Tuberculosis in a Refugee Camp: A campaign to reduce transmission

Abstract

In November 1985, tuberculosis was highly prevalent among the 6,250 Tigrayan refugees ofFau I camp in Eastern Sudan. It was therefore decided to launch an active case-finding campaign aimed at decreasing transmission, to be carried out by primary health care workers. The entire population of the camp was screened for symptoms of pulmonary tuberculosis and the sputum of people with productive cough was examined by direct microscopy. However, it was considered that this examination was insufficiently sensitive in the camp situation. For this reason, people with non-productive cough or sputum-negative were enrolled in a follow-up program whose length was determined by the severity of their symptoms. The campaign was interrupted by circumstances that are typical of refugee situations. On the basis of results obtained a few conclusions can nonetheless be made on the appropriateness of introducing an active screening program in situations where a stable refugee population has good access to basic health care of good quality.

Feasibility, Acceptability, and Effectiveness of Non-Pharmaceutical Interventions for Infectious Disease Prevention and Control in Crisis-Affected Settings and Informal Settlements: A Scoping Review

“…Nearly half (N = 39, 45.9%) of the articles were from the Sub-Saharan African region. The majority of these studies were in East and Central Africa, with nine from the Democratic Republic of the Congo (DRC) [36,49,61,64–66,72,105,107], seven from Sudan/South Sudan [30,39,79,80,104,106,108] and four from Uganda [75,76,78,99]. Almost all (N = 35, 89.7%) of the studies in this region were in conflict-affected settings, with two of the remaining four studies being the sole examples of both food crises [106] and complex emergencies [35] (Figure 2).…”

“…The majority of these studies were in East and Central Africa, with nine from the Democratic Republic of the Congo (DRC) [36,49,61,64–66,72,105,107], seven from Sudan/South Sudan [30,39,79,80,104,106,108] and four from Uganda [75,76,78,99]. Almost all (N = 35, 89.7%) of the studies in this region were in conflict-affected settings, with two of the remaining four studies being the sole examples of both food crises [106] and complex emergencies [35] (Figure 2). South Asia (N = 17, 20.0%), and East Asia and the Pacific (N = 13, 15.3%), accounted for the bulk of the remainder, with fewer than ten studies in each of the remaining regions.…”

“…Active case finding (ACF) for HIV and TB was judged to be both feasible [75,76,106] and acceptable [76] in refugee camps in Sudan and Uganda, while ACF of diarrhoeal disease by household visitation and mobile phone surveillance was feasible, but limited by technical issues, lack of treatment follow-up and by poor information sharing and coordination [32,38]. For case detection of human African trypanosomiasis, passive screening at health facilities was easier to implement than ACF among refugees in South Sudan [79], while widespread ACF among a rural, non-displaced conflict-affected population in the DRC was prevented by conflict and instability [105].…”

“…‘Opt-out’ and community-based screening strategies increased access and uptake, particularly among high-risk groups [61,76,83]. In a refugee camp in Sudan, refusal of TB screening was associated with a fear of negative consequences of a positive test result, linked to the status of refugees within the host country and lack of trust [106].…”

Feasibility, acceptability, and effectiveness of non-pharmaceutical interventions against infectious diseases among crisis-affected populations: a scoping review

“…Nearly half (n = 39, 45.9%) of the articles were from the sub-Saharan African region. The majority of these studies were in East and Central Africa, with nine from the Democratic Republic of the Congo (DRC) [40, 53, 65, 68-70, 76, 109, 111], seven from Sudan/South Sudan [34,43,83,84,108,110,112] and four from Uganda [79,80,82,103]. Almost all (N = 35, 89.7%) of the studies in this region were in conflict-affected settings, with two of the remaining four studies being the sole examples of both food crises [110] and complex emergencies [39] (Fig.…”