Health service utilization and access to medicines among Syrian refugee children in Jordan

Doocy, Shannon; Lyles, Emily; Akhu‐Zaheya, Laila; Burton, Ann; Weiss, William

doi:10.1002/hpm.2336

Cited by 22 publications

(27 citation statements)

References 7 publications

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“…When taking into account all primary and secondary diagnoses ( Fig 1 ), the marked occurrence of respiratory diseases with upper and lower respiratory tract infections and asthma among the studied children becomes even more obvious (22%, 13% and 9% respectively). This corresponds with earlier reports from emergency medical teams in different types of natural and man-made disasters [ 5 , 27 , 30 , 31 , 38 , 45 , 46 , 48 ]. In addition to the aforementioned facilitating factors, the atomisation of rubble dust from destroyed constructions may also play a role, together with interruption of chronic treatment, especially in the occurrence of asthma cases [ 38 ].…”

Section: Discussionsupporting

confidence: 91%

“…Global health literature covering the Syrian situation is scarce, and did not yet deliver sufficient epidemiologic data to provide a comprehensive and complete overview [ 1 , 2 , 4 , 6 , 8 , 11 , 17 , 22 – 26 ]. Some studies discussed the health problems of Syrian refugees in neighbouring countries, or asylum seekers in European countries, but they vary widely in methodology and points of interest, and most are expert opinions or undocumented statements [ 7 , 16 , 19 , 27 – 33 ]. Some grey reports discuss the burden of mortality and morbidity, but also lack to document specific diagnoses.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnoses, infections and injuries in Northern Syrian children during the civil war: A cross-sectional study

Berlaer

Elsafti

Safadi³

et al. 2017

PLoS ONE

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BackgroundThe civil war in Syria including the deliberate targeting of healthcare services resulted in a complex humanitarian emergency, seriously affecting children's health. The objectives of this study are to document diagnoses and disease categories in Northern Syrian children after four years of conflict, and to document infectious diseases and injuries in this vulnerable population.MethodsIn a prospective cross-sectional observational sample study conducted in May 2015, healthcare workers registered demographics, comorbidities, and diagnoses (categorised according to the International Classification of Diseases version 10) in children visited at home and in internally displaced persons camps in four Syrian governorates.ResultsOf 1080 filled-out records, 1002 were included. Children originated from Aleppo (41%), Idleb (36%), Hamah (15%) and Lattakia (8%). Median age was 6 years (0–15; IQR 3–11), 61% were boys, 40% were younger than 5 years old. Children suffered from respiratory (29%), neurological (19%), digestive (17%), eye (5%) and skin (5%) diseases. Clinical malnutrition was seen in 4%, accidental injury in 3%, intentional injury in 1%, and mental disorders in 2%. Overall, 64% had features of infectious diseases (OR 0.635; CI 0.605–0.665). Most common comorbidities were chronic respiratory diseases (14, malnutrition (5%), acute flaccid paralysis (5%), and epilepsy (4%). Logistic regression analysis indicated that the risk for children to have communicable diseases was higher in Aleppo than in Idleb (OR 1.7; CI 1.2–2.3), Hamah (OR 4.9; CI 3.3–7.5), or Lattakia (OR 5.5; CI 3.3–9.3). Children in Aleppo and Lattakia were more at risk to be injured than in Idleb (OR 5.6; CI 2.1–14.3), or in Hamah (OR 5.9; CI 1.4–25.6), but more often from intentional violence in Lattakia. Mental problems were more prominent in Hamah.ConclusionsFour years far in the conflict, 64% of the studied children in four Northern Syrian governorates suffer from infections, mostly from respiratory, neurological and digestive origin, while 4% was injured or victim of intentional aggression. Substandard living conditions and the lack of paediatric healthcare put Syrian children at risk for serious infections, epidemics and morbidity, and ask for urgent international humanitarian relief efforts.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Diagnoses, infections and injuries in Northern Syrian children during the civil war: A cross-sectional study

Berlaer

Elsafti

Safadi³

et al. 2017

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…The reasons for needing care among infants and young children were predominately communicable diseases associated with poor living conditions. These findings are aligned with health assessments of Syrian refugee children in neighbouring countries as well as Iraqi IDP children in other parts of Iraq [ 13 – 15 ]. While communicable diseases remain common among adult and older persons, the prevalence of non-communicable diseases increases significantly with age.…”

Section: Discussionsupporting

confidence: 74%

Health needs and care seeking behaviours of Yazidis and other minority groups displaced by ISIS into the Kurdistan Region of Iraq

