Journal Article > LetterFull Text
Clin Infect Dis. 2017 August 1; Volume 65 (Issue 3); DOI:10.1093/cid/cix382
Brooks HM, Jean Paul MK, Claude KM, Houston S, Hawkes MT
Clin Infect Dis. 2017 August 1; Volume 65 (Issue 3); DOI:10.1093/cid/cix382
Journal Article > CommentaryFull Text
Lancet Diabetes Endocrinol. 2020 February 1; Volume 8 (Issue 2); DOI:10.1016/S2213-8587(19)30408-5
Kehlenbrink S, Boulle P
Lancet Diabetes Endocrinol. 2020 February 1; Volume 8 (Issue 2); DOI:10.1016/S2213-8587(19)30408-5
Journal Article > ResearchFull Text
Confl Health. 2019 July 11 (Issue 1)
Vernier L, Cramond V, Hoetjes M, Lenglet AD, Hoare T
Confl Health. 2019 July 11 (Issue 1)
BACKGROUND:
War in Syria has lasted for more than eight years, causing population displacement, collapse of medical and public health services, extensive violence and countless deaths. Since November 2016, military operations in Northeast Syria intensified. In October 2017 a large influx of internally displaced persons (IDPs) arrived to Ein Issa camp, Raqqa governate. Médecins Sans Frontières (MSF) assessed the health status of recently arrived IDPs in Ein Issa camp.
METHODS:
MSF carried out a cross-sectional survey using simple random sampling between 8 and 18 November 2017, enrolling households who had arrived to Ein Issa camp since 1 October 2017. A questionnaire collected data on demographics, history of displacement, retrospective one-year mortality, two-week morbidities, non-communicable diseases, exposure to violence in the last year and two-week psychological distress symptoms among all household members as well as vaccination status in children aged 6 to 59 months. The latter were also screened for malnutrition. Prevalence estimates and mortality rates were calculated with their 95% confidence interval. Mortality rates were calculated as the number of deaths/10,000 persons/day using the individual person-day contribution of all household members.
RESULTS:
MSF surveyed 257 households (1482 participants). They reported 31 deaths in the previous year, resulting in a crude mortality rate of 0.56 deaths/10,000 persons/day (95%CI: 0.39-0.80). Conflict-related violence was the most frequently reported cause of death (64.5%). In the previous year, 31.7% (95%CI: 29.4-34.2) of the participants experienced at least one violent episode. The most frequent type of violence reported was witnessing atrocities (floggings, executions or public body displays); 18.9% (95%CI: 17.0-21.0) of the population and 9.8% (95%CI: 7.9-12.0) of the children under 15 years had witnessed such atrocities. In men over 14 years, 15.8% (95%CI: 11.9-20.8) were detained/kidnapped and 11.3% (95%CI: 8.0-15.8) tortured/beaten/attacked. In the two weeks prior to interview, 14.4% (95%CI: 10.6-19.3) of the respondents felt so hopeless that they did not want to carry on living most of the time.
CONCLUSIONS:
High levels of mortality, exposure to violence and psychological distress were reported. These survey results increase understanding of the impact of the conflict on the IDP population in Northeast Syria.
War in Syria has lasted for more than eight years, causing population displacement, collapse of medical and public health services, extensive violence and countless deaths. Since November 2016, military operations in Northeast Syria intensified. In October 2017 a large influx of internally displaced persons (IDPs) arrived to Ein Issa camp, Raqqa governate. Médecins Sans Frontières (MSF) assessed the health status of recently arrived IDPs in Ein Issa camp.
METHODS:
MSF carried out a cross-sectional survey using simple random sampling between 8 and 18 November 2017, enrolling households who had arrived to Ein Issa camp since 1 October 2017. A questionnaire collected data on demographics, history of displacement, retrospective one-year mortality, two-week morbidities, non-communicable diseases, exposure to violence in the last year and two-week psychological distress symptoms among all household members as well as vaccination status in children aged 6 to 59 months. The latter were also screened for malnutrition. Prevalence estimates and mortality rates were calculated with their 95% confidence interval. Mortality rates were calculated as the number of deaths/10,000 persons/day using the individual person-day contribution of all household members.
