Literature review of health impact post-earthquakes in China 1906-2007

Systematic review on chronic non-communicable disease in disaster settings

BACKGROUND

Non-communicable diseases (NCDs) constitute the leading cause of mortality globally. Low and middle-income countries (LMICs) not only experience the largest burden of humanitarian emergencies but are also disproportionately affected by NCDs, yet primary focus on the topic is lagging. We conducted a systematic review on the effect of humanitarian disasters on NCDs in LMICs assessing epidemiology, interventions, and treatment.

METHODS

A systematic search in MEDLINE, MEDLINE (PubMed, for in-process and non-indexed citations), Social Science Citation Index, and Global Health (EBSCO) for indexed articles published before December 11, 2017 was conducted, and publications reporting on NCDs and humanitarian emergencies in LMICs were included. We extracted and synthesized results using a thematic analysis approach and present the results by disease type. The study is registered at PROSPERO (CRD42018088769).

RESULTS

Of the 85 included publications, most reported on observational research studies and almost half (48.9%) reported on studies in the Eastern Mediterranean Region (EMRO), with scant studies reporting on the African and Americas regions. NCDs represented a significant burden for populations affected by humanitarian crises in our findings, despite a dearth of data from particular regions and disease categories. The majority of studies included in our review presented epidemiologic evidence for the burden of disease, while few studies addressed clinical management or intervention delivery. Commonly cited barriers to healthcare access in all phases of disaster and major disease diagnoses studied included: low levels of education, financial difficulties, displacement, illiteracy, lack of access to medications, affordability of treatment and monitoring devices, and centralized healthcare infrastructure for NCDs. Screening and prevention for NCDs in disaster-prone settings was supported. Refugee status was independently identified both as a risk factor for diagnosis with an NCD and conferring worse morbidity.

CONCLUSIONS

An increased focus on the effects of, and mitigating factors for, NCDs occurring in disaster-afflicted LMICs is needed. While the majority of studies included in our review presented epidemiologic evidence for the burden of disease, research is needed to address contributing factors, interventions, and means of managing disease during humanitarian emergencies in LMICs.

Health-Related Rehabilitation after the 2008 Great Wenchuan Earthquake in China: A Ten Year Retrospective Systematic Review

Being one of the world's seismically hazard-prone countries, the People's Republic of China (PRC) witnessed an 8.0-magnitude earthquake on May 12th 2008-which was reported as one of the most destructive disasters since its founding. Following this earthquake, rehabilitation was greatly required for survivors to enable them to achieve and maintain optimal independence; functioning; full physical, mental and social ability; inclusion; and participation in all aspects of life and environments. We conducted a systematic review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to retrospectively identify, in five English databases/sources, the existing evidence about the Health-Related Rehabilitation (HRR) that was rendered to the survivors of the 2008 Wenchuan earthquake between 2008 and 2018. Only 11 studies out of 828 initial studies retrieved were included in our study and reported the survivors of the 2008 Wenchuan earthquake to have been aged between 10.5 and 55.7, and predominantly diagnosed with posttraumatic stress disorders. Their HRR was mainly premised on physical and physiological therapies, as well as traditional Chinese medicine and digital technologies. Although all HRR interventions used were reported to be effective, none was identified as much more effective than the others in the post-earthquake era -which calls for more robust research to build upon our systematic review.

A Retrospective Analysis of Mortality From 2015 Gorkha Earthquakes of Nepal: Evidence and Future Recommendations

OBJECTIVE

The aim of this study was to explore the mortality pattern due to Gorkha earthquakes in 2015 and review the response and recovery efforts immediately following the earthquakes.

METHODS

Data from published reports of the Nepal Police showed over 8000 deaths. These death counts were categorized by gender, ethnicity, and age groups (interval of 5 years). The mortality rate was calculated (per 100 000 population), using the projected population as the denominator as of April 2015.

RESULTS

Children < 10 years and older adults > 55 years showed a higher rate of deaths, with similar trends for the most affected districts. Almost 8 more females' deaths were reported per 100 000 population compared with their male counterparts. There was a higher death rate from Province 3 with a notable gender difference: Nearly 20 more females' deaths were reported per 100 000 population compared with their male counterparts. There was a higher death rate in mountains (542.4 per 100 000) compared with hills (55.0 per 100 000) and the southern Terai region (0.96 per 100 000) of Nepal.

CONCLUSIONS

Young and older adults, female, and residents of remote, mountainous regions of Nepal were vulnerable to the earthquakes. Future earthquake preparedness should focus on the vulnerable population by age and gender and the geographical accessibility.

