Haiti earthquake: situation report 4 - 23 August 2021

As a result of the 7.2 magnitude earthquake on August 14, 2021, according to Haiti's Civil Protection agency (DGPC), 2,207 people have died, 12,268 people were injured, and 320 are missing. In the most affected departments ­ Sud, Grand'Anse and Nippes ­ around 53,000 houses were destroyed and more than 77,000 damaged. Rapid assessments reported 59 health facilities affected in Grand'Anse, Nippes and Sud Departments: 27 severely damaged and 32 slightly damaged. In the affected departments, health sector evaluators are carrying out assessments to gather data on injured patients (hospitalizations, types of injuries and demographics) and the degree of damage to health facilities and needs. Logistics and security challenges continue limiting the delivery of supplies, deployment of personnel to affected areas and the transfer of patients to hospitals that are not overwhelmed. Health sector needs include: medical personnel, medicines, supplies and stock management, mental health and psychosocial support initiatives, implementation of preventive and control measures for communicable diseases, WASH operations in health facilities and shelters, rehabilitation of injured patients, among others

Post-traumatic stress disorder, emotional and behavioral difficulties in children and adolescents 2 years after the 2012 earthquake in Italy: an epidemiological cross-sectional study.

Despite the occurrence of several earthquakes, only a few studies were conducted in Italy on the psychological impact in children and adolescents, with data mostly collected within one year after the disaster. This cross-sectional study aimed at exploring the prevalence of both post-traumatic stress disorder (PTSD) and emotional/behavioral difficulties, as well as at identifying their main predictors, among youths 2 years after the earthquake that hit Northern Italy in 2012. 682 children and adolescents (9-14 years) living in two districts (earthquake zone vs control zone) were administered an exposure questionnaire, the UCLA PTSD-Index for DSM-IV, and the Strengths and Difficulties Questionnaire (SDQ) and 1162 parents were assessed through the Symptom Checklist-90 (SCL-90). The prevalence of a likely PTSD in the earthquake zone was 1.9% (4.4% near the epicenter) and the total PTSD score in the affected area was significantly higher than in the control zone. 14.9% of youths living in the earthquake zone had a borderline/abnormal SDQ total difficulties score and 87.5% of youth with a likely PTSD also had a SDQ total score in the borderline/abnormal range. Regression analysis showed that the number of lifetime traumatic events (e.g., death of a relative) was the best predictor of children/adolescents psychological difficulties 2 years after the earthquake, followed by severity of exposure (personal injuries and losses) and parental psychopathology. Despite some limitations, this study highlights that youths may exhibit PTSD symptoms years after disasters, often in comorbidity with behavioral/emotional difficulties, stressing the need for long-term surveillance and interventions in exposed populations.

Extrication time and earthquake-related mortality in the 2016 Taiwan earthquake.

BACKGROUND/PURPOSE: People with different age distributions and extrication times might have distinct injury characteristics and outcomes in earthquakes. METHODS: A retrospective study was conducted to analyze the casualties in the 2016 Taiwan earthquake using data from the incident registry system and the field disaster operation system. The study subjects were assigned to 4 groups by age: preschool (<5 years), school (5-17 years), adult (18-64 years), and elderly (>64 years). Classification and regression tree analysis and receiver-operating characteristic curves were utilized to examine several factors, including extrication time, age group, floor height, and structural damage, for earthquake-related mortality. A two-sided p value less than 0.05 was considered statistically significant. RESULTS: A total of 238 enrollees were assigned to the preschool (n = 18, 7.6%), school (n = 45, 18.9%), adult (n = 169, 71.0%), or elderly (n = 6, 2.5%) groups. Among the parameters, the extrication time exhibited the strongest association with mortality. Regarding the association between the extrication time and mortality hazard in multivariate models, we found significant odds ratios (ORs) at the extrication time cutoffs of 12, 24 and 72 h (OR = 42.61, 95% confidence interval [CI]: 13.92-130.37; OR = 37.58, 95% CI: 14.77-95.60; OR = 95.16, 95% CI: 23.02-393.48, respectively, all p < 0.001). The optimal extrication time cutoff for mortality was 12 h in the preschool group and 24 h in the school and adult groups. CONCLUSION: Extrication time is strongly associated with earthquake-related mortality. These findings may facilitate strategic approaches for patients entrapped in damaged buildings and can contribute to future training for field search and rescues after earthquakes.