RESULTS:
MSF surveyed 257 households (1482 participants). They reported 31 deaths in the previous year, resulting in a crude mortality rate of 0.56 deaths/10,000 persons/day (95%CI: 0.39-0.80). Conflict-related violence was the most frequently reported cause of death (64.5%). In the previous year, 31.7% (95%CI: 29.4-34.2) of the participants experienced at least one violent episode. The most frequent type of violence reported was witnessing atrocities (floggings, executions or public body displays); 18.9% (95%CI: 17.0-21.0) of the population and 9.8% (95%CI: 7.9-12.0) of the children under 15 years had witnessed such atrocities. In men over 14 years, 15.8% (95%CI: 11.9-20.8) were detained/kidnapped and 11.3% (95%CI: 8.0-15.8) tortured/beaten/attacked. In the two weeks prior to interview, 14.4% (95%CI: 10.6-19.3) of the respondents felt so hopeless that they did not want to carry on living most of the time.
CONCLUSIONS:
High levels of mortality, exposure to violence and psychological distress were reported. These survey results increase understanding of the impact of the conflict on the IDP population in Northeast Syria.
Journal Article > ReviewFull Text
J Migr Health. 2020 December 31; Volume 3; 100041.; DOI:10.1016/j.jmh.2021.100041
Hayward SE, Deal A, Cheng C, Crawshaw A, Orcutt M, et al.
J Migr Health. 2020 December 31; Volume 3; 100041.; DOI:10.1016/j.jmh.2021.100041
BACKGROUND
Migrants in high-income countries may be at increased risk of COVID-19 due to their health and social circumstances, yet the extent to which they are affected and their predisposing risk factors are not clearly understood. We did a systematic review to assess clinical outcomes of COVID-19 in migrant populations, indirect health and social impacts, and to determine key risk factors.
METHODS
We did a systematic review following PRISMA guidelines (PROSPERO CRD42020222135). We searched multiple databases to 18/11/2020 for peer-reviewed and grey literature on migrants (foreign-born) and COVID-19 in 82 high-income countries. We used our international networks to source national datasets and grey literature. Data were extracted on primary outcomes (cases, hospitalisations, deaths) and we evaluated secondary outcomes on indirect health and social impacts and risk factors using narrative synthesis.
RESULTS
3016 data sources were screened with 158 from 15 countries included in the analysis (35 data sources for primary outcomes: cases [21], hospitalisations [4]; deaths [15]; 123 for secondary outcomes). We found that migrants are at increased risk of infection and are disproportionately represented among COVID-19 cases. Available datasets suggest a similarly disproportionate representation of migrants in reported COVID-19 deaths, as well as increased all-cause mortality in migrants in some countries in 2020. Undocumented migrants, migrant health and care workers, and migrants housed in camps have been especially affected. Migrants experience risk factors including high-risk occupations, overcrowded accommodation, and barriers to healthcare including inadequate information, language barriers, and reduced entitlement.
CONCLUSIONS
Migrants in high-income countries are at high risk of exposure to, and infection with, COVID-19. These data are of immediate relevance to national public health and policy responses to the pandemic. Robust data on testing uptake and clinical outcomes in migrants, and barriers and facilitators to COVID-19 vaccination, are urgently needed, alongside strengthening engagement with diverse migrant groups.
Migrants in high-income countries may be at increased risk of COVID-19 due to their health and social circumstances, yet the extent to which they are affected and their predisposing risk factors are not clearly understood. We did a systematic review to assess clinical outcomes of COVID-19 in migrant populations, indirect health and social impacts, and to determine key risk factors.
METHODS
We did a systematic review following PRISMA guidelines (PROSPERO CRD42020222135). We searched multiple databases to 18/11/2020 for peer-reviewed and grey literature on migrants (foreign-born) and COVID-19 in 82 high-income countries. We used our international networks to source national datasets and grey literature. Data were extracted on primary outcomes (cases, hospitalisations, deaths) and we evaluated secondary outcomes on indirect health and social impacts and risk factors using narrative synthesis.
RESULTS
3016 data sources were screened with 158 from 15 countries included in the analysis (35 data sources for primary outcomes: cases [21], hospitalisations [4]; deaths [15]; 123 for secondary outcomes). We found that migrants are at increased risk of infection and are disproportionately represented among COVID-19 cases. Available datasets suggest a similarly disproportionate representation of migrants in reported COVID-19 deaths, as well as increased all-cause mortality in migrants in some countries in 2020. Undocumented migrants, migrant health and care workers, and migrants housed in camps have been especially affected. Migrants experience risk factors including high-risk occupations, overcrowded accommodation, and barriers to healthcare including inadequate information, language barriers, and reduced entitlement.
CONCLUSIONS
Migrants in high-income countries are at high risk of exposure to, and infection with, COVID-19. These data are of immediate relevance to national public health and policy responses to the pandemic. Robust data on testing uptake and clinical outcomes in migrants, and barriers and facilitators to COVID-19 vaccination, are urgently needed, alongside strengthening engagement with diverse migrant groups.
