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Kampalath V, Tarnas MMC, Patel MV, Hamze M, Loutfi R, Tajaldin B, Albik A, Kassas A, Khashata A, Abbara A. An analysis of paediatric clinical presentations in Northwest Syria and the effect of forced displacement, 2018-2022. GLOBAL EPIDEMIOLOGY 2024; 8:100146. [PMID: 38947221 PMCID: PMC11214201 DOI: 10.1016/j.gloepi.2024.100146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/30/2024] [Accepted: 05/30/2024] [Indexed: 07/02/2024] Open
Abstract
Background One in six children worldwide lives in a region exposed to armed conflict. In conflicts, children are among the most vulnerable, and at risk of adverse health outcomes. We sought to describe trends in child and adolescent morbidity in northwest Syria (NWS) and understand how forced displacement affects clinical utilisation during the Syrian conflict. Methods Retrospective data between January 2018 and December 2022 were obtained from the Syrian American Medical Society (SAMS), a non-governmental organisation that operates health facilities in NWS. After initial descriptive analyses were completed, we performed a seasonal-trend decomposition to estimate the seasonality of clinical presentations. We subsequently employed a multivariate regression model incorporating age, gender, residency status, season, and a random district-level intercept to measure the association between the odds of clinical consultation and forced displacement. Findings Across 51 reporting SAMS facilities, 2,687,807 clinical consultations were studied over a five-year period. Seasonality was demonstrated for every clinical consultation category. Higher levels of forced displacement were associated with increased odds of consultations for nutrition, trauma, NCDs and mental health and decreased odds of consultation for communicable diseases. Aside from traumatic injury, internally displaced persons (IDPs) had higher AORs of clinical consultations compared to host populations. Interpretation Forced displacement differentially impacts clinical utilisation among children in northwest Syria, and the effects of displacement persist for at least six months. Clinical needs vary by host/IDP status, sex, age, and season. This study can assist policymakers in forecasting the health needs of children in northwest Syria.
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Affiliation(s)
- Vinay Kampalath
- Perelman School of Medicine, University of Pennsylvania, USA
| | - Ms Maia C. Tarnas
- Department of Population Health and Disease Prevention, University of California Irvine, USA
| | | | - Mohamed Hamze
- Syrian American Medical Society, Washington, DC, USA
| | - Randa Loutfi
- Syrian American Medical Society, Washington, DC, USA
| | | | - Ahmad Albik
- Syrian American Medical Society, Washington, DC, USA
| | - Ayman Kassas
- Syrian American Medical Society, Washington, DC, USA
| | - Anas Khashata
- Syrian American Medical Society, Washington, DC, USA
| | - Aula Abbara
- Imperial College, London, UK
- Syrian American Medical Society, Washington, DC, USA
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Kamiab Hesari D, Aljadeeah S, Brhlikova P, Hyzam D, Komakech H, Patiño Rueda JS, Ocampo Cañas J, Ching C, Orubu S, Bernal Acevedo O, Basaleem H, Orach CG, Zaman M, Prazeres da Costa C. Access to and utilisation of antimicrobials among forcibly displaced persons in Uganda, Yemen and Colombia: a pilot cross-sectional survey. BMJ Open 2024; 14:e084734. [PMID: 39013652 PMCID: PMC11253744 DOI: 10.1136/bmjopen-2024-084734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 06/13/2024] [Indexed: 07/18/2024] Open
Abstract
OBJECTIVES Identifying key barriers to accessing quality-assured and affordable antimicrobials among forcibly displaced persons in Uganda, Yemen and Colombia and investigating their (1) utilisation patterns of antibiotics, (2) knowledge about antimicrobial resistance (AMR) and (3) perception of the quality of antimicrobials received. DESIGN Pilot cross-sectional survey. SETTING Data were collected from five health facilities in the Kiryandongo refugee settlement (Bweyale, Uganda), three camps for internally displaced persons (IDPs) in the Dar Sad district (Aden, Yemen) and a district with a high population of Venezuelan migrants (Kennedy district, Bogotá, Colombia). Data collection took place between February and May 2021. The three countries were selected due to their high number of displaced people in their respective continents. PARTICIPANTS South Sudanese refugees in Uganda, IDPs in Yemen and Venezuelan migrants in Colombia. OUTCOME MEASURE The most common barriers to access to quality-assured and affordable antimicrobials. RESULTS A total of 136 participants were enrolled in this study. Obtaining antimicrobials through informal pathways, either without a doctor's prescription or through family and friends, was common in Yemen (27/50, 54.0%) and Colombia (34/50, 68.0%). In Yemen and Uganda, respondents used antibiotics to treat (58/86, 67.4%) and prevent (39/86, 45.3%) a cold. Knowledge of AMR was generally low (24/136, 17.6%). Barriers to access included financial constraints in Colombia and Uganda, prescription requirements in Yemen and Colombia, and non-availability of drugs in Uganda and Yemen. CONCLUSION Our multicentred research identified common barriers to accessing quality antimicrobials among refugees/IDPs/migrants and common use of informal pathways. The results suggest that knowledge gaps about AMR may lead to potential misuse of antimicrobials. Due to the study's small sample size and use of non-probability sampling, the results should be interpreted with caution, and larger-scale assessments on this topic are needed. Future interventions designed for similar humanitarian settings should consider the interlinked barriers identified.
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Affiliation(s)
- David Kamiab Hesari
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Munich, Germany
- Centre for Global Health, Technical University of Munich, Munich, Germany
| | - Saleh Aljadeeah
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Petra Brhlikova
- Institute for Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Dalia Hyzam
- Women's Research and Training Centre, University of Aden, Aden, Yemen
| | - Henry Komakech
- Department of Community Health and Behavioral Science, Makerere University School of Public Health, Kampala, Uganda
| | | | | | - Carly Ching
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, USA
| | - Samuel Orubu
- Institute for Health System Innovation and Policy, Boston University, Boston, Massachusetts, USA
- Faculty of Pharmacy, Niger Delta University, Amassoma, Bayelsa, Nigeria
| | | | - Huda Basaleem
- Faculty of Medicine and Health Sciences, University of Aden, Aden, Yemen
| | | | - Muhammad Zaman
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, USA
| | - Clarissa Prazeres da Costa
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Munich, Germany
- Centre for Global Health, Technical University of Munich, Munich, Germany
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Anierobi CM, Obasi CO, Nnamani RG, Ajah BO, Iloma DO, Efobi KO, Nwaoga C, Ngozi A, Okonkwo UT, Innocent Chigbe E. Communal conflicts in Nigeria: Assessment of the impacts on internally displaced persons and settlements amidst COVID-19 pandemic. Heliyon 2024; 10:e30200. [PMID: 38707357 PMCID: PMC11066645 DOI: 10.1016/j.heliyon.2024.e30200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 04/18/2024] [Accepted: 04/22/2024] [Indexed: 05/07/2024] Open
Abstract
Acknowledging that violent communal conflicts can lead to increased displacement and overcrowding in IDP camps, this study investigates the impact of such conflicts on internally displaced persons (IDPs) and their camps in Benue State, Nigeria, amid the COVID-19 pandemic. Employing a mixed-method approach, 386 IDPs and 20 stakeholders were purposively selected. Based on the research objectives, descriptive and inferential statistics were employed to analyze the research objectives. Employing logistics and multi-linear regressions, the data reveal that unregulated access to IDP camps resulted in overcrowding, straining resources like food and shelter. The study identifies economic losses and various challenges stemming from communal conflict and COVID-19, causing chaos, anxiety, and uncertainty in the IDP camps. These findings highlight the urgent need for ongoing humanitarian assistance to alleviate the precarious conditions faced by IDPs and their camps nationwide and recommend that the IDPs camps across the country need constant humanitarian aid to mitigate the various precarious conditions in the camps.
