Seasonal patterns of communicable disease incidence and antibiotic prescribing in Moria refugee camp, Greece.

BACKGROUND: Infectious diseases remain a major risk for refugees living in camps. Limited research has been undertaken into the burden and impact of infections in the current refugee crisis around the Mediterranean.This analysis examines the frequency and incidence rates of common infections, and use of antibiotics at a healthcare facility inside Moria refugee camp on the island of Lesvos, Greece, during the winter and summer seasons of 2019. METHODS: This is a retrospective analysis of routinely, prospectively collected service data from the main acute healthcare facility inside Moria camp. RESULTS: Of a total of 9601 consultations, 25.16% were for infections (winter: 31.53%, summer: 19.45%). Respiratory, skin and gastrointestinal infections were the most frequent, with incidence rates up to 3.5 times, 50 times and twice as high as those in Western Europe, respectively. Antibiotic prescribing was high (27.7% of all respiratory infections) with high use of broad-spectrum antibiotics (40.2%), raising concerns about induction of antimicrobial resistance. CONCLUSIONS: The burden of infectious diseases in refugee camps remains high throughout all seasons. Antimicrobial stewardship programmes should be adapted to refugee camp settings to prevent the development of unnecessary antimicrobial resistance. Improving living conditions and access to healthcare in refugee camps is likely to reduce infection rates and antimicrobial resistance among refugees.

Lessons to learn from the analysis of routine health data from Moria Refugee Camp on Lesvos, Greece.

BACKGROUND: Refugees in humanitarian settings commonly experience many health needs and barriers to access healthcare; health data from these settings are infrequently reported, preventing effective healthcare provision. This report describes health needs of refugees in Moria Camp on Lesvos, Greece-Europe's largest refugee camp. METHODS: A set of routinely collected service data of 18 131 consultations of 11 938 patients, attending a primary care clinic in the camp over 6 months in 2019-20, was analysed retrospectively, focusing on chronic health conditions. RESULTS: The most frequent chronic conditions were musculoskeletal pain (25.1%), mental health (15.9%), cardiac (12.7%) and endocrine conditions (8.9%). In all, 70.4% of consultations were for acute health problems, with high rates of injuries and wounds (20.8%), respiratory infections (12.5%), gastroenteritis (10.7%) and skin problems (9.7%), particularly scabies. CONCLUSIONS: The prevalence of acute and chronic health problems is high in this setting, with some likely attributable to the deplorable living conditions in the camp. Despite its magnitude, the interpretability of routine health data is limited. A research agenda is identified, and a framework for chronic disease management in refugee camps is proposed.

Psychosocial problems and support for disaster medical assistance team members in the preparedness, response and recovery phases of natural hazards resulting in disasters: A scoping review.

BACKGROUND: Clinicians responding to disasters are at risk of experiencing psychosocial problems that can negatively impact them during, upon their return and years after the deployment. Clinicians often respond to disasters as members of organised Disaster Medical Assistance Teams (DMATs). The aim of this paper was to review and synthesise the literature regarding psychosocial problems and support provided to medical personnel in the preparedness, response, and recovery phases of a disaster. METHODS: A comprehensive search for literature was conducted using four databases: EMBASE; CINAHL; MEDLINE; and PsychInfo. Medical Subject Heading and key terms used in the search included: Disasters; First Responder; Disaster Medical Assistance Team (DMAT); Post-Traumatic Stress Disorder. RESULTS: Psychosocial problems were identified amongst DMAT members in all phases (preparedness, response and recovery) of disaster assistance. These ranged from pre-existing stress and anxiety to Post-Traumatic Stress Disorder. Psychosocial support was mostly reported in the recovery phase of the disaster deployment. CONCLUSION: A range of strategies exist to support psychosocial problems DMAT members experience, however, these tend to focus on the recovery phase of deployment with limited focus on preparedness and response phases. Further research is required to identify, implement, and evaluate short and long term psychosocial support needs and strategies for DMAT members in all phases of a disaster deployment.