Public health implications of complex emergencies and natural disasters
Tóm tắt
During the last decade, conflict or natural disasters have displaced unprecedented numbers of persons. This leads to conditions prone to outbreaks that imperil the health of displaced persons and threaten global health security. Past literature has minimally examined the association of communicable disease outbreaks with complex emergencies (CEs) and natural disasters (NDs). To examine this association, we identified CEs and NDs using publicly available datasets from the Center for Research on the Epidemiology of Disasters and United Nations Flash and Consolidated Appeals archive for 2005–2014. We identified outbreaks from World Health Organization archives. We compared findings to identify overlap of outbreaks, including their types (whether or not of a vaccine-preventable disease), and emergency event types (CE, ND, or Both) by country and year using descriptive statistics and measure of association. There were 167 CEs, 912 NDs, 118 events linked to ‘Both’ types of emergencies, and 384 outbreaks. Of CEs, 43% were associated with an outbreak; 24% NDs were associated with an outbreak; and 36% of ‘Both’ types of emergencies were associated with an outbreak. Africa was disproportionately affected, where 67% of total CEs, 67% of ‘Both’ events (CE and ND), and 46% of all outbreaks occurred for the study period. The odds ratio of a vaccine-preventable outbreak occurring in a CE versus an ND was 4.14 (95% confidence limits 1.9, 9.4). CEs had greater odds of being associated with outbreaks compared with NDs. Moreover, CEs had high odds of a vaccine-preventable disease causing that outbreak. Focusing on better vaccine coverage could reduce CE-associated morbidity and mortality by preventing outbreaks from spreading.
Tài liệu tham khảo
UNHCR. Global trends, forced displacement in 2016. Geneva: UNHCR; 2017. Available from: http://www.unhcr.org/en-us/statistics/unhcrstats/5943e8a34/global-trends-forced-displacement-2016.html
Centre IDM. GRID 2017 global report on internal displacement. Geneva: IDMC; 2017. Available from: http://www.internal-displacement.org/global-report/grid2017/
Inter-Agency Standing Committee. Definition of complex emergencies. Geneva: IASC; 1994. Available from: https://interagencystandingcommittee.org/content/definition-complex-emergency
Paquet C, Hanquet G. Control of infectious diseases in refugee and displaced populations in developing countries. Bull Inst Pasteur. 1998;96(1):3–14.
Spiegel PB, Le P, Ververs M, Salama P. Occurrence and overlap of natural disasters, complex emergencies, and epidemics during the past decade (1995-2004). Confl Health. 2007;1:2. Available from: https://conflictandhealth.biomedcentral.com/articles/10.1186/1752-1505-1-2.
Anderson JL. A history of violence. The New Yorker: New York; 2012. Available from: http://www.newyorker.com/magazine/2012/07/23/a-history-of-violence-4
Martens P, Hall L. Malaria on the move: human population movement and malaria transmission. Emerg Infect Dis. 2000;6(2):103–9. https://doi.org/10.3201/eid0602.000202
Center for Research on the Epidemiology of Disasters. EM-DAT; Available from: http://emdat.be/ Accessed 18 Sept 2015.
Watson JT, Gayer M, Connolly MA. Epidemics after natural disasters. Emerg Infect Dis. 2007;13(1):1. https://doi.org/10.3201/eid1301.060779
Morgan O. Infectious disease risks from dead bodies following natural disasters. Rev Panam Salud Publica. 2004;15(5):307–12.
Center for Research on the Epidemiology of Disasters. CE-DAT. Available from: http://www.cedat.be/ Accessed 18 Sept 2015.
United Nations. Consolidated appeal process; Available from: http://www.unocha.org/themes. Accessed 2 Nov 2015.
Altare C, Guha-Sapir D. The complex emergency database: a global repository of small-scale surveys on nutrition, health, and mortality. PLoS One. 2014;9(10):e109022.
United Nations. Who we are. Available from: http://www.unocha.org/cerf/about-us/who-we-are.
Jennings S. Time's bitter flood: trends in the number of reported natural disasters. London: OXFAM; 2011. Available from: http://www.oxfam.org.hk/content/98/content_10110tc.pdf
Guha-Sapir D, Hoyois P. Measuring the human and economic impact of disasters. Brussels: CRED, Government Office for Science; 2012. Available from: http://www.cred.be/node/1310
Laframboise N, Loko B. Natural Disasters: Mitigating Impact, Managing Risks. IMF Working Papers. 2012;12/245:1–32.
WHO. Disease outbreaks by year. Available from: http://www.who.int/csr/don/archive/year/en/ Accessed 29 Nov 2015.
Global Alliance for Vaccines and Immunizations. Gavi Mission Indicators. 2015. Available from: http://www.gavi.org/results/goal-level-indicators/mission-indicators/.
WHO, UNICEF, World Bank. State of the world’s vaccines and immunization. 3rd ed. Geneva: WHO; 2009.
WHO. Global immunization vision and strategy. Geneva: WHO; 2011. Available from: http://www.who.int/immunization/givs/en/
WHO. WHO statement on the meeting of the international health regulations emergency committee concerning the international spread of wild poliovirus. Geneva: WHO; 2014.
Rubenstein L. Defying expectations: polio vaccination programs amid political and armed conflict. Washington, DC: United States Institute of Peace; 2010.
Smith A. Polio-related murders kill more than the disease itself. Newsweek: New York; 2014. Available from: http://www.newsweek.com/search/site/Polio-related%20murders%20kill%20more%20than%20the%20disease%20itself. Accessed 2 Nov 2017.
Piarroux R, Barrais R, Faucher B, Haus R, Piarroux M, Gaudart J, et al. Understanding the cholera epidemic, Haiti. Emerg Infect Dis. 2011;17(7):1161–8. https://doi.org/10.3201/eid1707.110059
International Federation of Red Cross and Red Crescent Societies. Disaster Management. 2013 Available from: http://www.ifrc.org/en/what-we-do/disastermanagement/about-disaster-management/. Accessed 2 Nov 2017.