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Affiliation(s)
- Christopher M. Anierobi
- Department of Urban and Regional Planning, Faculty of the Environmental Sciences, University of Nigeria, Nsukka, Nigeria
| | - Cletus Onyema Obasi
- Department of Religion and Cultural Studies/ Social Sciences Unit, Faculty of the Social Sciences, University of Nigeria, Nsukka, Nigeria
| | - Rebecca Ginika Nnamani
- Department of Political Science/ Social Sciences Unit, Faculty of the Social Sciences, University of Nigeria, Nsukka, Nigeria
| | - Benjamin Okorie Ajah
- Directorate of Research Innovation Consultancy and Extensions, Main Campus, Kampala International University, P.O. Box, 20000, Kampala, Uganda
- Department of Sociology and Anthropology, Faculty of the Social Sciences, University of Nigeria, Nsukka, Nigeria
| | - David O. Iloma
- Department of Sociology/Criminology and Security Studies, Topfaith University, Mkpatak, Nigeria
| | - Kingsley O. Efobi
- Department of Urban and Regional Planning, Faculty of the Environmental Sciences, University of Nigeria, Nsukka, Nigeria
| | - Chinyere Nwaoga
- Department of Religion and Cultural Studies, Faculty of the Social Sciences, University of Nigeria, Nsukka, Nigeria
| | - Asadu Ngozi
- Department of Sociology and Anthropology, Faculty of the Social Sciences, University of Nigeria, Nsukka, Nigeria
| | - Uchenna Teresa Okonkwo
- Department of Sociology and Anthropology, Faculty of the Social Sciences, University of Nigeria, Nsukka, Nigeria
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Oakley R, Hedrich N, Walker A, Dinkita HM, Tschopp R, Abongomera C, Paris DH. Status of zoonotic disease research in refugees, asylum seekers and internally displaced people, globally: A scoping review of forty clinically important zoonotic pathogens. PLoS Negl Trop Dis 2024; 18:e0012164. [PMID: 38768252 PMCID: PMC11142688 DOI: 10.1371/journal.pntd.0012164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 05/31/2024] [Accepted: 04/23/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND At the end of 2022, there were over 108 million forcibly displaced people globally, including refugees, asylum seekers (AS) and internally displaced people (IDPs). Forced migration increases the risk of infectious disease transmission, and zoonotic pathogens account for 61% of emerging and re-emerging infectious diseases. Zoonoses create a high burden of disease and have the potential to cause large-scale outbreaks. This scoping review aimed to assess the state of research on a range of clinically relevant zoonotic pathogens in displaced populations in order to identify the gaps in literature and guide future research. METHODOLOGY / PRINCIPAL FINDINGS Literature was systematically searched to identify original research related to 40 selected zoonotic pathogens of interest in refugees, AS and IDPs. We included only peer-reviewed original research in English, with no publication date restrictions. Demographic data, migration pathways, health factors, associated outbreaks, predictive factors and preventative measures were extracted and synthesized. We identified 4,295 articles, of which 347 were included; dates of publications ranged from 1937 to 2022. Refugees were the most common population investigated (75%). Migration pathways of displaced populations increased over time towards a more complex web, involving migration in dual directions. The most frequent pathogen investigated was Schistosoma spp. (n = 99 articles). Disease outbreaks were reported in 46 publications (13.3%), with viruses being the most commonly reported pathogen type. Limited access to hygiene/sanitation, crowding and refugee status were the most commonly discussed predictors of infection. Vaccination/prophylaxis drug administration, surveillance/screening and improved hygiene/sanitation were the most commonly discussed preventative measures. CONCLUSIONS / SIGNIFICANCE The current research on zoonoses in displaced populations displays gaps in the spectrum of pathogens studied, as well as in the (sub)populations investigated. Future studies should be more inclusive of One Health approaches to adequately investigate the impact of zoonotic pathogens and identify transmission pathways as a basis for designing interventions for displaced populations.
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Affiliation(s)
- Regina Oakley
- Department of Medicine, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Nadja Hedrich
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland
| | - Alexandra Walker
- Department of Medicine, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Rea Tschopp
- University of Basel, Basel, Switzerland
- One Health Division, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | - Charles Abongomera
- Department of Medicine, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Daniel H. Paris
- Department of Medicine, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Thompson N, Kyaw KWY, Singh L, Cikomola JC, Singh NS, Roberts B. The effect of COVID-19 on the non-COVID health outcomes of crisis-affected peoples: a systematic review. Confl Health 2024; 18:37. [PMID: 38664834 PMCID: PMC11044391 DOI: 10.1186/s13031-024-00592-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic posed considerable risks to populations affected by humanitarian crises in low- and middle-income countries (LMICs). However, there is limited understanding of how the pandemic may have affected non-COVID health outcomes among crisis-affected populations. Our aim was to examine the evidence on the impact of the COVID-19 pandemic on non-COVID-19 health outcomes for crisis-affected populations in LMICs. METHODS A systematic review methodology was applied following PRISMA guidelines. Eligibility criteria were: crisis-affected populations in LMICS; COVID-19; and all health topics, except for sexual and reproductive health which was covered in a linked review. Five bibliographic databases and additional grey literature sources were searched. The search period was from 2019 to 31 July 2022. Eligible papers were extracted and analysed using a narrative synthesis approach based on the study objectives and relevant health access and systems frameworks. A quality appraisal was also conducted. FINDINGS 4320 articles were screened, and 15 eligible studies were identified and included in this review. Ten studies collected health outcomes data. Eight related to mental health, which generally showed worse mental health outcomes because of the pandemic, and pandemic-related stressors were identified. Two studies assessed physical health outcomes in children, while none addressed physical health outcomes among adults. Nine studies reported on access to healthcare, revealing worse access levels due to the pandemic and noting key barriers to care. Seven studies reported on the impact on health systems, with key challenges including reduced and distorted health care funding, reduced staff capacity, interrupted medicines and supplies, weak information and mixed-messaging, and weak leadership. All fifteen studies on the social determinants of health, particularly highlighting the effect of increasing poverty, the role of gender, and food insecurity on health outcomes. The quality of papers was limited overall. CONCLUSION This review found some limited evidence indicating negative mental health effects, increased barriers to accessing care, damage to health systems and magnified impacts on the social determinants of health for crisis-affected people during the COVID-19 pandemic. However, the small number and limited quality of the studies make the overall strength of evidence quite weak.
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Affiliation(s)
- N Thompson
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - K W Y Kyaw
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - L Singh
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - J C Cikomola
- Faculty of Medicine, Université Catholique de Bukavu, Democratic Republic of the Congo, Central African Republic
| | - N S Singh
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Bayard Roberts
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
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Jolof L, Rocca P, Carlsson T. Support interventions to promote health and wellbeing among women with health-related consequences following traumatic experiences linked to armed conflicts and forced migration: a scoping review. Arch Public Health 2024; 82:8. [PMID: 38225672 PMCID: PMC10790529 DOI: 10.1186/s13690-023-01235-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 12/28/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Women exposed to armed conflicts and forced migration face significant health-related risks and consequences. Consequently, there is a need to identify and develop effective interventions that provide tailored support for them. The aim of this scoping review was to examine research evaluating support interventions promoting the health and well-being among women with traumatic experiences linked to armed conflict and/or forced migration. METHODS A scoping review of empirical studies evaluating non-pharmacologic/non-surgical interventions promoting health and well-being among adult women with traumatic experiences linked to armed, torture, and/or forced migration, identified through systematic searches in February 2022 within five databases (AMED, CINAHL, Cochrane Library, PsycINFO, and PubMed). Methodological characteristics and results were extracted and analyzed with narrative analysis using tabulations, descriptive statistics, text-based summaries, and thematization. RESULTS Assessment of 16 748 records resulted in 13 included reports. The methodological approaches were quantitative (n = 9), qualitative (n = 2), and mixed methods (n = 2), with most reports being feasibility/pilot studies (n = 5) and/or randomized controlled trials (n = 4). The most common recruitment strategy was non-probability sampling (n = 8). Most interventions were conducted in North America (n = 4), Asia (n = 3) or Middle East (n = 3). Thirteen intra-intervention techniques and five categories of components utilized within the interventions were identified, the most common being skill building (n = 12). Ten developed the interventions through theoretical frameworks or manuals/therapy, while five developed interventions through public or stakeholder involvement. Eleven studies evaluated outcomes related to psychological health, disorders, or distress. A large proportion of the investigated outcomes showed post-exposure improvements and improvements when compared with controls. Qualitative findings highlighted improved mental and physical health, empowerment and stigma reduction, and enhanced knowledge. CONCLUSION Few studies have developed and evaluated tailored support interventions for this population, containing a range of components and intra-intervention techniques. No clear focus was identified regarding outcome measures, and most studies used non-probability sampling. Few developed interventions through public contribution in collaboration with women. While limited studies show promising effects on women's mental health, more empirical intervention research that closely corresponds to women's needs are needed.
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Affiliation(s)
- Linda Jolof
- The Red Cross Treatment Center for Persons Affected by War and Torture, Malmö, Sweden
| | - Patricia Rocca
- The Red Cross Treatment Center for Persons Affected by War and Torture, Malmö, Sweden
| | - Tommy Carlsson
- The Department of Health Sciences, The Swedish Red Cross University, Huddinge, Sweden.