Post-traumatic stress disorder and its risk factors in bereaved Tibetan adolescents 3 years after the 2010 Yushu earthquake, a cross-sectional study in China.

OBJECTIVES: This study examined the incidence of symptomatological post-traumatic stress disorder (PTSD) in bereaved Tibetan adolescents 3 years after the 2010 Yushu earthquake, then to identify possible and relational risk factors of PTSD by a cross-sectional study. METHODS: A total of 867 bereaved Tibetan adolescents seriously impacted by the 2010 earthquake were investigated. Symptomatological PTSD was evaluated by the PTSD Checklist-Civilian Version. And coping styles were evaluated by the Coping Styles Scale. Exposure of trauma to the 2010 Yushu earthquake was evaluated by a checklist about earthquake containing sociodemographic variables. RESULTS: 3 years after the Yushu earthquake, 24.4% of the bereaved Tibetan adolescents had symptomatological PTSD. The results also indicated that coping styles and disaster-related experiences after the 2010 earthquake were connected with PTSD among survivors. When the 2010 earthquake struck, those having symptomatological PTSD were more probably to be buried/injured/amputated, and to witness burial/injury/death, and to have property damage. An individual who adopted positive coping skill was probably to have less symptomatological PTSD. CONCLUSIONS: The results showed that the existence of PTSD in bereaved Tibetan adolescents in the Yushu earthquake was very prevailing after 3 years. Effective psychological rescue work should be carried out, especially targeting bereaved Tibetan adolescents with more severe PTSD.

The Imbalance in Medical Demand and Supply for Pediatric Victims in an Earthquake.

OBJECTIVES: We quantified an absolute imbalance of the medical risks and the support needs for children at each disaster-based hospital in Kanagawa immediately following the occurrence of a large earthquake by using the risk resource ratio (RRR) and need for medical resources (NMR). METHODS: The RRR and NMR of 33 disaster-based hospitals were estimated through dividing the estimated number of pediatric victims by the number of critically patients. We calculated the ratio of the NMR of each hospital. RESULTS: The total number of pediatric victims in Kanagawa was estimated at 8,391. The total number of vacant beds for pediatric victims was 352. The median RRR and NMR of the total number of pediatric victims were 27 and 224. The median RRR and NMR of the number of critically ill pediatric patients were 27 and 12. CONCLUSIONS: The absolute imbalance of the RRR and NMR for children in Kanagawa was quantified. This suggests that we might embark on preparedness strategies for children in advance. (Disaster Med Public Health Preparedness. 2018;13:672-676).

Earthquake-Induced Injuries: Retrospective Epidemiological Analysis of the 2015 Hindu Kush Earthquake in Pakistan.

OBJECTIVE: The aim of this study was to analyze retrospectively the earthquake-induced injuries caused by the October 2015 Hindu Kush earthquake in Pakistan. This is the first population-based study to assess epidemiologically earthquake-induced injuries in the Hindu Kush region, one of the world's most mountainous and seismically active regions. Unfortunately, only limited studies have investigated the earthquake-induced injuries and deaths in the region epidemiologically. METHODS: The 5 worst affected districts were selected according to the highest number of deaths and injuries recorded. A total of 1,790 injuries and 232 deaths were reported after the 2015 earthquake. In our study area, 391 persons were recorded and verified to have been injured as a result of the earthquake. We attempted to investigate all of the 391 injured people, but the final study looked at 346 subjects because the remaining 45 subjects could not be traced because of the non-availability of their complete records and their refusal to participate in the study. RESULTS: Using the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD 10), we found that the highest number - 20.23% (70 of 346) - of injuries in the earthquake fall in the class of "Injuries to an unspecified part of trunk, limb, or body region (T08-T14)." The class of "Injuries to knee and lower leg (S80-S89)," which count 15.61% (54 out of 346), followed it, and "Injuries involving multiple body regions (T00-T07)" were making 14.74% of total injuries (51 out of 346). CONCLUSION: In times of natural disasters like earthquakes, collecting and analyzing real-time data can be challenging. Therefore, a retrospective data analysis of deaths and injuries induced by the earthquake is of high importance. Studies in these emerging domains will be crucial to initiate health policy debates and to prevent and mitigate future injuries and deaths. (Disaster Med Public Health Preparedness. 2018;13:732-739).