Decision Analysis of Disturbance Management in the Process of Medical Supplies Transportation after Natural Disasters

Public health emergencies, such as casualties and epidemic spread caused by natural disasters, have become important factors that seriously affect social development. Special medical supplies, such as blood and vaccines, are important public health medical resources, and the cold-chain distribution of medical supplies is in a highly unstable environment after a natural disaster that is easily affected by disturbance events. This paper innovatively studies the distribution optimization of medical supplies after natural disasters from the perspective of disturbance management. A disturbance management model for medical supplies distribution is established from two dimensions: time and cost. In addition, a hybrid genetic algorithm is introduced to solve the model. Disturbance recovery schemes with different weight coefficients are obtained through the actual numerical experiments, and experimental results show the effectiveness of the proposed model and algorithm. Finally, we discuss the formulation of weight coefficients in the case of emergency distribution and general distribution, which provide a reference for emergency decisions in disturbance events.

Burden and Management of Noncommunicable Diseases After Earthquakes and Tsunamis

This integrative review examines extant literature assessing the burden and management of noncommunicable diseases 6 months or more after earthquakes and tsunamis. We conducted an integrative review to identify and characterize the strength of published studies about noncommunicable disease-specific outcomes and interventions at least 6 months after an earthquake and/or tsunami. We included disasters that occurred from 2004 to 2016. We focused primarily on the World Health Organization noncommunicable disease designations to define chronic disease, but we also included chronic renal disease, risk factors for noncommunicable diseases, and other chronic diseases or symptoms. After removing duplicates, our search yielded 6,188 articles. Twenty-five articles met our inclusion criteria, some discussing multiple noncommunicable diseases. Results demonstrate that existing medical conditions may worsen and subsequently improve, new diseases may develop, and risk factors, such as weight and cholesterol levels, may increase for several years after an earthquake and/or tsunami. We make 3 recommendations for practitioners and researchers: (1) plan for noncommunicable disease management further into the recovery period of disaster; (2) increase research on the burden of noncommunicable diseases, the treatment modalities employed, resulting population-level outcomes in the postdisaster setting, and existing models to improve stakeholder coordination and action regarding noncommunicable diseases after disasters; and (3) coordinate with preexisting provision networks, especially primary care.

The changing health priorities of earthquake response and implications for preparedness: a scoping review

OBJECTIVES

Earthquakes have substantial impacts on mortality in low- and middle-income countries (LMIC). The academic evidence base to support Disaster Risk Reduction activities in LMIC settings is, however, limited. We sought to address this gap by identifying the health and healthcare impacts of earthquakes in LMICs and to identify the implications of these findings for future earthquake preparedness.

STUDY DESIGN

Scoping review.

METHODS

A scoping review was undertaken with systematic searches of indexed databases to identify relevant literature. Key study details, findings, recommendations or lessons learnt were extracted and analysed across individual earthquake events. Findings were categorised by time frame relative to earthquakes and linked to the disaster preparedness cycle, enabling a profile of health and healthcare impacts and implications for future preparedness to be established.

RESULTS

Health services need to prepare for changing health priorities with a shift from initial treatment of earthquake-related injuries to more general health needs occurring within the first few weeks. Preparedness is required to address mental health and rehabilitation needs in the medium to longer term. Inequalities of the impact of earthquakes on health were noted in particular for women, children, the elderly, disabled and rural communities. The need to maintain access to essential services such as reproductive health and preventative health services were identified. Key preparedness actions include identification of appropriate leaders, planning and training of staff. Testing of plans was advocated within the literature with evidence that this is possible in LMIC settings.

CONCLUSIONS

Whilst there are a range of health and healthcare impacts of earthquakes, common themes emerged in different settings and from different earthquake events. Preparedness of healthcare systems is essential and possible, in order to mitigate the adverse health impacts of earthquakes in LMIC settings. Preparedness is needed at the community, organisational and system levels.

An examination of resilience cross-culturally in child and adolescent survivors of the 2008 China earthquake using the Connor-Davidson Resilience Scale (CD-RISC)

BACKGROUND

The 2008 Sichuan earthquake in China destroyed towns and village, displaced over a million people and caused thousands of deaths. There is a need to understand how children and adolescents are able to bounce back after this distressing event. This study conducts a psychometric assessment of the Connor-Davidson Resilience Scale (CD-RISC) and the measure's validity among children and adolescent survivors in order to identify the factors associated with resilience in this socio-cultural setting.

METHODS

Translated and culturally verified versions of the CD-RISC, UCLA-PTSD Index and Birleson Self-rating Depression Scale were used to collect data from 2132 children and adolescents located in post-disaster areas 1 year after the event.

RESULTS

Through exploratory factor analysis, a 2-factor model was found and defined by Chinese scholars as Rational Thinking and Self-Awareness. Internal consistency of total CD-RISC was 0.86, 0.91 for Rational Thinking and 0.74 for Self-Awareness. Convergent validity between items ranged from 0.17-0.69 and 0.12-0.20 to the total score. Items related to post-traumatic stress disorder loaded separately than CD-RISC items, demonstrating discriminant validity.