- The Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
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Cantor DJ. Divergent dynamics: disasters and conflicts as 'drivers' of internal displacement? DISASTERS 2024; 48:e12589. [PMID: 37172110 DOI: 10.1111/disa.12589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Disasters and conflicts are both widely recognised as 'drivers' of internal displacement. Yet, despite a growing body of research and policy, there has been little consideration to date of how the different features of each 'context' shape the micro-level dynamics of internal displacement. Where and why are these dynamics similar across the two contexts and how do they differ? This paper draws on general concepts from the disaster field to develop a comparative analytical model of internal displacement dynamics in the disaster and conflict contexts. Based on inferences from the patchy extant data across the two contexts, it identifies and explains points of convergence and divergence between internal displacement dynamics in both the disaster and conflict contexts. This 'contextual' model of the micro-level dynamics of internal displacement has implications for academic debates, as well as for policy and practice, in the disaster, conflict, peace, climate change, and forced migration/displacement fields.
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Affiliation(s)
- David James Cantor
- Professor and Director, Refugee Law Initiative, School of Advanced Study, University of London, United Kingdom
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Ajike SO, Oloyede BL. Determinants of child survival practice among caregivers in internally displaced persons' camps in Abuja Municipal Area Council, Nigeria. Child Care Health Dev 2024; 50:e13201. [PMID: 37950536 DOI: 10.1111/cch.13201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/23/2023] [Accepted: 10/19/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Child survival remains a major public health challenge in the sub-Saharan region of Africa, especially Nigeria. The Boko Haram crisis, which has aggravated this, has led to the displacement of many people in the north-eastern region, including children under five. This study investigated the determinants of child survival practice among caregivers in internally displaced persons' (IDP) camps in Abuja Municipal Area Council (AMAC), Nigeria. METHODOLOGY A cross-sectional design was used to collect data on determinants of child survival practice from 312 caregivers in five purposively selected IDP camps in AMAC using the snowball sampling technique. Data were analysed using univariate, bivariate, and multivariate statistics at 5% level of significance. RESULTS The mean age of respondents was 29.6 ± 6.72 years. There was a significant (p < 0.05) relationship between the predisposing, reinforcing, enabling and environmental factors studied and child survival practice. Findings also indicated that all factors were significant (p < 0.05) predictors of child survival practice with the reinforcing factor being the major predictor (ß = 0.38; t = 6.08). CONCLUSION Attention needs to be paid to all factors, particularly the reinforcing factor of social support in order to promote optimal child survival practice among caregivers in AMAC IDP camps. Collaboration with social work professionals would be an added benefit to enhance social support.
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Affiliation(s)
- Saratu Omagbemi Ajike
- Department of Public Health, School of Public and Allied Health, Babcock University, Ilishan-Remo, Ogun State, Nigeria
| | - Busola Loveall Oloyede
- Department of Public Health, School of Public and Allied Health, Babcock University, Ilishan-Remo, Ogun State, Nigeria
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Kadio K, Ly A, Ouédraogo A, Ahmed MAA, Yaya S, Gagnon MP. "if we don't regroup, hunger will kill us…": a qualitative study on measures of physical distancing during covid-19 among internally displaced persons in Burkina Faso. FRONTIERS IN SOCIOLOGY 2023; 8:1189235. [PMID: 38162932 PMCID: PMC10757600 DOI: 10.3389/fsoc.2023.1189235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024]
Abstract
This study contributes to the body of knowledge on IDPs in the context of security crisis related to terrorism. Very little research has been done on covid-19 amongst IDPs in Africa and this is one of the first studies in Burkina Faso. Our diversified sample allowed us to consider the discourses of humanitarian actors working with IDPs, but also the discourses of IDPs in a context of aggravated health and security crisis. The challenges encountered by IDPs in implementing physical distancing and the coping strategies have been documented. It showed some possible solutions that decision-makers could use in order to facilitate the appropriation of this measure by IDPs. This is a contribution to the field of applied human and social science research They will help to anticipate solutions in the event of a resurgence of covid-19 cases. In the current context, where the spread of the disease seems to be under control, concerted action should now be taken in the event of the detection of a case of covid-19 in the various IDP sites.
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Affiliation(s)
- Kadidiatou Kadio
- Département Biomédical et de Santé Publique, Institut de recherche en sciences de la santé (IRSS), du Centre National de la Recherche scientifique et Technologique (CNRST), Ouagadougou, Burkina Faso
- Fellow Pilote African Postdoctrorat Academy – PAPA, Goethe University Frankfurt, Frankfurt, Hesse, Germany
| | - Antarou Ly
- Département Biomédical et de Santé Publique, Institut de recherche en sciences de la santé (IRSS), du Centre National de la Recherche scientifique et Technologique (CNRST), Ouagadougou, Burkina Faso
- Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec, QC, Canada
- Centre de recherche du CHU de Québec, Laval University, Quebec, QC, Canada
| | - Adidjata Ouédraogo
- Département Biomédical et de Santé Publique, Institut de recherche en sciences de la santé (IRSS), du Centre National de la Recherche scientifique et Technologique (CNRST), Ouagadougou, Burkina Faso
| | | | - Sanni Yaya
- Faculté des sciences sociales, University of Ottawa, Ottawa, ON, Canada
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Mazhnaya A, Meteliuk A, Pykalo I, Altice FL. Qualitative exploration of the early experiences of opioid use disorder patients from private clinics after Russia's invasion of Ukraine in five major cities in Ukraine. Front Public Health 2023; 11:1238188. [PMID: 38162610 PMCID: PMC10756895 DOI: 10.3389/fpubh.2023.1238188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 11/06/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Following the full-scale invasion of Ukraine by the Russian Federation on 24 February 2022, over 6,000 patients were at risk of potential disruptions in treatment with medications for opioid use disorder (MOUD) in Ukraine. Before 2022, privatized MOUD clinics had emerged, partly driven by restrictive governmental policies and practices in state-funded facilities. Nevertheless, scant information exists regarding their operation and the patient's experiences, especially during crises. This study seeks to elucidate the initial lived experiences of patients utilizing private MOUD clinics, integrating these insights with an analysis of the responding health system during war. Methods The findings are derived from 20 qualitative semi-structured interviews conducted between March and June 2022, engaging participants from five major Ukrainian cities: Kharkiv, Kyiv, Odesa, Poltava, and Zaporizhzhya. Employing a rapid analysis procedure, we examined the data through descriptive and analytical summaries aligned with the domains of the data collection instrument. Results Emergent themes encompassed stress and uncertainty following the invasion's onset, challenges accessing MOUD, and consequent perceptions concerning state-funded versus private clinics. The study identified disruptions in the operation of private MOUD clinics across most cities examined. Issues pertaining to MOUD medication availability were linked to dosage reductions at state-funded clinics or pharmacy medication shortages or closures. Despite varied experiences at different MOUD clinics and cities, most participants continued their treatment. Discussion This qualitative exploration provides a perspective on lived experiences with MOUD treatment at private clinics amidst the initial months of the invasion, illuminating how the early days' stress, access challenges, varied responses from private MOUD clinics, and precarious conditions informed or altered preferences regarding MOUD treatment options. Moreover, these findings corroborate previously documented efforts by myriad stakeholders to mitigate war-related disruptions to MOUD delivery. These insights contribute to the international understanding of health system navigation and resilience during major crises, offering valuable lessons for preparedness development.
