title: Epidemiology of tornado destruction in rural northern Bangladesh: risk factors for death and injury.
abstract: The epidemiology of tornado-related disasters in the developing world is poorly understood. An August 2005 post-tornado cohort study in rural Bangladesh identified elevated levels of death and injury among the elderly (≥ 60 years of age) (adjusted odds ratio (AOR) = 8.9 (95 per cent confidence interval (CI): 3.9-20.2) and AOR = 1.6 (95 per cent CI: 1.4-1.8), respectively), as compared to 15-24 year-olds, and among those outdoors versus indoors during the tornado (AOR = 10.4 (95 per cent CI: 5.5-19.9) and AOR = 6.6 (95 per cent CI: 5.8-7.5), respectively). Females were 1.24 times (95 per cent CI: 1.15-1.33) more likely to be injured than males. Elevated risk of injury was significantly associated with structural damage to the house and tin construction materials. Seeking treatment was protective against death among the injured, odds ratio = 0.08 (95 per cent CI: 0.03-0.21). Further research is needed to develop injury prevention strategies and to address disparities in risk between age groups and between men and women.
authors.affiliation: Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, and Fred Hutchinson Cancer Research Center, United States.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Sugimoto
authors.forename: Alain B
authors.initials: AB
authors.lastname: Labrique
authors.forename: Salahuddin
authors.initials: S
authors.lastname: Ahmad
authors.forename: Mahbubur
authors.initials: M
authors.lastname: Rashid
authors.forename: Abu Ahmed
authors.initials: AA
authors.lastname: Shamim
authors.forename: Barkat
authors.initials: B
authors.lastname: Ullah
authors.forename: Rolf D W
authors.initials: RD
authors.lastname: Klemm
authors.forename: Parul
authors.initials: P
authors.lastname: Christian
authors.forename: Keith P
authors.initials: KP
authors.lastname: West
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003906:Developing Countries; D004190:Disasters / Q000706:statistics & numerical data*; D005260:Female; D006798:Housing / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055869:Tornadoes; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D055815:Young Adult