Journal Article > ResearchFull Text
Confl Health. 2017 May 15; Volume 11 (Issue 1); 7.; DOI:10.1186/s13031-017-0110-4
Coldiron ME, Roederer T, Llosa AE, Bouhenia M, Madi S, et al.
Confl Health. 2017 May 15; Volume 11 (Issue 1); 7.; DOI:10.1186/s13031-017-0110-4
The Central African Republic has known long periods of instability. In 2014, following the fall of an interim government installed by the Séléka coalition, a series of violent reprisals occurred. These events were largely directed at the country's Muslim minority and led to a massive displacement of the population. In 2014, we sought to document the retrospective mortality among refugees arriving from the CAR into Chad by conducting a series of surveys.
Journal Article > ResearchAbstract
Trop Med Int Health. 2012 July 29; Volume 17 (Issue 9); 1163-1170.; DOI:10.1111/j.1365-3156.2012.03048
Khader A, Zachariah R
Trop Med Int Health. 2012 July 29; Volume 17 (Issue 9); 1163-1170.; DOI:10.1111/j.1365-3156.2012.03048
Recording and reporting systems borrowed from the DOTS framework for tuberculosis control can be used to record, monitor and report on chronic disease. In a primary healthcare clinic run by UNRWA in Amman, Jordan, serving Palestine refugees with hypertension, we set out to illustrate the method of cohort reporting for persons with hypertension by presenting on quarterly and cumulative case finding, cumulative and 12-month analysis of cohort outcomes and to assess how these data may inform and improve the quality of hypertension care services.
Journal Article > ResearchAbstract Only
J Immigr Minor Health. 2021 October 26; Volume 24 (Issue 5); 1281-1287.; DOI:10.1007/s10903-021-01298-1
Cubides JC, Peiter PC, Garone DB, Antierens A
J Immigr Minor Health. 2021 October 26; Volume 24 (Issue 5); 1281-1287.; DOI:10.1007/s10903-021-01298-1
Médecins sans Frontières (MSF) conducted a study to identify health needs and access barriers of Venezuelan migrants and refugees at La Guajira and Norte de Santander Colombian border states. The Migration History tool was used to gather information that included various health-related issues such as referred morbidity, exposure to violence, mental health, and access to health care services. A group migration profile with long-term permanence plans was identified. Was evidenced an important share of young population (50% under 20), indigenous people (20%), and returnees (11%). The respondents referred to a mixed pattern of chronic and acute diseases, for which the main difficulty was accessing diagnosis and continuous treatment. Health-seeking behavior was identified as the main barrier to access health care services. The article compiles main findings on the Venezuelan migrants and refugees' health conditions, contributing important evidence for the humanitarian responses in migration contexts.
Journal Article > ResearchSubscription Only
Vaccine. 2006 February 6; Volume 24 (Issue 6); 730-737.; DOI:10.1016/j.vaccine.2005.08.077
Huhn GD, Brown J, Perea W, Berthe A, Otero H, et al.
Vaccine. 2006 February 6; Volume 24 (Issue 6); 730-737.; DOI:10.1016/j.vaccine.2005.08.077
Yellow fever (YF) is a mosquito-borne vaccine-preventable disease with high mortality. In West Africa, low population immunity increases the risk of epidemic transmission. A cluster survey was conducted to determine the effectiveness of a mass immunization campaign using 17D YF vaccine in internally displaced person (IDP) camps following a reported outbreak of YF in Liberia in February 2004. Administrative data of vaccination coverage were reviewed. A cluster sample size was determined among 17,384 shelters using an 80% vaccination coverage threshold. A questionnaire eliciting demographic information, household size, and vaccination status was distributed to randomly selected IDPs. Data were analyzed to compare vaccination coverage rates of administrative versus survey data. Among 87,000 persons estimated living in IDP camps, administrative data recorded 49,395 (57%) YF vaccinated persons. A total of 237 IDPs were surveyed. Of survey respondents, 215 (91.9%, 95% CI 88.4-95.4) reported being vaccinated during the campaign and 196 (83.5%, 95% CI 78.6-88.5) possessed a valid campaign vaccination card. The median number of IDPs living in a shelter was 4 (range, 1-8) and 69,536 persons overall were estimated to be living in IDP camps. Coverage rates from a rapid survey exceeded 90% by self-report and 80% by evidence of a vaccination card, indicating that the YF immunization campaign was effective. Survey results suggested that administrative data overestimated the camp population by at least 20%. An emergency, mop-up vaccination campaign was avoided. Coverage surveys can be vital in the evaluation of emergency vaccination campaigns by influencing both imminent and future immunization strategies.