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Affiliation(s)
- Alyona Mazhnaya
- School of Public Health, National University of Kyiv-Mohyla Academy, Kyiv, Ukraine
| | - Anna Meteliuk
- International Charitable Foundation “Alliance for Public Health”, Kyiv, Ukraine
| | - Iryna Pykalo
- Ukrainian Institute on Public Health Policy, Kyiv, Ukraine
| | - Frederick L. Altice
- Department of Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT, United States
- Division of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, United States
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Badri R, Fahal AH. The impact of the Sudan armed conflict on Mycetoma control. PLoS Negl Trop Dis 2023; 17:e0011783. [PMID: 38060462 PMCID: PMC10703249 DOI: 10.1371/journal.pntd.0011783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Affiliation(s)
- Rawa Badri
- The Mycetoma Research Center, University of Khartoum, Khartoum, Sudan
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
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Gidado S, Musa M, Ba'aba AI, Okeke LA, Nguku PM, Hadejia IS, Hassan IA, Bande IM, Onuoha M, Ugbenyo G, Godwin N, Usman R, Manu JI, Mohammed AM, Abdullahi MM, Bammami MI, Nuorti P, Atkins S. Factors associated with health-seeking patterns among internally displaced persons in complex humanitarian emergency, Northeast Nigeria: a cross-sectional study. Confl Health 2023; 17:54. [PMID: 37940958 PMCID: PMC10630990 DOI: 10.1186/s13031-023-00552-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/01/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Currently, over two million persons are internally displaced because of the complex humanitarian emergency in Nigeria's northeast region. Due to crowded and unsanitary living conditions, the risk of communicable disease transmission, morbidity, and mortality among this population is high. This study explored patterns and factors associated with health-seeking among internally displaced persons (IDPs) in northeast Nigeria to inform and strengthen disease surveillance and response activities. METHODS In a cross-sectional study conducted during June-October 2022, we employed stratified sampling technique to select 2,373 IDPs from 12 IDPs camps. A semi-structured tool was used to collect data on health-seeking patterns, socio-demographics, households, and IDPs camps characteristics. We classified health-seeking patterns into three outcome categories: 'facility care' (reference category), 'non-facility care' (patent medicine vendors, chemists, traditional healers, religious centers), and 'home care/no care'. We performed complex survey data analysis and obtained weighted statistical estimates. Univariate analysis was conducted to describe respondents' characteristics and health-seeking patterns. We fitted weighted multivariable multinomial logistic regression models to identify factors associated with health-seeking patterns. RESULTS Of 2,373 respondents, 71.8% were 18 to 39 years old, 78.1% were females, and 81.0% had no formal education. Among the respondents, 75.7% (95% CI: 72.9-78.6) sought 'facility care', 11.1% (95% CI: 9.1-13.1) sought 'non-facility care', while 13.2% (95% CI: 10.9-15.4) practiced 'home care/no care'. Respondents who perceived illness was severe (Adjusted Odds Ratio (AOR) = 0.15, [95% CI: 0.08-0.30]) and resided in officially-recognized camps (AOR = 0.26, [95% CI: 0.17-0.39]) were less likely to seek 'non-facility care' compared to 'facility care'. Similarly, respondents who resided in officially-recognized camps (AOR = 0.58, [95% CI: 0.36-0.92]), and received disease surveillance information (AOR = 0.42, [95% CI: 0.26-0.67) were less likely to practice 'home care/no care' rather than seek 'facility care'. CONCLUSIONS This population exhibited heterogeneous patterns of health-seeking at facility and non-facility centers. Perception of illness severity and camps' status were major factors associated with health-seeking. To enhance surveillance, non-facility care providers should be systematically integrated into the surveillance network while ramping up risk communication to shape perception of illness severity, prioritizing unofficial camps.
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Affiliation(s)
- Saheed Gidado
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland.
| | - Melton Musa
- African Field Epidemiology Network, Borno State Field Office, Maiduguri, Nigeria
| | | | - Lilian Akudo Okeke
- African Field Epidemiology Network, Adamawa State Field Office, Yola, Nigeria
| | - Patrick M Nguku
- African Field Epidemiology Network, Country Office, Abuja, Nigeria
| | - Idris Suleman Hadejia
- Department of Community Medicine, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - Isa Ali Hassan
- Borno State Ministry of Health, Maiduguri, Borno State, Nigeria
| | - Ibrahim Muhammad Bande
- Department of Disease Control and Immunization, Yobe State Primary Health Care Board, Damaturu, Yobe State, Nigeria
| | - Martins Onuoha
- Nigerian Correctional Service, Adamawa State Office, Yola, Adamawa State, Nigeria
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
| | - Gideon Ugbenyo
- African Field Epidemiology Network, Country Office, Abuja, Nigeria
| | - Ntadom Godwin
- Epidemiology Division, Federal Ministry of Health, Abuja, Nigeria
| | | | | | | | | | | | - Pekka Nuorti
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Salla Atkins
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
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Koshe T, Jarso MH, Walde MT, Ebrahim J, Mamo A, Esmael A, Wedajo LF, Seife S, Mohammedhussein M, Nigatu D, Debele GR, Gezmu W. A post-traumatic stress disorder among internally displaced people in sub-Saharan Africa: a systematic review. Front Psychiatry 2023; 14:1261230. [PMID: 38025413 PMCID: PMC10655091 DOI: 10.3389/fpsyt.2023.1261230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Despite the prevalence of post-traumatic disorder in internally displaced persons, which is well established, and the fact that respective international organizations are working on the issues, little attention is given in the context of sub-Saharan Africa, This study aims to review the available data about the prevalence and determinants of post-traumatic stress disorders among internally displaced people in sub-Saharan Africa. Methods Studies published in the English language that have a clear outcome of interest and are available in full text were included. Six electronic databases were searched to identify published studies on the prevalence and determinants of posttraumatic stress disorder among IDPs in sub-Saharan Africa. This includes PubMed/MEDLINE, Scopus, EMBASE, PsychInfo, and the Web of Science. All relevant studies till June, 2023 were assessed. The review was done as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA-2009) and registered on PROSPERO (CRD420222997111). Results Originally, 33,138 articles were found in six databases, and finally, eleven studies were reviewed. The prevalence of post-traumatic stress disorder in sub-Saharan African countries was disproportionately presented in this review, ranging from 12.3% in Central Sudan to 85.5% in Nigeria. From a total of 11 studies, eight of them reported more than 50% of the magnitude of post-traumatic stress disorder, pointing to a higher magnitude of the prevalence of post-traumatic stress disorders in the region. The study identified numerous factors that contributed to post-traumatic stress disorder among the internally displaced population. Female gender, depression, anxiety, stress, being single, low level of educational status, experiencing or witnessing traumatic events, and psychological trauma were evidenced for their association with post-traumatic stress disorder. Conclusion These results demonstrate a higher prevalence of post-traumatic stress disorder compared to other regions of the world. The participants' socio-demographic characteristics, including age, being single, being female, and a low level of education, were identified as factors contributing to PTSD. Moreover, the review identified that depression, anxiety, and experiencing or witnessing traumatic events were also influencing factors for PTSD among IDPs. The concerned bodies need to reinforce the monitoring and evaluation of the mental health programs of IDPs in the region. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=299711, CRD42022299711.
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Affiliation(s)
- Tura Koshe
- Department of Nursing, College of Health Sciences, Madda Walabu University, Shashemene, Ethiopia
| | | | - Mandaras Tariku Walde
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Jemal Ebrahim
- Department of Psychiatry, College of Health Sciences, Madda Walabu University, Shashemene, Ethiopia
| | - Aman Mamo
- Department of Nursing, College of Health Sciences, Madda Walabu University, Shashemene, Ethiopia
| | - Adem Esmael
- Department of Psychiatry, College of Health Sciences, Madda Walabu University, Robe, Ethiopia
| | - Lema Fikadu Wedajo
- Department of Midwifery, College of Health Sciences, Mattu University, Mattu, Ethiopia
| | - Solomon Seife
- Department of Midwifery, College of Health Sciences, Madda Walabu University, Shashemene, Ethiopia
| | - Mustefa Mohammedhussein
- Department of Psychiatry, College of Health Sciences, Madda Walabu University, Robe, Ethiopia
| | - Desalegn Nigatu
- Department of Nursing, College of Health Sciences, Mattu University, Mattu, Ethiopia
| | - Gebiso Roba Debele
- Department of Public Health, College of Health Sciences, Mattu University, Mattu, Ethiopia
| | - Wubishet Gezmu
- Department of Nursing, College of Health Sciences, Mattu University, Mattu, Ethiopia
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Kelly-Hope LA, Harding-Esch EM, Willems J, Ahmed F, Sanders AM. Conflict-climate-displacement: a cross-sectional ecological study determining the burden, risk and need for strategies for neglected tropical disease programmes in Africa. BMJ Open 2023; 13:e071557. [PMID: 37197807 DOI: 10.1136/bmjopen-2023-071557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Abstract
OBJECTIVES Complex challenges such as political instability, climate change and population displacement are increasing threats to national disease control, elimination and eradication programmes. The objective of this study was to determine the burden and risk of conflict-related and climate-related internal displacements and the need for strategies for countries endemic with neglected tropical diseases (NTDs). DESIGN, SETTING AND OUTCOME MEASURES A cross-sectional ecological study was conducted including countries that are endemic with at least one of five NTDs requiring preventive chemotherapy in the African region. For each country, the number of NTDs, population size and the number and rate per 100 000 of conflict-related and natural disaster-related internal displacements reported in 2021 were classified into high and low categories and used in unison to stratify and map the burden and risk. RESULTS This analysis identified 45 NTD-endemic countries; 8 countries were co-endemic with 4 or 5 diseases and had populations classified as 'high' totalling >619 million people. We found 32 endemic countries had data on internal displacements related to conflict and disasters (n=16), disasters only (n=15) or conflict only (n=1). Six countries had both high conflict-related and disaster-related internal displacement numbers totalling >10.8 million people, and five countries had combined high conflict-related and disaster-related internal displacement rates, ranging from 770.8 to 7088.1 per 100 000 population. Weather-related hazards were the main cause of natural disaster-related displacements, predominately floods. CONCLUSIONS This paper presents a risk stratified approach to better understand the potential impact of these complex intersecting challenges. We advocate for a 'call to action' to encourage national and international stakeholders to further develop, implement and evaluate strategies to better assess NTD endemicity, and deliver interventions, in areas at risk of, or experiencing, conflict and climate disasters, in order to help meet the national targets.
