Deadliest Conflict of 21st Century

October 11, 2006

In News

the full report:

Burnham-Doocy-Lafta-Roberts-Lancet Mortality
after the 2003 invasion of Iraq — a cross sectional cluster sample survey

  • Johns Hopkins Bloomberg School of Public Health
    Baltimore, MD, USA (Prof G Burnham MD,
    S Doocy PhD, L Roberts PhD);
  • School of Medicine, Al Mustansiriya University, Baghdad, Iraq (Prof R Lafta MD)

By Gilbert Burnham, Riyadh Lafta, Shannon Doocy, Les Roberts


Background An excess mortality of nearly 100 000 deaths was reported in Iraq for the period March, 2003–September,
2004, attributed to the invasion of Iraq. Our aim was to update this estimate.


Between May and July, 2006, we did a national cross-sectional cluster sample survey of mortality in Iraq.
50 clusters were randomly selected from 16 Governorates, with every cluster consisting of 40 households. Information
on deaths from these households was gathered.


Three misattributed clusters were excluded from the final analysis; data from 1849 households that contained
12 801 individuals in 47 clusters was gathered. 1474 births and 629 deaths were reported during the observation
period. Pre-invasion mortality rates were 5·5 per 1000 people per year (95% CI 4·3–7·1), compared with 13·3 per
1000 people per year (10·9–16·1) in the 40 months post-invasion. We estimate that as of July, 2006, there have been
654 965 (392 979–942 636) excess Iraqi deaths as a consequence of the war, which corresponds to 2·5% of the
population in the study area. Of post-invasion deaths, 601 027 (426 369–793 663) were due to violence, the most
common cause being gunfire.


The number of people dying in Iraq has continued to escalate. The proportion of deaths ascribed to
coalition forces has diminished in 2006, although the actual numbers have increased every year. Gunfire remains the
most common cause of death, although deaths from car bombing have increased.