Historical Earthquakes and Their Socioeconomic Consequences in China: 1950⁻2017.

Understanding the spatiotemporal pattern of historical earthquake disasters and resultant socioeconomic consequences is essential for designing effective disaster risk reduction measures. Based on historical earthquake disaster records, this study compiles a Chinese earthquake disaster catalog (CH-CAT) that includes records of 722 earthquake disasters that occurred during 1950⁻2017 in the mainland of China. This catalog includes more complete data records than other existing global earthquake databases for China as a whole. Statistical results demonstrate that the number of earthquake disasters and the resultant direct economic losses (DELs) exhibit significant increasing trends (p < 0.01) over the studied 68-year period. Earthquake-induced deaths vary greatly between individual years and exhibit no significant trend. The Qinghai-Tibet seismic zone is the area with the highest frequency of earthquake disasters and the largest accumulated DELs, whereas the North China seismic zone is associated with the highest number of deaths. Among the 722 earthquake disasters, nearly 99.0% of deaths and 95.0% of DELs are attributable to 1.8% and 3.9% of the earthquake disasters, respectively. Approximately 54.2% of recorded earthquake disasters have earthquake magnitude (Ms) values between 5.0 and 5.9, while earthquake disasters with Ms greater than or equal to 7.0 account for 88.5% of DELs and 98.8% of deaths. On average, earthquake-induced DELs and deaths increase nonlinearly with increasing Ms per earthquake. DELs have a positive correlation with deaths and casualties on a logarithmic scale. This study further discusses that during different stages of socioeconomic development, changes in both exposure and vulnerability may be the major factors leading to change differences in earthquake-induced socioeconomic consequences. This study is a beneficial supplement to the global earthquake database and is useful for calibrating global or regional empirical loss models.

Differences in infant and child mortality before and after the Great East Japan Earthquake and Tsunami: a large population-based ecological study.

OBJECTIVES: To examine associations between access to medical care, geological data, and infant and child mortality in the area of North-Eastern Japan that was impacted by the Great East Japan Earthquake and Tsunami (GEJET) in 2011. DESIGN: A population-based ecological study using publicly available data. SETTING: Twenty secondary medical areas (SMAs) in the disaster-affected zones in the north-eastern prefectures of Japan (Iwate, Fukushima and Miyagi). PARTICIPANTS: Children younger than 10 years who died in the 20 SMAs between 2008 and 2014 (n=1 748). Primary and secondary outcome measures: Multiple regression analysis for infant and child mortality rate. The mean values were applied for infant and child mortality rates and other factors before GEJET (2008-2010) and after GEJET (2012-2014). RESULTS: Between 2008 and 2014, the most common cause of death among children younger than 10 years was accidents. The mortality rate per 100 000 persons was 39.1±41.2 before 2011, 226.7±43.4 in 2011 and 31.4±39.1 after 2011. Regression analysis revealed that the mortality rate was positively associated with low age in each period, while the coastal zone was negatively associated with fewer disaster base hospitals in 2011. By contrast, the number of obstetrics and gynaecology centres (ß=-189.9, p=0.02) and public health nurses (ß=-1.7, p=0.01) was negatively associated with mortality rate per person in 2011. CONCLUSIONS: In 2011, the mortality rate among children younger than 10 years was 6.4 times higher than that before and after 2011. Residence in a coastal zone was significantly associated with higher child mortality rates.