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Affiliation(s)
- Louise A Kelly-Hope
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | | | - Johan Willems
- CBM Christoffel-Blindenmission Christian Blind Mission e.V, Bensheim, Germany
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Rengifo-Reina H, Barrientos-Gutiérrez T, López-Olmedo N, Sánchez BN, Diez Roux AV. Frailty in Older Adults and Internal and Forced Migration in Urban Neighborhood Contexts in Colombia. Int J Public Health 2023; 68:1605379. [PMID: 37215649 PMCID: PMC10196000 DOI: 10.3389/ijph.2023.1605379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 04/20/2023] [Indexed: 05/24/2023] Open
Abstract
Objective: We investigated the association between the density of internal human migration, in the urban neighborhood, on frailty in the older adult population in Colombia. Methods: The data used in this study are from four Colombian population surveys. We analyzed 633 census tracts with a sample of 2,194 adults 60 years and over for frailty (measured using the Fried criteria). We considered the proportion of inhabitants in a census tract with a history of internal migration as the exposure variable considering three temporalities. For contextual forced migration, we identified two types: 5-year, and 1-year. Poisson multivariable regression models with two hierarchical levels (individual and census tracts) were estimated. Results: The prevalence of pre-fragile/frailty was 80.63% [CI 95%: 77.67, 83.28]. The prevalence ratio were significantly higher for the older adults who live in neighborhoods where a higher proportion of internal migrants reside. Conclusion: We conclude that older adults who lived in neighborhoods with a high proportion of internal migrants experience more frailty. Potential explanations are that neighborhoods with high internal migration could experience social (l increase in cultural heterogeneity, in the perception of insecurity, violence and physical conditions (pressure on local economies and services, leading elderly residents to compete for neighborhood resources), translated into social stress.
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Affiliation(s)
- Herney Rengifo-Reina
- Center for Population Health Research, National Institute of Public Health (Mexico), Cuernavaca, Mexico
| | | | - Nancy López-Olmedo
- Center for Population Health Research, National Institute of Public Health (Mexico), Cuernavaca, Mexico
| | - Brisa N. Sánchez
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, PA, United States
| | - Ana V. Diez Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
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Benson J, Brand T, Christianson L, Lakeberg M. Localisation of digital health tools used by displaced populations in low and middle-income settings: a scoping review and critical analysis of the Participation Revolution. Confl Health 2023; 17:20. [PMID: 37061703 PMCID: PMC10105546 DOI: 10.1186/s13031-023-00518-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 04/04/2023] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND Forced displacement is a crucial determinant of poor health. With 31 people displaced every minute worldwide, this is an important global issue. Addressing this, the Participation Revolution workstream from the World Humanitarian Summit's Localisation commitments has gained traction in attempting to improve the effectiveness of humanitarian aid. Simultaneously, digital health initiatives have become increasingly ubiquitous tools in crises to deliver humanitarian assistance and address health burdens. OBJECTIVE This scoping review explores how the localisation agenda's commitment to participation has been adopted within digital health interventions used by displaced people in low-and-middle-income countries. METHODS This review adopted the Arksey and O'Malley approach and searched five academic databases and three online literature repositories with a Population, Concept and Context inclusion criteria. Data were synthesised and analysed through a critical power lens from the perspective of displaced people in low-and-middle-income-countries. RESULTS 27 papers demonstrated that a heterogeneous group of health issues were addressed through various digital health initiatives, principally through the use of mobile phones. The focus of the literature lay largely within technical connectivity and feasibility assessments, leaving a gap in understanding potential health implications. The varied conceptualisation of the localisation phenomenon has implications for the future of participatory humanitarian action: Authorship of reviewed literature primarily descended from high-income countries exposing global power dynamics leading the narrative. However, power was not a central theme in the literature: Whilst authors acknowledged the benefit of local involvement, participatory activities were largely limited to informing content adaptations and functional modifications within pre-determined projects and objectives. CONCLUSION With over 100 million people displaced globally, effective initiatives that meaningfully address health needs without perpetuating harmful inequalities are an essential contribution to the humanitarian arena. The gap in health outcomes evidence, the limited constructions of health, and the varying and nuanced digital divide factors are all indicators of unequal power in the digital health sphere. More needs to be done to address these gaps meaningfully, and more meaningful participation could be a crucial undertaking to achieve this. Registration The study protocol was registered before the study (10.17605/OSF.IO/9D25R) at https://osf.io/9d25r .
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Affiliation(s)
- Jennifer Benson
- Faculty of Human and Health Sciences, Public Health, The University of Bremen, Bremen, Germany.
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
- Leibniz Science Campus Digital Public Health, Bremen, Germany.
| | - Tilman Brand
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Lara Christianson
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Meret Lakeberg
- Faculty of Human and Health Sciences, Public Health, The University of Bremen, Bremen, Germany
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
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17
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Kyaw KWY, Platt L, Bijl M, Rathod SD, Naing AY, Roberts B. The effect of different types of migration on symptoms of anxiety or depression and experience of violence among people who use or inject drugs in Kachin State, Myanmar. Harm Reduct J 2023; 20:45. [PMID: 37013591 PMCID: PMC10068727 DOI: 10.1186/s12954-023-00766-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/13/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Evidence on the social determinants of mental health conditions and violence among people who inject or use drugs (PWUD) is limited, particularly in conflict-affected countries. We estimated the prevalence of symptoms of anxiety or depression and experience of emotional or physical violence among PWUD in Kachin State in Myanmar and examined their association with structural determinants, focusing on types of past migration (migration for any reason, economic or forced displacement). MATERIALS A cross-sectional survey was conducted among PWUD attending a harm reduction centre between July and November 2021 in Kachin State, Myanmar. We used logistic regression models to measure associations between past migration, economic migration and forced displacement on two outcomes (1) symptoms of anxiety or depression (Patient Health Questionnaire-4) and (2) physical or emotional violence (last 12 months), adjusted for key confounders. RESULTS A total of 406, predominantly male (96.8%), PWUD were recruited. The median age (IQR) was 30 (25, 37) years, most injected drugs (81.5%) and more commonly opioid substances such as heroin or opium (85%). Symptoms of anxiety or depression (PHQ4 ≥ 6) were high (32.8%) as was physical or emotional violence in the last 12 months (61.8%). Almost one-third (28.3%) had not lived in Waingmaw for their whole life (migration for any reason), 77.9% had left home for work at some point (economic migration) and 19.5% had been forced to leave home due to war or armed conflict (forced displacement). A third were in unstable housing in the last 3 months (30.1%) and reported going hungry in the last 12 months (27.7%). Only forced displacement was associated with symptoms of anxiety or depression [adjusted odds ratio, aOR 2.33 (95% confidence interval, CI 1.32-4.11)] and recent experience of violence [aOR 2.18 (95% CI 1.15-4.15)]. CONCLUSION Findings highlight the importance of mental health services integrated into existing harm reduction services to address high levels of anxiety or depression among PWUD, particularly among those who have been displaced through armed conflict or war. Findings reinforce the need to address broader social determinants, in the form of food poverty, unstable housing and stigma, in order to reduce mental health and violence.
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Affiliation(s)
- Khine Wut Yee Kyaw
- Asian Harm Reduction Network (AHRN), Yangon, Myanmar.
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
| | - Lucy Platt
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Murdo Bijl
- Asian Harm Reduction Network (AHRN), Yangon, Myanmar
| | - Sujit D Rathod
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Aung Yu Naing
- Asian Harm Reduction Network (AHRN), Yangon, Myanmar
| | - Bayard Roberts
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Tarnas MC, Ching C, Lamb JB, Parker DM, Zaman MH. Analyzing Health of Forcibly Displaced Communities through an Integrated Ecological Lens. Am J Trop Med Hyg 2023; 108:465-469. [PMID: 36746662 PMCID: PMC9978544 DOI: 10.4269/ajtmh.22-0624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/03/2022] [Indexed: 02/08/2023] Open
Abstract
Health care among forcibly displaced persons is frequently driven by siloed approaches. Aspects of the built environment, social factors, and the bidirectional relationship between the changing ecosystem and residents are often ignored in health policy design and implementation. While recognizing factors that create a preference for siloed approaches and appreciating the work of humanitarian agencies, we argue for a new data-driven and holistic approach to understand the health of the forcibly displaced. It should be rooted in the realities of the emergence of new diseases, dynamic demographics, and degrading environments around the displaced communities. Such an approach envisions refugee and internally displaced camps as dynamic, complex ecosystems that alter, and are altered by, spatial and temporal factors. At the root of this approach is the necessity to work across disciplines, to think holistically, to go beyond treating single ailments, and to develop ethical approaches that provide dignity to those who are forcibly displaced.
