Following a natural, man-made, or technological disaster, local disaster relief and development staff workers (referred to herein as humanitarian workers) act as vital linkages in the disaster relief chain.
In 2010, the State Department requested $350,000 in International Military Education and Training funding for Libya to "support education and training of Libyan security forces, creating vital linkages with Libyan officers after a 35-year break in contact," according to a Congressional Research Service report.
The Convention on Biological Diversity and the World Health Organization recently co-convened two regional workshops on these intricate but vital linkages.
Importantly, we found that subsequent to vital registry linkage, novel associations with true LTF emerged that were not apparent before correcting for mortality, including pregnancy and less severe immunodeficiency at ART initiation.
Risk factors for LTF using routine data (prior to vital status linkage) were male sex (hazard ratio [HR] 1.32, p = 0.003), younger age (per 5 years older, HR 0.94, p = 0.027), lower weight (per 10 kg, HR 0.87, p<0.001) and increasing calendar year of initiation on ART (p<0.001; Table 2).
However, when length of time since last contact is long, e.g., more than 5 years, an initial vital statistics linkage may help to exclude deceased prior to initial recruitment into the new study.
Of the 750 women searched during the pilot study, 507 were eligible (e.g., community-dwelling, aged 65 89 years and alive based on a vital statistics linkage completed in August 2002) for the new study to begin recruitment in 2003.
In the current study, the primary outcomes included deaths from all causes, deaths from cardiovascular diseases (including coronary heart diseases and stroke) and deaths from cancers occurring between the baseline recruitment and the most recent follow-up and/or annual vital status linkage.
For those women who refused to participate, we obtained consent to collect pertinent medical records for the index pregnancy, the outcome of the next pregnancy via vital records linkage, and to conduct a much abbreviated survey to obtain data on important demographic, psychosocial and behavioral risk factors.
Both approaches are subject to potential biases: in the case of sampling, there may be differences between those who are traced and those who could not be traced; in the case of vital registration linkages, there may be differences between those with and without civil identification numbers.