2017

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BackgroundDuring the summer of 2014, ISIS overran Nineveh governorate in Northern Iraq. Yazidis and other religious minorities were subjected to brutal attacks and forced to seek refuge into the neighbouring Kurdistan Region, where they remain living in local communities or in camps. This survey provides a population-based assessment of the health needs and care seeking behaviours of Yazidis and other groups currently residing in camps.MethodsThe survey covered 13 camps managed by the Kurdish Board of Relief and Humanitarian Affairs. A systematic random sample of 1,300 households with a total of 8,360 members were interviewed between November and December 2015. Participants were asked if any household members had needed care for a health condition in the two weeks preceding the survey, and whether care was obtained from the camp primary health care centre, an outside public hospital or a private clinic. If care was received, the out-of-pocket payment was recorded; otherwise, the reason for not seeking care was queried.ResultsIn 33.9% (CI: 31.0–37.0) of households one or more members had needed care for a health condition in the two weeks preceding the survey. The most likely to have needed care were older persons (18.5%; CI: 13.6–24.6) and infants (18.0%; CI: 11.6–26.8). The reported health conditions revealed a complex picture of communicable and non-communicable diseases as well as mental health problems and physical injuries. Care was primarily sought from private clinics (41.8%; CI: 36.4–47.4) or public hospitals (27.3%; CI: 22.6–32.7) rather than from the camp primary health care clinics (23.6%; CI: 19.5–28.2). The mean out-of-pocket payment for care received was nearly 3 times higher in public hospitals than in the camp primary health care clinics and nearly 11 times higher in private clinics. Cost was the main perceived barrier to obtaining health services.ConclusionDemand for health services was high among Yazidis and other minorities living in camps. Private services were preferred in spite of the tenuous economic circumstances of displaced households. Declines in public sector funding may further restrict access from camp clinics stressing the need for alternative access strategies.

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“…On the other hand, the poor economic level also hinders or delays access to health care, resulting in delayed diagnosis and treatment of diseases. All of these adverse conditions are said to facilitate the spread of infectious diseases and even cause epidemics [40,[43][44][45].…”

Section: Discussionmentioning

confidence: 99%

Syrian Refugees at Risk of Hepatitis Diseases in Turkey, in Şanliurfa?

Keklik¹,

Koruk²,

Allahverdi³

2019

SJM

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Aim:The aim of this study is to determine the prevalence of hepatitis B/C diseases among Syrian refugees living outside the temporary accommodation centers in Şanlıurfa city center, and individuals' levels of knowledge and risky behaviors related to these diseases. Methods: The research is cross-sectional. It was carried out with 473 Syrian refugees who were living in Şanlıurfa city center outside the temporary accommodation centers in April 2015 -2016. Cluster sampling method was preferred in the selection of the sample. The questionnaire form, which was prepared by the researchers, was applied, and a venous blood sample was collected from the individuals during data collection. HBsAg, Anti-HBs, Anti-HBc total and Anti-HCV levels of the blood samples were examined. Descriptive statistics, Chi-square, and Mann-Whitney U tests were used in the evaluation of the data. Statistical analyses were performed at 95% confidence level. p<0.05 value was accepted as statistically significant. Results: Of the Syrians, 62.2% were women and 37.8% men, with a median age of 34.0. 25.6% of participants had never attended school, and 82.2% of them were married. 57.3% of asylum seekers were Arabian, and 41.9% were Kurdish. 80.1% of them didn't know enough Turkish to communicate. Participants' average monthly income was 171$. An average of 8.6 individuals was living in the household, and the individual/room rate was 3.2. 60.3% of Syrian refugees had not heard of hepatitis B disease, and 69.1% of them had not heard of hepatitis C disease. Only 2.3% (n=11) of the individuals correctly answered all the questions about the transmission and prevention of hepatitis B/C diseases. 1.7% of Syrian refugees were HBsAg positive, 23.9% were Anti-HBc total positive, and 0.4% of them were Anti-HCV positive. 25.2% of Syrian refugees were anti-HBS positive, while 7.1% were immunized with the hepatitis B vaccine. There was no statistically significant difference in the distribution of HBsAg and Anti-HCV antibody status of Syrian refugees according to socio-demographic characteristics and risky behaviors used in this study (p>0.05). Anti-HBc total antibody positivity was higher in males, in those over 50 years of age, in those who had never attended school and in those who had married at least once (p<0.05). Anti-HBc total positivity was higher in women, especially in those who had given birth at least once (p<0.05). Conclusions: The prevalence of hepatitis B/C in Syrian refugees was lower than in Turkey. This suggests that Syrian refugees are at more risk than individuals in our country. Low immunization rates also support this situation. It is believed that the risk of transmission of hepatitis B/C diseases can be reduced by giving information about the transmission and prevention ways of hepatitis B/C diseases to individuals at marriage age, by screening the group at risk and immunizing them against hepatitis B, increasing the rate of condom use in case of risky sexual intercourse, increasing education level, regular antenatal care of pregnant women...

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Health service utilization and access to medicines among Syrian refugee children in Jordan

Cited by 22 publications

References 7 publications

Diagnoses, infections and injuries in Northern Syrian children during the civil war: A cross-sectional study

Diagnoses, infections and injuries in Northern Syrian children during the civil war: A cross-sectional study

Health needs and care seeking behaviours of Yazidis and other minority groups displaced by ISIS into the Kurdistan Region of Iraq

Syrian Refugees at Risk of Hepatitis Diseases in Turkey, in Şanliurfa?

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