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Affiliation(s)
- Maia C. Tarnas
- Department of Population Health and Disease Prevention, University of California, Irvine, California
| | - Carly Ching
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts
| | - Joleah B. Lamb
- Department of Ecology & Evolutionary Biology, University of California, Irvine, California
| | - Daniel M. Parker
- Department of Population Health and Disease Prevention, University of California, Irvine, California
| | - Muhammad H. Zaman
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts
- Address correspondence to Muhammad Zaman, Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Rm. 301, Boston, MA 02215. E-mail:
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Rofo S, Gelyana L, Moramarco S, Alhanabadi LHH, Basa FB, Dellagiulia A, Emberti Gialloreti L. Prevalence and risk factors of posttraumatic stress symptoms among Internally Displaced Christian couples in Erbil, Iraq. Front Public Health 2023; 11:1129031. [PMID: 37033064 PMCID: PMC10076725 DOI: 10.3389/fpubh.2023.1129031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/07/2023] [Indexed: 04/11/2023] Open
Abstract
Background Research about the impact of war and displacement experiences on the mental health of Internally Displaced People (IDPs) has recently grown. However, a limited number of studies focus on minorities. The objective of the present preliminary study was to estimate the prevalence of posttraumatic stress symptoms (PTSSs) among IDPs who live outside camps and belong to the Christian minority in Iraq, and to identify possible predictors. Methods Overall, 108 internally displaced Christians (54 married couples) participated in the study. Traumatic events and PTSSs were assessed using the Harvard Trauma Questionnaire. Multivariable linear regression models were used to investigate possible predictors of PTSSs. Multivariable logistic regression models have been developed to estimate the odds of presenting PTSSs. Results Results demonstrated high rates of trauma exposure, with all participants having experienced at least three traumatic events. The estimated prevalence of PTSSs was 20.3%. A low economic status, the number of traumatic events, and a second experience of displacement were associated with increased PTSSs. Five traumatic events were identified as the main predictors of PTSSs. Conclusion Findings from the current preliminary study indicated the impact of war-related traumatic events on IDPs' mental health and the negative effects of post-displacement experiences. These findings may have important implications for setting up psychosocial interventions, as well as for further promoting physical and mental health services among these populations.
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Affiliation(s)
- Sana Rofo
- Department of Psychology, Salesian University of Rome, Rome, Italy
| | - Lina Gelyana
- Department of Psychology, Salesian University of Rome, Rome, Italy
| | - Stefania Moramarco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Luma H. H. Alhanabadi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Department of Primary Health Care, Preventive Health Affairs Directorate, Duhok, Iraq
| | - Faiq B. Basa
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Internal Medicine Department, Rizgary Teaching Hospital, Erbil, Iraq
| | | | - Leonardo Emberti Gialloreti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- *Correspondence: Leonardo Emberti Gialloreti
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Lee C, Emeto TI, Walsh N. Prevalence of hepatitis B virus amongst refugees, asylum seekers and internally displaced persons in low- and middle-income countries: A systematic review. J Viral Hepat 2023; 30:4-18. [PMID: 36357172 PMCID: PMC10100144 DOI: 10.1111/jvh.13770] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 11/03/2022] [Indexed: 11/12/2022]
Abstract
Hepatitis B, caused by the hepatitis B virus (HBV), is a global public health issue that affects 290 million people worldwide. Most people with hepatitis B are in low- and middle-income countries (LMIC), where health systems and resources are often constrained. Refugees, asylum seekers and internally displaced persons (IDPs) often face barriers in seeking health care and are a priority population at risk of hepatitis B. No systematic review to date has evaluated the prevalence of hepatitis B amongst refugees in in LMIC. We undertook a systematic review of the literature identifying 28 studies addressing this topic. Though few studies on this topic exist, the available evidence suggests a high prevalence amongst refugees in LMIC, with wide variation between and within countries. Possible risk factors contributing to hepatitis B include unsafe injections, low immunization coverage, low awareness, mother-to-child transmission, and limited health services. Further study is needed to better understand the prevalence and risk factors for hepatitis B amongst refugees in LMIC, to inform public health responses. Vulnerable populations such as refugees are an important group to consider in national and global efforts to eliminate hepatitis B.
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Affiliation(s)
- Caroline Lee
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.,University of New South Wales, Kensington, New South Wales, Australia
| | - Theophilus I Emeto
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.,World Health Organization Collaborating Center for Vector-Borne and Neglected Tropical Diseases, James Cook University, Townsville, Queensland, Australia.,Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia
| | - Nick Walsh
- Monash University, Clayton, Victoria, Australia
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O'Connell KA, Hailegebriel TS, Garfinkel D, Durham J, Yakob B, Kassaw J, Kebede AT. Meeting the Sexual and Reproductive Health Needs of Internally Displaced Persons in Ethiopia's Somali Region: A Qualitative Process Evaluation. GLOBAL HEALTH, SCIENCE AND PRACTICE 2022; 10:GHSP-D-21-00818. [PMID: 36316134 PMCID: PMC9622291 DOI: 10.9745/ghsp-d-21-00818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 09/26/2022] [Indexed: 03/11/2023]
Abstract
INTRODUCTION Meeting the sexual and reproductive health and rights (SRHR) needs of internally displaced persons (IDPs) is critical. Despite increased prioritization and coverage of sexual and reproductive health (SRH) services in humanitarian settings in recent decades, significant unmet needs remain. In Ethiopia, there are more than 2 million IDPs, an estimated 40% of whom have unmet need for modern contraceptives. To address this, EngenderHealth implemented a model of SRHR programming in Ethiopia's Somali region. We share the lessons learned from this project to improve access to SRH services among IDPs. METHODS In 2021, an independent research team implemented a qualitative process evaluation among 13 key informant interviews (KIIs) with health system actors, local government partners, and organizations, and 4 focus group discussions (FGDs) with community members and community health volunteers. The team selected participants purposively following the maximum variation sampling technique and analyzed the data in NVivo 12. The team used KII and FGD guides to explore and understand what was implemented, which stakeholders were engaged in the processes and how, what was achieved, and the barriers and facilitators in implementation. RESULTS Contributions to project achievements included strong partnerships and stakeholder engagement, an enabling environment for SRHR, improving health worker capacity, and flexibility and adaptability. Challenges included a fragile security situation, retention of providers, and difficulty in accessing gender-based violence services, exacerbated by the coronavirus disease (COVID-19) pandemic. CONCLUSION Our article offers guidance for organizations and government entities seeking to design and implement SRHR programs in humanitarian settings. Findings highlight the importance of prioritizing SRHR programming in IDP settings and illustrate adaptable activities to assist with project implementation and minimize operational challenges.
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Affiliation(s)
| | | | | | | | - Bereket Yakob
- College of Health Sciences and Medicine, Wolaita Sodo University, Sodo, Ethiopia
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22
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Noh JW, Cheon J, Kim KB, Song SE, Cha J, Kwon YD. Contributing Factors in Whether Displaced Households Want to Receive Humanitarian Information from Humanitarian Actors: Iraq Multi-Cluster Needs Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610114. [PMID: 36011749 PMCID: PMC9408100 DOI: 10.3390/ijerph191610114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/10/2022] [Accepted: 08/15/2022] [Indexed: 05/30/2023]
Abstract
Due to political conflict, insurgency, and the COVID-19, the number of displaced households in need of humanitarian support in Iraq has increased. This study investigated factors related to desire of displaced households to receive humanitarian information. Data from the eighth round of the Iraq Multi-Cluster Needs Assessment was used. We classified the household displacement status, identifying levels and types of humanitarian information that the households sought, together with whether the households were impacted by COVID-19. We identified safety and security, housing, water and electricity services, education, health care, and levels of humanitarian assistance resulted in significant differences between internally displaced person (IDP) and returnee households in terms of interest in receiving humanitarian information. The desire to receive humanitarian information was related to whether household members were unemployed due to COVID-19, displacement status, and walking time to reach the nearest health care facility and marketplace. Returnees and IDPs in Iraq are facing a new crisis. Their individual, structural, and environmental vulnerabilities are increasing commensurately. New strategies such as strategies using online or mobile communication that provide humanitarian information are needed to provide humanitarian information to vulnerable groups such as those who have lost jobs due to COVID-19, female heads of households, and those with health problems. In addition to traditional cash and voucher support, the use of the latest technologies such as smartphones and mobile clinics in humanitarian settings would be new strategies.
