Tuberculosis (TB) in the refugee camps in Ethiopia: trends of case notification, profile, and treatment outcomes, 2014 to 2017.

BACKGROUND: Severity of TB increases in refugee populations. Monitoring TB case notification and treatment outcomes are essential to improve the effectiveness of TB programs. This study aimed to investigate trends in TB case notification and treatment outcomes and explore factors associated with unsuccessful treatment outcome in refugee camps in Ethiopia. METHODS: In this retrospective cohort study, demographic and clinical data of all TB cases registered in 25 refugee camps in Ethiopia from January 2014 to December 2017 were extracted. Multivariate logistic regression was fitted to estimate odds ratios and corresponding 95% confidence intervals for the measure of association linked with factors significantly associated with unsuccessful treatment outcomes. RESULTS: A total of 1553 TB cases, mean age 27.7 years, were registered from 2014 to 2017. Of these notified cases 54.7% were men, 27.7% children (< 15 years), 71.2% pulmonary TB (PTB), 27.8% Extra-PTB (EPTB) and 98.3% new and relapse. From 2014 to 2017: there was consistent increase in number of notified TB cases (138 to 588 cases), in percentage of EPTB (23.2 to 32.7%), in contribution of children to total TB cases (18.8 to 30.1%) and to EPTB (40.6 to 65.1%), and in proportion of bacteriologically confirmed new and relapse pulmonary cases (43.8 to 64.8%). Treatment success rates for all TB cases remained lower at 72.7-79.4%. On average 24.8% had unfavorable treatment outcome, including 11.5% not evaluated, 8.0% LTFU, 4.8% died and 0.5% treatment failed. Unsuccessful treatment was significantly associated with pretreatment weight below 40 Kg, age over 45 years, and being HIV positive. CONCLUSIONS: There was continuous increase in notified TB cases and in percentage of childhood TB. Proportion of bacteriologically confirmed new and relapse pulmonary cases increased overtime. TB treatment success remained lower than the national achievement in 2017 (96%) and global target (> = 90%), which needs improvement. The higher LTFU, not evaluated, and death suggests the need to strengthen adherence education and supervision. Special socio-economic support and monitoring is required for patients with pretreatment weight below 40 Kg, age over 45 years and HIV positives.

Is it possible to become a midwife in a refugee camp?

The historical backdrop of Western Sahara has meant that, for the last 43 years, part of its indigenous population has survived in refugee camps located in the Algerian desert. International aid from abroad has become the main source of sustenance for all people living in this hostile environment. Since the beginning of this type of settlement, the Sahrawi Arab Democratic Republic has been concerned with creating the necessary infrastructures to meet the health needs of the people living in these conditions. As a result, the Ahmed Abdel-Fatah School of Nursing was created in the Sahrawi refugee camps, which began to train midwives to care for women during the stages of pregnancy, childbirth and postpartum in 2002. The aim of this paper is to provide an approach to the origin and evolution of midwifery education for the Sahrawi refugee camps, in the only school of nursing that exists worldwide in a refugee camp.

Health Challenges in Refugee Reception: Dateline Europe 2016.

The arrival of more than one million migrants, many of them refugees, has proved a major test for the European Union. Although international relief and monitoring agencies have been critical of makeshift camps in Calais and Eidomeni where infectious disease and overcrowding present major health risks, few have examined the nature of the official reception system and its impact on health delivery. Drawing upon research findings from an Economic and Social Research Council (ESRC) funded project, this article considers the physical and mental health of asylum-seekers in transit and analyses how the closure of borders has engendered health risks for populations in recognised reception centres in Sicily and in Greece. Data gathered by means of a survey administered in Greece (300) and in Sicily (400), and complemented by in-depth interviews with migrants (45) and key informants (50) including representatives of government offices, humanitarian and relief agencies, NGOs and activist organisations, are presented to offer an analysis of the reception systems in the two frontline states. We note that medical provision varies significantly from one centre to another and that centre managers play a critical role in the transmission of vital information. A key finding is that, given such disparity, the criteria used by the UNHCR to grade health services reception do not address the substantive issue that prevent refugees from accessing health services, even when provided on site. Health provision is not as recorded in UNHCR reporting but rather there are critical gaps between provision, awareness, and access for refugees in reception systems in Sicily and in Greece. This article concludes that there is a great need for more information campaigns to direct refugees to essential services.