CONCLUSIONS

Our findings demonstrate that resilience may be understood and manifested dissimilarly in different socio-cultural settings. This study confirms the applicability of the CD-RISC scale to Chinese children and adolescent earthquake survivors, and adds to the richness of resilience research cross-culturally.

Moderating effects of a postdisaster intervention on risk and resilience factors associated with posttraumatic stress disorder in Chinese children

This study is an evaluation of a psychosocial intervention involving child and adolescent survivors of the 2008 Sichuan China earthquake. Sociodemographics, earthquake-related risk exposure, resilience using the Connor-Davidson Resilience Scale, and posttraumatic stress disorder (PTSD) using the UCLA-PTSD Index were collected from 1,988 intervention participants and 2,132 controls. Mean resilience scores and the odds of PTSD did not vary between groups. The independent factors for risk and resilience and the dependent variable, PTSD, in the measurement models between control and intervention groups were equivalent. The structural model of risk and 2 resilience factors on PTSD was examined and found to be unequivalent between groups. In contrast to controls, risk exposure (B = −0.32, p <.001) in the intervention group was negatively associated with PTSD. Rational thinking (B = −0.48, p < .001), a resilience factor, was more negatively associated with PTSD in the intervention group. The second resilience factor explored, self-awareness, was positively associated with PTSD in both groups (B = 0.46 for controls, p < .001, and B = 0.69 for intervention, p < .001). Results highlight the need for more cross-cultural research in resilience theory to develop culturally appropriate interventions and evaluation measures.

Impact of the 2004 tsunami on self-reported physical health in Thailand for the subsequent 2 years

OBJECTIVES

We examined self-reported physical health during the first 2 years following the 2004 tsunami in Thailand.

METHODS

We assessed physical health with the revised Short Form Health Survey. We evaluated 6 types of tsunami exposure: personal injury, personal loss of home, personal loss of business, loss of family member, family member's injury, and family's loss of business. We examined the relationship between tsunami exposure and physical health with multivariate linear regression.

RESULTS

One year post-tsunami, we interviewed 1931 participants (97.2% response rate), and followed up with 1855 participants 2 years after the tsunami (96.1% follow-up rate). Participants with personal injury or loss of business reported poorer physical health than those unaffected (P < .001), and greater health impacts were found for women and older individuals.

CONCLUSIONS

Exposure to the tsunami disaster adversely affected physical health, and its impact may last for longer than 1 year, which is the typical time when most public and private relief programs withdraw.

The human impact of earthquakes: a historical review of events 1980-2009 and systematic literature review

Introduction. Population growth and increasing urbanization in earthquake-prone areas suggest that earthquake impacts on human populations will increase in the coming decades. Recent large earthquakes affecting large populations in Japan, Haiti, Chile and New Zealand are evidence of this trend and also illustrate significant variations in outcomes such damage and mortality levels. The objectives of this review were to describe the impact of earthquakes on human populations in terms of mortality, injury and displacement and, to the extent possible, identify risk factors associated with these outcomes. This is one of five reviews on the human impact of natural disasters. Methods. Data on the impact of earthquakes were compiled using two methods, a historical review from 1980 to mid 2009 of earthquake events from multiple databases and a systematic literature review of publications, ending in October 2012. Analysis included descriptive statistics and bivariate tests for associations between earthquake mortality and characteristics using STATA 11. Findings. From 1980 through 2009, there were a total of 372,634 deaths (range 314,634-412,599), 995,219 injuries (range: 845,345-1,145,093), and more than 61 million people affected by earthquakes, and mortality was greatest in Asia. Inconsistent reporting across data sources suggests that the numbers injured and affected are likely underestimates. Findings from a systematic review of the literature indicate that the primary cause of earthquake-related death was trauma due to building collapse and, the very young and the elderly were at increased mortality risk, while gender was not consistently associated with mortality risk. Conclusions. Strategies to mitigate the impact of future earthquakes should include improvements to the built environment and a focus on populations most vulnerable to mortality and injury.

Time for order in chaos! A health system framework for foreign medical teams in earthquakes

The number of reported natural disasters is increasing, as is the number of foreign medical teams (FMTs) sent to provide relief. Studies show that FMTs are not coordinated, nor are they adapted to the medical needs of victims. Another key challenge to the response has been the lack of common terminologies, definitions, and frameworks for FMTs following disasters.In this report, a conceptual health system framework that captures two essential components of health care response by FMTs after earthquakes is presented. This framework was developed using expert panels and personal experience, as well as an exhaustive literature review.The framework can facilitate decisions for deployment of FMTs, as well as facilitate coordination in disaster-affected countries. It also can be an important tool for registering agencies that send FMTs to sudden onset disasters, and ultimately for improving disaster response.