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Affiliation(s)
- Jin-Won Noh
- Division of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju 26493, Korea
| | - Jooyoung Cheon
- Department of Nursing Science, Sungshin Women’s University, Seoul 02844, Korea
| | - Kyoung-Beom Kim
- Department of Health University, Dankook University, Cheonan 31116, Korea
| | - Si Eun Song
- Department of Health University, Dankook University, Cheonan 31116, Korea
- Industry-University Cooperation Foundation, Soonchunhyang University, Asan 31538, Korea
| | - Jiho Cha
- Moon Soul Graduate School of Future Strategy, Korea Advanced Institute of Science and Technology, Daejeon 34141, Korea
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, The Catholic University of Korea, Seoul 06591, Korea
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23
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Lefrant JY, Pirracchio R, Benhamou D, Fischer MO, Njeim R, Allaouchiche B, Bastide S, Biais M, Bouvet L, Brissaud O, Brull SJ, Capdevila X, Clausen N, Cuvillon P, Dadure C, David JS, Du B, Einav S, Eley V, Forget P, Fujii T, Godier A, Gopalan DP, Hamada S, Hasanin A, Joannes-Boyau O, Kerever S, Kipnis É, Kolodzie K, Landau R, Le Gall A, Le Guen M, Legrand M, Lorne E, Mercier FJ, Mongardon N, Myatra S, Nicolas-Robin A, John Peters M, Quintard H, Rello J, Richebé P, Roberts JA, Rocquilly A, Sanfilippo F, Schneider A, Sofonea MT, Veyckemans F, Zetlaoui P, Zeidan A, Zieleskiewicz L, Zielinska M, Von Ungern-Sternberg B, Abou Arab O, Blet A, Bounes F, Boisson M, Caillard A, Carillion A, Clavier T, Frasca D, James A, Sigaut S, Rozencwajg S, Albaladejo P, Bouaziz H. Peace, not war in Ukraine or anywhere else, please. Anaesth Crit Care Pain Med 2022; 41:101068. [PMID: 35460922 DOI: 10.1016/j.accpm.2022.101068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Jean-Yves Lefrant
- Department of Anaesthesiology, Critical Care and Emergency Medicine, Université de Montpellier-Nîmes, CHU de Nîmes, 30029 Nîmes, France; Editor-in-Chief of ACCPM, French Society of Anaesthesia and Critical Care (SFAR), 74, rue Raynouard, 75016 Paris, France.
| | - Romain Pirracchio
- Department of Anaesthesia and Perioperative Medicine, University of California, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, USA; Deputy Editor-in-Chief of ACCPM, French Society of Anaesthesia and Critical Care (SFAR), 74, rue Raynouard, 75016 Paris, France
| | - Dan Benhamou
- University, Department of Anaesthesia and Intensive Care Medicine, Bicêtre Hospital, 94270 Le Kremlin-Bicêtre, France; Advisory Editor of ACCPM, French Society of Anaesthesia and Critical Care (SFAR), 74, rue Raynouard, 75016 Paris, France
| | - Marc-Olivier Fischer
- Advisory Editor of ACCPM, French Society of Anaesthesia and Critical Care (SFAR), 74, rue Raynouard, 75016 Paris, France; Caen University Hospital, Anaesthesiology and Critical Care Medicine Department, Caen, France
| | - Rosanna Njeim
- Editorial Assistant of ACCPM, French Society of Anaesthesia and Intensive Care Medicine (SFAR), 74, rue Raynouard, 75016 Paris, France
| | | | | | - Matthieu Biais
- University Hospital Centre Bordeaux, Department of Anaesthesiology and Critical Care Medicine, 33300 Bordeaux, France; Univ. Bordeaux, INSERM, Biologie des Maladies Cardiovasculaires, U1034, F-33600 Pessac, France
| | - Lionel Bouvet
- Department of Anaesthesiology and Intensive Care, Hospices Civils de Lyon, Groupement Hospitalier Est - Hôpital Femme Mère Enfant, 69500 Bron, France
| | - Olivier Brissaud
- University Hospital Centre Bordeaux, Paediatric Intensive Care Unit, 33300 Bordeaux, France
| | - Sorin J Brull
- Mayo Clinic, College of Medicine and Science, Department of Anaesthesiology and Perioperative Medicine, Jacksonville, United States
| | - Xavier Capdevila
- Montpellier University Hospital Centre, Department of Anaesthesia and Intensive Care, 34090 Montpellier, France
| | - Nicola Clausen
- Anæstesiologisk Intensiv Afdeling V, Odense, Odense Universitetshospital, J.B. Winsløws Vej 4, 5000 Odense C, Danmark
| | - Philippe Cuvillon
- Nîmes University Hospital, CHU Carémeau, Critical Care and Emergency Medicine, Pain Dept, 30029 Nîmes, France
| | - Christophe Dadure
- Lapeyronie Hospital, Paediatric Anaesthesia Department, 34090 Montpellier, France
| | - Jean-Stéphane David
- Civil Hospices of Lyon Department of Anaesthesiology and Critical Care Medicine, Lyon, France
| | - Bin Du
- State Key Laboratory of Rare, Complex and Critical Diseases, Medical Intensive Care Unit, Peking Union Medical College Hospital, Beijing 100730, China
| | - Sharon Einav
- General Intensive Care Unit of the Shaare Zedek Medical Centre, Jerusalem, Israel; Hebrew University Faculty of Medicine, Jerusalem, Israel
| | - Victoria Eley
- Department of Anaesthesia and Perioperative Medicine, The Royal Brisbane and Women's Hospital, Butterfield St, Herston 4006, Queensland, Australia; Faculty of Medicine, The University of Queensland, St Lucia 4067, Queensland, Australia
| | - Patrice Forget
- University of Aberdeen, Institute of Applied Health Sciences, Department of Anaesthesia, Aberdeen, United Kingdom
| | - Tomoko Fujii
- Jikei University Hospital, Intensive Care Unit, Tokyo, Japan
| | - Anne Godier
- Department of Anaesthesia and Intensive care, Hôpital Européen Georges Pompidou, Université de Paris, 20 rue Leblanc, 75015 Paris, France
| | - Dean P Gopalan
- University of KwaZulu-Natal College of Health Sciences, Durban, South Africa
| | - Sophie Hamada
- Department of Anaesthesia and Intensive care, Hôpital Européen Georges Pompidou, Université de Paris, 20 rue Leblanc, 75015 Paris, France
| | - Ahmed Hasanin
- epartment of Anesthesia and Critical Care, Cairo University, Cairo, Egypt
| | | | - Sébastien Kerever
- Department of Anesthesiology and Critical Care Medicine, Lariboisière University Hospital, DMU PARABOL, AP-HP. Nord, Paris, France; Fédération Hospitalo-Universitaire PROMICE, INSERM UMR-S 942 MASCOT, Université de Paris, Paris, France
| | - Éric Kipnis
- Department of Anaesthesia and Intensive Care, Lille University Hospital, 1, rue Michel-Polonowski, 59037 Lille, France
| | - Kerstin Kolodzie
- Department of Anaesthesia and & Perioperative Care, University of California San Francisco, San Francisco, California, USA
| | - Ruth Landau
- Columbia University Vagelos College of Physicians and Surgeons, New York, United States
| | - Arthur Le Gall
- Department of Anaesthesia, Critical Care and Peri-operative Medicine, Rennes University Hospital, Rennes, France
| | - Morgan Le Guen
- Paris Saclay University, Department of Anaesthesia and Pain Medicine, Foch Hospital, 92150 Suresnes, France
| | - Matthieu Legrand
- Department of Anaesthesia and Perioperative Medicine, University of California, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, USA
| | - Emmanuel Lorne
- Department of Anaesthesia and Critical Care Medicine, Clinique du Millénaire, 34960 Montpellier Cedex 2, France
| | - Frédéric J Mercier
- Paris-Saclay University, Antoine-Béclère Hospital, Department of Anaesthesia and Critical Care Medicine, Clamart, France
| | - Nicolas Mongardon
- Service d'anesthésie-réanimation chirurgicale, DMU CARE, DHU A-TVB, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Université Paris Est Créteil, Faculté de Santé, F-94010 Créteil, France
| | - Sheila Myatra
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | | | - Mark John Peters
- Great Ormond Street Hospital for Children Paediatric Intensive Care Unit, London, United Kingdom
| | - Hervé Quintard
- University Hospital Centre Nice Anesthesia, Resuscitation Emergency Department, Nice, France
| | - Jordi Rello
- International University of Cataluna Faculty of Medicine and Health Sciences, Sant Cugat del Valles, Spain
| | - Philippe Richebé
- niversity of Montreal Department of Anaesthesiology and Pain Medicine, Maisonneuve Rosemont Hospital, CIUSSS de l'Est de l'Ile de Montreal, Montréal, Canada
| | | | - Antoine Rocquilly
- University of Nantes - Anaesthesiology and Intensive Care Unit, Nantes, France
| | - Filippo Sanfilippo
- Department of Anaesthesia and Intensive Care, Policlinico University Hospital, Catania, Italy
| | - Antoine Schneider
- Lausanne University Hospital Adult Intensive Care Unit, Vaud, Switzerland
| | | | - Francis Veyckemans
- Department of Paediatric Anaesthesia, Jeanne de Flandre hospital, University Hospitals of Lille, 59037 Lille, France
| | - Paul Zetlaoui
- University, Department of Anaesthesia and Intensive Care Medicine, Bicêtre Hospital, 94270 Le Kremlin-Bicêtre, France
| | - Ahed Zeidan
- King Fahad Specialist Hospital, Anesthesiology Department, Dammam, Saudi Arabia
