Infectious disease surveillance during emergency relief to Bhutanese refugees in Nepal

Marfin, Anthony A.; Moore, Jazmyn; Collins, Christopher S.; Biellik, Robin; Kattel, Umesh; Toole, Michael J.; Moore, Patrick S.

doi:10.1001/jama.272.5.377

Cited by 31 publications

(14 citation statements)

References 14 publications

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“…Most of these (n = 18) were refugee populations, of which 11 occurred during the acute emergency phase (Cambodians in Thailand, 1980 [24]; Somalis in Ethiopia, 1989 [25]; Iraqi Kurds in Iran, 1991 [26]; Bhutanese in Nepal, 1992 [n = 2] [27,28]; Burundians in Rwanda, 1993 [29]; Rwandans in Zaire, 1994 [n = 2] [30,31]; Kosovars in Albania, 1999 [n = 3] [32-34]), and seven during the post-emergency phase (Guatemalans in Mexico, 1983 [35]; Nicaraguans in Costa Rica, 1986 [36]; Afghans in Pakistan, 1986 [37]; Cambodians in Thailand, 1987-1991 [n = 2] [38,39]; Vietnamese in Hong Kong, 1991-1992 [40]; Sudanese in Uganda, 1992-1994 [41]). All of the above refugee populations were living in camps with the exception of some Kosovar refugees in Albania.…”

Section: Resultsmentioning

confidence: 99%

“…Among Bhutanese refugees in Nepal in 1992-1993, 0.29 deaths per 10 000 person-days were due to ALRI, defined as fever, cough and >50 breaths per minute, making ALRI the leading cause of death over the 6 months analysis period [28]. In the same population and over a partly overlapping period, ARI-attributable mortality rates were 0.5 per 10 000 person-days among all ages, 1.6 among children under 5 y and 0.3 in older persons [27].…”

Section: Resultsmentioning

confidence: 99%

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The burden of acute respiratory infections in crisis-affected populations: a systematic review

et al. 2010

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Crises due to armed conflict, forced displacement and natural disasters result in excess morbidity and mortality due to infectious diseases. Historically, acute respiratory infections (ARIs) have received relatively little attention in the humanitarian sector. We performed a systematic review to generate evidence on the burden of ARI in crises, and inform prioritisation of relief interventions. We identified 36 studies published since 1980 reporting data on the burden (incidence, prevalence, proportional morbidity or mortality, case-fatality, attributable mortality rate) of ARI, as defined by the International Classification of Diseases, version 10 and as diagnosed by a clinician, in populations who at the time of the study were affected by natural disasters, armed conflict, forced displacement, and nutritional emergencies. We described studies and stratified data by age group, but did not do pooled analyses due to heterogeneity in case definitions. The published evidence, mainly from refugee camps and surveillance or patient record review studies, suggests very high excess morbidity and mortality (20-35% proportional mortality) and case-fatality (up to 30-35%) due to ARI. However, ARI disease burden comparisons with non-crisis settings are difficult because of non-comparability of data. Better epidemiological studies with clearer case definitions are needed to provide the evidence base for priority setting and programme impact assessments. Humanitarian agencies should include ARI prevention and control among infants, children and adults as priority activities in crises. Improved data collection, case management and vaccine strategies will help to reduce disease burden.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The burden of acute respiratory infections in crisis-affected populations: a systematic review

et al. 2010

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“…Although conflict situations do not substantially change the pre-existing child-disease profile, studies have underlined significant increases of mortality due to diarrhoeal diseases, severe malnutrition, respiratory infections and measles among conflict-affected children (Marfin et al, 1994;Boss et al, 1994;Save the Children, 2001;Murray and Lopez, 1994). Mortality surveys during conflicts indicate high rates of mortality during the first few weeks of relief and a general decrease substantially soon after (Toole and Waldman, 1990;Salignon et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Conflict‐related Mortality: An Analysis of 37 Datasets

Guha-Sapir

Panhuis²

2004

Disasters

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Mortality rates are among the main indicators of the human impact of armed conflict and many surveys have assessed this impact both for targeting and evaluating humanitarian aid programmes. Almost no epidemiological analysis such as calculating relative risk was performed nor were reference values clearly described. Here the aim is to review published mortality rates for a better understanding of age-specific mortality in armed conflict. Published mortality rates from conflict situations were collected and pre-conflict reference rates composed. We calculated the relative risk of dying in conflict compared to pre-conflict for children under 5 and people older than five years old. Although limited by reporting inadequacies, the results confirm the high vulnerability of children < 5 but identify a higher relative risk of dying among the > or = 5 year olds. Although not entirely new, this observation is not fully understood. Further systematic epidemiological research is needed to estimate and understand the impact of armed conflict on mortality.

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“…After the tsunami, many people continued to live in evacuation camps in the affected countries for various periods of times. (2) and cases of pneumonia increased after the Hanshin-Awaji earthquake in Japan (3). Haemophilus influenzae and Streptococcus pneumoniae are bacteria that colonize the human nasopharynx and can cause a variety of infections, including otitis media, meningitis, bronchitis and pneumonia (4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Possible Prevalence and Transmission of Acute Respiratory Tract Infections Caused by Streptococcus pneumoniae and Haemophilus influenzae among the Internally Displaced Persons in Tsunami Disaster Evacuation Camps of Sri Lanka

et al. 2007

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Infectious disease surveillance during emergency relief to Bhutanese refugees in Nepal

Cited by 31 publications

References 14 publications

The burden of acute respiratory infections in crisis-affected populations: a systematic review

The burden of acute respiratory infections in crisis-affected populations: a systematic review

Conflict‐related Mortality: An Analysis of 37 Datasets

Possible Prevalence and Transmission of Acute Respiratory Tract Infections Caused by Streptococcus pneumoniae and Haemophilus influenzae among the Internally Displaced Persons in Tsunami Disaster Evacuation Camps of Sri Lanka

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