title: Crippling Violence: Conflict and Incident Polio in Afghanistan.
abstract: BACKGROUND
  Designing effective public health campaigns in areas of armed conflict requires a nuanced understanding of how violence impacts the epidemiology of the disease in question.
  
  
  METHODS
  We examine the geographical relationship between violence (represented by the location of detonated Improvised Explosive Devices) and polio incidence by generating maps of IEDs and polio incidence during 2010, and by comparing the mean number of IED detonations in polio high-risk districts with non polio high-risk districts during 2004-2009.
  
  
  RESULTS
  We demonstrate a geographic relationship between IED violence and incident polio. Districts that have high-risk for polio have highly statistically significantly greater mean numbers of IEDs than non polio high-risk districts (p-values 0.0010-0.0404).
  
  
  CONCLUSIONS
  The geographic relationship between armed conflict and polio incidence provides valuable insights as to how to plan a vaccination campaign in violent contexts, and allows us to anticipate incident polio in the regions of armed conflict. Such information permits vaccination planners to engage interested armed combatants to co-develop strategies to mitigate the effects of violence on polio.
authors.affiliation: Division of Epidemiology, College of Public Health, Ohio State University, Columbus, Ohio, United States of America.
authors.forename: Alison
authors.initials: A
authors.lastname: Norris
authors.affiliation: College of Medicine, Ohio State University, Columbus, Ohio, United States of America.
authors.forename: Kevin
authors.initials: K
authors.lastname: Hachey
authors.affiliation: GIS, Health & Hazards Lab, Department of Geography, Kent State University, Kent, Ohio, United States of America.
authors.forename: Andrew
authors.initials: A
authors.lastname: Curtis
authors.affiliation: Brigham and Women's Hospital, Division of Global Health, Boston, Massachusetts, United States of America.
authors.forename: Margaret
authors.initials: M
authors.lastname: Bourdeaux
mesh_terms: D000346:Afghanistan / Q000453:epidemiology; D003220:Conflict, Psychological; D053834:Explosive Agents; D005843:Geography; D006801:Humans; D015994:Incidence; D011051:Poliomyelitis / Q000453:epidemiology* / Q000517:prevention & control; D023321:Poliovirus Vaccines / Q000276:immunology; D012307:Risk Factors; D014754:Violence
chemical_list: D053834:Explosive Agents; D023321:Poliovirus Vaccines