| | - Laurent Zieleskiewicz
- Aix-Marseille University, University Hospital of Marseille, Department of Anaesthesia and Intensive Care Medicine, Marseille, France
| | - Marzena Zielinska
- Wroclaw Medical University, Department of Paediatric Anaesthesiology and Intensive Care, Poland
| | - Britta Von Ungern-Sternberg
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Perth, WA, Australia; Emergency Medicine, Anaesthesia and Pain Medicine, Medical School, The University of Western Australia, Perth, WA, Australia; Team Perioperative Medicine, Telethon Kids Institute, Perth, WA, Australia
| | - Osama Abou Arab
- Anesthésie réanimation cardiovasculaire et thoracique, CHU Amiens, Laboratoire MP3CV, EA 7517, Université Picardie Jules Verne, 1 rue du Professeur Christian Cabrol, 80054 Amiens, France
| | - Alice Blet
- Lyon University Hospital, Department of Anaesthesiology and Critical Care, Croix Rousse University Hospital, Hospices Civils de Lyon, Lyon, France
| | - Fanny Bounes
- INSERM U1052, Cancer Research Center of Lyon, Lyon, France; Pôle Anesthesie Réanimation Médecine peri operatoire CHU Toulouse, 1av du Pr J Poulhes, 31000 Toulouse, France
| | - Matthieu Boisson
- Service d'Anesthésie-Réanimation et Médecine Péri-Opératoire, CHU de Poitiers, Poitiers, France; INSERM U1070, « Pharmacologie des anti-infectieux et résistances », Université de Poitiers, Poitiers, France
| | - Anaïs Caillard
- Centre Hospitalier Universitaire La Cavale Blanche Université de Bretagne Ouest, Anaesthesiology, Critical care and Perioperative medicine Department, Brest, France
| | - Aude Carillion
- Département d'Anesthésie-Réanimation, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Département d'Anesthésie Réanimation, F-75013 Paris, France; UMR-S 1166 ICAN, Unité de recherche sur les maladies cardiovasculaires et métaboliques, Sorbonne Université, France
| | - Thomas Clavier
- Département de Réanimation, Anesthésie et Médecine Périopératoire, Unité de Réanimation Chirurgicale Polyvalente, CHU de Rouen, 37 Bd Gambetta, 76000 Rouen, France; Laboratoire INSERM U1096, Université de Rouen-Normandie, France
| | - Denis Frasca
- Service d'Anesthésie-Réanimation et Médecine Péri-Opératoire, CHU de Poitiers, Poitiers, France; INSERM U1246, SPHERE, Université de Nantes, France
| | - Arthur James
- Sorbonne Université, GRC 29, AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Département d'Anesthésie Réanimation, F-75013 Paris, France
| | - Stéphanie Sigaut
- Department of Anesthesiology and Critical Care, Beaujon Hospital, DMU Parabol, AP-HP, Nord, Paris, France
| | - Sacha Rozencwajg
- Department of Anaesthesiology and Surgical Intensive Care, Bichat Claude-Bernard Hospital, AP-HP, DMU PARABOL, France
| | - Pierre Albaladejo
- Department of Anaesthesiology and Critical Care, Université Grenoble Alpes, CHU Grenoble Alpes, Grenoble, France; Current President of the French Society of Anaesthesia and Intensive Care Medicine (SFAR), Paris, France
| | - Hervé Bouaziz
- Department of Anaesthesiology and Obstetric Critical Care Unit, University Maternity Hospital of Nancy, 54000 Nancy, France; Past President of the French Society of Anaesthesia and Intensive Care Medicine (SFAR), Paris, France
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24
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Measuring contraceptive use in a displacement-affected population using the Multiple Indicator Cluster Survey: the case of Iraq. J Migr Health 2022; 6:100114. [PMID: 35677661 PMCID: PMC9168485 DOI: 10.1016/j.jmh.2022.100114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 04/19/2022] [Accepted: 05/10/2022] [Indexed: 11/23/2022] Open
Abstract
Offers substantive and methodological contributions to the literature on IDP health. Uses Multiple Indicator Cluster Survey data with displacement screening questions. Tests associations between modern contraceptive use and displacement in Iraq. Total survey error and feminist approaches highlight the limits of national household surveys.
Access to safe, effective, affordable, and acceptable contraceptive methods of choice is a basic right for displaced people. Yet displaced people are typically invisible in national sample surveys on population health, and quantitative evidence on their reproductive health outcomes is limited. This study focuses on the case of Iraq, a country with widespread displacement and where contraceptive use is a government policy priority. Using displacement screening questions in the Iraq 2018 Multiple Indicator Cluster Survey questionnaires, I construct two displacement-related indicators based on reason for last move and previous household residence. Descriptive statistics and binary logistic regression are used to test associations between modern contraceptive use and displacement, demographic, and socioeconomic factors. Controlling for the variables in the models, factors significantly associated with modern contraceptive use among married women aged 15–49 in Iraq are Federal Iraq region (reference Kurdish Region of Iraq, OR 1.78), upper secondary and primary education (reference pre-primary or no education, OR 1.50 and 1.20, respectively), parity, age, and exposure to television. The association between displacement (reason for last move) and modern contraceptive use significantly depends on a woman's level of education and whether they live in an urban or rural area. Women who previously lived in a camp are almost half as likely to use modern contraception compared to other previous residence types. This paper highlights the methodological potential and substantive value of using national household surveys to analyse reproductive health outcomes through a displacement lens. It also critically examines the limitations of these data and measures, drawing on total survey error and feminist theory.
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25
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Abbara A, Rayes D, Ekzayez A, Jabbour S, Marzouk M, Alnahhas H, Basha S, Katurji Z, Sullivan R, Fouad FM. The health of internally displaced people in Syria: are current systems fit for purpose? J Migr Health 2022; 6:100126. [PMID: 35942086 PMCID: PMC9356202 DOI: 10.1016/j.jmh.2022.100126] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/22/2022] [Accepted: 07/19/2022] [Indexed: 11/28/2022] Open
Abstract
At 6.7 million, Syria has the largest number of internally displaced people globally. Health of IDPs in Syria is often not disaggregated from that of other populations. IDPs face intersecting vulnerabilities and social determinants which impact health. Syria's fragmented health system results in different system responses for IDPs. The evidence base on IDP health in Syria is weak and requires strengthening.
Introduction: Syria has the largest number of internally displaced people (IDPs) globally with 6.7 million forced from their homes since the uprising erupted in 2011. Most face multiple intersecting vulnerabilities with adverse health impacts. We explore the key health concerns among IDPs, how the various health systems in Syria have responded to the dynamic health needs of IDPs and what modalities have been used by humanitarian actors to address these needs. Methods: We undertook a scoping review of academic and grey literature for available evidence regarding the health of IDPs in Syria. We then organised an online workshop in November 2021 with around 30 participants who represent local, regional, and international organisations and who have relevant expertise. The discussion focused on how the health systems in Syria's various territories have responded to the health needs of IDPs, what this means to the structure and dynamics of these health systems and their intended outcomes and responsiveness. Findings: These emphasised the weak evidence base around IDP health in Syria, particularly in certain geographical areas. Workshop participants explored the applicability of the term IDP in the Syrian context given the fragmented health system and its impact on IDPs, the importance of considering co-determinants (beyond forced displacement) on the health of IDPs and taking a transectoral, community led approach to identify and respond to needs. Conclusion: This manuscript presents some of the current issues with regards to IDP health in Syria, however, there remain numerous unknowns, both for the health of IDP as well as non-IDP populations. We hope that it will be the foundation for further discussions on practical steps relating to research, analysis and interventions which can support health system responses for IDPs in Syria.
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