Journal Article > Short ReportFull Text
Morbidity and Mortality Weekly Report. 2015 May 22
Browne L, Menkir Z, Kahi V, Maina G, Asnakew S, et al.
Morbidity and Mortality Weekly Report. 2015 May 22
In early April 2014, two South Sudanese refugees in the Gambella region of western Ethiopia experienced acute onset of jaundice, accompanied by fever. One patient was a pregnant woman aged 24 years evaluated at a routine prenatal clinic visit in Leitchour refugee camp. The second patient was a malnourished boy aged 1 year who resided in Tierkidi refugee camp. The boy died despite hospitalization. During the last 2 weeks of May, four more cases of acute jaundice syndrome (AJS), defined as yellow discoloration of the eyes, were detected in Leitchuor. By mid-June, an additional 50 AJS cases were reported across three large camps in the region, Kule, Leitchuor, and Tierkidi, with 45 (90%) of these cases reported in Leitchuor. Sera collected from a convenience sample of 21 AJS cases were sent to Addis Ababa and Nairobi for real-time polymerase chain reaction testing; 12 (57%) were positive for hepatitis E virus (HEV) RNA. By January 2015, a total of 1,117 suspected cases of hepatitis E meeting the case definition of AJS were reported among refugees in camps across Gambella.
Journal Article > ResearchFull Text
BMJ. 2003 September 20; Volume 327 (Issue 7416); 650.; DOI:10.1136/bmj.327.7416.650
Grein T
BMJ. 2003 September 20; Volume 327 (Issue 7416); 650.; DOI:10.1136/bmj.327.7416.650
OBJECTIVE
To measure retrospectively mortality among a previously inaccessible population of former UNITA members and their families displaced within Angola, before and after their arrival in resettlement camps after ceasefire of 4 April 2002.
DESIGN
Three stage cluster sampling for interviews. Recall period for mortality assessment was from 21 June 2001 to 15-31 August 2002.
SETTING
Eleven resettlement camps over four provinces of Angola (Bié, Cuando Cubango, Huila, and Malange) housing 149 000 former UNITA members and their families. PARTICIPANTS: 900 consenting family heads of households, or most senior household members, corresponding to an intended sample size of 4500 individuals. MAIN
OUTCOME MEASURES
Crude mortality and proportional mortality, overall and by period (monthly, and before and after arrival in camps).
RESULTS
Final sample included 6599 people. The 390 deaths reported during the recall period corresponded to an average crude mortality of 1.5/10 000/day (95% confidence interval 1.3 to 1.8), and, among children under 5 years old, to 4.1/10 000/day (3.3 to 5.2). Monthly crude mortality rose gradually to a peak in March 2002 and remained above emergency thresholds thereafter. Malnutrition was the leading cause of death (34%), followed by fever or malaria (24%) and war or violence (18%). Most war victims and people who had disappeared were women and children.
CONCLUSIONS
This population of displaced Angolans experienced global and child mortality greatly in excess of normal levels, both before and after the 2002 ceasefire. Malnutrition deaths reflect the extent of the food crisis affecting this population. Timely humanitarian assistance must be made available to all populations in such conflicts.
To measure retrospectively mortality among a previously inaccessible population of former UNITA members and their families displaced within Angola, before and after their arrival in resettlement camps after ceasefire of 4 April 2002.
DESIGN
Three stage cluster sampling for interviews. Recall period for mortality assessment was from 21 June 2001 to 15-31 August 2002.
SETTING
Eleven resettlement camps over four provinces of Angola (Bié, Cuando Cubango, Huila, and Malange) housing 149 000 former UNITA members and their families. PARTICIPANTS: 900 consenting family heads of households, or most senior household members, corresponding to an intended sample size of 4500 individuals. MAIN
OUTCOME MEASURES
Crude mortality and proportional mortality, overall and by period (monthly, and before and after arrival in camps).
RESULTS
Final sample included 6599 people. The 390 deaths reported during the recall period corresponded to an average crude mortality of 1.5/10 000/day (95% confidence interval 1.3 to 1.8), and, among children under 5 years old, to 4.1/10 000/day (3.3 to 5.2). Monthly crude mortality rose gradually to a peak in March 2002 and remained above emergency thresholds thereafter. Malnutrition was the leading cause of death (34%), followed by fever or malaria (24%) and war or violence (18%). Most war victims and people who had disappeared were women and children.
CONCLUSIONS
This population of displaced Angolans experienced global and child mortality greatly in excess of normal levels, both before and after the 2002 ceasefire. Malnutrition deaths reflect the extent of the food crisis affecting this population. Timely humanitarian assistance must be made available to all populations in such conflicts.