The Community Health Response Team: a culturally and linguistically tailored community response to COVID-19 addressing barriers to testing and vaccinations for refugee, immigrant and migrant communities in Atlanta, Georgia

The International Rescue Committee (IRC) in Atlanta and Community Organized Relief Effort (CORE) established a Community Health Response Team in May 2020. The team members represented refugee, immigrant and migrant populations and had expertise in health care and public health. These 18 individuals were recruited from IRC Atlanta's Career Development program, had a variety of backgrounds and spoke 20 languages. They implemented a community-centered COVID-response intervention model of pairing education and outreach efforts with testing and vaccination clinics. Due to their team makeup, the Community Health Response Team conducted tailored outreach and education that was culturally and linguistically congruent with their target communities. They administered over 16,000 COVID-19 tests at mobile community sites within the first 6 months. Once COVID-19 vaccinations were available, the Community Health Response Team coordinated a total of 834 vaccination events in communities with a high number of refugees and in partnership with refugee- and immigrant-trusted community-based organizations, resulting in 31,888 vaccinations. Hiring staff from refugee, immigrant and migrant populations created a sustainable staffing model. Also, embedding culturally specific strategies in their model of pairing education and outreach led to long-term relationships and greater trust with community members. This approach of engaging and empowering community members to create tailored public health responses should serve as guidance for future public health campaigns.

Environmental determinants of diarrheal morbidity in under-five children, Keffa-Sheka zone, south west Ethiopia

A population-based cross-sectional study on diarrheal morbidity was carried out in thirty two rural and urban areas of Keffa-Sheka zone, to determine the prevalence of diarrhea in under-5 children and identify environmental risk factors. A total of 952 children between the ages of 0 and 59 months living in the sampled households formed the study population. Data collected include demographic characteristics of the child, and information on environmental and housing variables. The overall diarrheal prevalence was 15%. Acute watery diarrhea, dysentery, and persistent diarrhea were responsible for 66%, 20%, and 14% of the episodes, respectively. Overall a third of the diarrheal episodes were bloody and/or persistent. Young age, male gender, living in a house with fewer number of rooms, and obtaining water from storage containers by dipping showed statistically significant association with diarrheal morbidity (p < 0.05). Type of water source, amount of water consumed, and latrine availability were not found to be significant risk factors (p > 0.05). Diarrhea, particularly dysentery and/or persistent diarrhea, affect a large proportion of children. Water is scarce and the environmental status of the area is generally poor. Efforts to educate the community about correct water handling behavior, personal and domestic hygiene should also be important components of the diarrhea control strategy. Further study on other environmental determinants, socio-demographic factors, feeding patterns and immunization status of children, and ORS accessibility is also recommended.