Survival analysis of post-war mortality in conflict-affected communities of Laelay Maichew Woreda, Tigray Region, Ethiopia.

OBJECTIVES: The Tigray war devastated Laelay Maichew Woreda in terms of death and displacement, health care disruption, and food insecurity. This study analyzes the mortality trend with associated determinants and provides evidence that strengthens healthcare resilience. METHODS: The study analyzed 303 war-affected individuals from November 2020 to March 2024, utilizing Kaplan-Meier survival analysis, log-rank tests, Cox proportional hazards, parametric, and accelerated failure time models to identify possible factors impacting survival. RESULTS: This study revealed a mortality rate of 44.55% in conflict-affected vulnerable groups, where children aged ≤14 years constituted the majority of registered deaths. Direct combat was identified as the major cause of death (72%), with a median survival time of 17 weeks. The Gompertz model indicated that children ( hazard ratio [ HR ] = 2.06 , P = 0.044 ) , young adults ( HR = 3.15 , P = 0.007 ) , males ( HR = 1.68 , p = 0.011 ) , individuals with poor health status ( HR = 2.68 , P = 0.001 ), those with acute health problems ( HR = 1.56 , P = 0.018 ) , and individuals with chronic illness and poor overall health status ( HR = 3.28 , P = 0.002 ) had significantly higher hazards of mortality, while disease outbreaks, lack of medicines and health facilities, and access to health care were associated with reduced hazards of mortality. CONCLUSION: Post-conflict mortality risks in Laelay Maichew Woreda are higher for children, young adults, males, and those exposed to direct combat, disease outbreaks, or a lack of healthcare access. The long-term impact of war on survival necessitates targeted interventions and policies.