didier L1, Garba I1, Idé K1, Hama Y1, Sanoussi S1.
1Department of Surgery and Surgical specialties, Niamey National Hospital, Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niger.
2Department of Surgery, Zinder National Hospital, Faculty of Health Sciences, University of Zinder, Niger.
3Department of Anesthesia and Critical Care, Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niger.
4Department of Surgery, Diffa regional Hospital, Niger.
*Corresponding author: Harissou ADAMOU. E-mail address: harissou1976@yahoo.fr ;
Conflict of interest: None
Sources of grant or other support: None
Conflict of interest: None
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ABSTRACT
Background:
Currently, wounds of wars, terrorism and criminality are increasing and constitute major public health problem worldwide.
Aim: To present the epidemiological, clinical and therapeutic characteristics of the wounds observed during the Boko Haram (BH) insurgency in the South-east of the Republic of Niger. Methodology: This was a cross-sectional study from December 2014 to December 2016 at Diffa Regional Hospital, Diffa, Niger of individuals whose injuries were as a result of Boko Haram insurgency.
Results: In the period of this study, 573 injuries from Boko Haram insurgency were managed at the Regional Hospital at Diffa. The majority, 513(89.5%), were males while females constituted 60(10.5%) with a male/female ratio of 8.55. The mean age was 30,94(SD24,91) years (range 1 to 97 years). Civilian victims accounted for 379 (66.1%) while Nigerien soldiers accounted for 160(27.9%) and 34 (5.9%) were Boko Haram fighters. 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. Injuries to limbs accounted for 361(63%) of cases and polytrauma in 65(11.34%). 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.
Postoperative follow-up was uneventful in 460 (80.28%) of cases; there were 29 deaths, giving a mortality rate of 5.1%. Predictors of death after injuries of Boko Haram terrorism in this study included: being civilian patients (OR = 3.38 [1.15-9.85], p=0.018), injuries to head, neck, trunk or spine (OR 3.45[1.58-7.58], p= 0.001) or the presence of polytrauma on admission (OR = 17.30 [7.72-38.80], p<0.0001).
Conclusion: This study has shown that injuries sustained in Boko Haram insurgency in Niger were mainly firearm injuries and injuries from the use of traditional weapons, affecting mostly young civilian males. The part of the body most commonly involved were the extremities, with mainly soft tissue injuries. Wound debridement was the commonest surgical procedure performed and the mortality rate was 5.1%. Predictors of mortality were being civilian patients, injuries of head, neck, trunk or spine and polytrauma. The ICRC has played a major role in strengthening our hospital for the task of caring for the victims, in terms of provision of material resources and in the further training of our personnel.
Key words: Boko Haram insurgency, Missile injuries, Explosions, Extremities, Young males.Click for full text