Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 257
Filtrar
1.
Sci Total Environ ; 780: 146504, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34030293

RESUMO

Drinking water provision has been a constant challenge in the Sahrawi refugee camps, located in the desert near Tindouf (Algeria). The drinking water supply system is itself divided in three zones which pump groundwater from different deep aquifers. It is equipped with reverse osmosis plants and chlorination systems for treating water. The allocation of water supplied to the Saharawi refugees for human consumption in 2016 has been estimated at between 14 and 17 L/person/day on average. This supplied water volume is below recommended standards, and also below the strategic objective of the Sahrawi government (20 L/person/day). Yet the local groundwater resources are huge in comparison with estimated consumption, and hence there is great potential for increasing the supplied volume through effecting improvements in the supply system. The physico-chemical quality of the raw and supplied water between 2006 and 2016 has been assessed according to Algerian standards for human consumption. The raw water of two zones of the supply system presents a very high conductivity and high concentrations of chloride, nitrate, fluoride, sulfate, sodium, calcium, potassium and iodide concentrations of natural origin, which may entail health risks. The treatment of water in a reverse osmosis plant greatly improves its quality and osmosed water met the standards. However, the supply of osmosed and raw water needs to be combined in Zone 1, to avoid an excessive reduction in water volume, and the supplied raw water poses a risk to the health of the refugees. The present study provides an example of a drinking water supply system under extreme drought conditions and in the political and social conditions of a refugee camp. Furthermore, it establishes a reference for supplied water allocation and quality in the Sahrawi refugee camps.


Assuntos
Água Potável , Refugiados , Argélia , Humanos , Campos de Refugiados , Abastecimento de Água
3.
Artigo em Inglês | MEDLINE | ID: mdl-33668164

RESUMO

Although resources are scarce and outputs incorporate the potential to save human lives, efficiency measurement endeavors with data envelopment analysis (DEA) methods are not yet commonplace in the research and practice of non-government organizations (NGO) and states involved in humanitarian logistics. We present a boot-strapped DEA window analysis and Malmquist index application as a methodological state of the art for a multi-input and multi-output efficiency analysis and discuss specific adaptions to typical core challenges in humanitarian logistics. A characteristic feature of humanitarian operations is the fact that a multitude of organizations are involved on at least two levels, national and supra-national, as well as in two sectors, private NGO and government agencies. This is modeled and implemented in an international empirical analysis: First, a comprehensive dataset from the 34 least developed countries in Africa from 2002 to 2015 is applied for the first time in such a DEA Malmquist index efficiency analysis setting regarding the national state actor level. Second, an analysis of different sections in a Rohingya refugee camp in Bangladesh is analyzed based on a bootstrapped DEA with window analysis application for 2017, 2018, and 2019 quarter data regarding the private NGO level of operations in humanitarian logistics.


Assuntos
Países em Desenvolvimento , Campos de Refugiados , África , Bangladesh , Humanos , Organizações
4.
BMC Infect Dis ; 21(1): 139, 2021 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-33535974

RESUMO

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.


Assuntos
Notificação de Doenças , Campos de Refugiados/tendências , Resultado do Tratamento , Tuberculose/epidemiologia , Adolescente , Adulto , Criança , Etiópia/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Refugiados/estatística & dados numéricos , Estudos Retrospectivos , Adulto Jovem
5.
BMC Public Health ; 21(1): 390, 2021 02 22.
Artigo em Inglês | MEDLINE | ID: mdl-33618684

RESUMO

BACKGROUND: More than 100 million people were forcibly displaced over the last decade, including millions of refugees displaced across international borders. Although refugee health and well-being has gained increasing attention from researchers in recent years, few studies have examined refugee birth outcomes or newborn health on a regional or global scale. This study uses routine health information system data to examine neonatal mortality burden and trends in refugee camps between 2006 and 2017. METHODS: Refugee population and mortality data were exported from the United Nations High Commissioner for Refugees (UNHCR) Health Information System (HIS) database. Tableau was used to export the data. Stata was used for data cleaning and statistical analysis. Neonatal mortality burdens and trends in refugee camps were analyzed and compared to national and subnational neonatal mortality rates captured by household surveys. FINDINGS: One hundred fifty refugee camps in 21 countries were included in this study, with an average population of 1,725,433 between 2006 and 2017. A total of 663,892 live births and 3382 neonatal deaths were captured during this period. Annual country-level refugee camp neonatal mortality rates (NMR) ranged from 12 to 56 neonatal deaths per 1000 live births. In most countries and years where national population-based surveys are available, refugee camp NMR as reported in the UNHCR HIS was lower than that of the immediate host community. CONCLUSION: The UNHCR HIS provides insights into the neonatal mortality burden among refugees in camp settings and issues to consider in design and use of routine health information systems to monitor neonatal health in sub-national populations. Increased visibility of neonatal deaths and stillbirths among displaced populations can drive advocacy and inform decisions needed to strengthen health systems. Efforts to count every stillbirth and neonatal death are critical, as well as improvements to reporting systems and mechanisms for data review within broader efforts to improve the quality of neonatal care practices within and outside of health facilities.


Assuntos
Campos de Refugiados , Refugiados , Feminino , Humanos , Mortalidade Infantil , Recém-Nascido , Gravidez , Estudos Retrospectivos , Nações Unidas
6.
BMC Public Health ; 21(1): 272, 2021 02 02.
Artigo em Inglês | MEDLINE | ID: mdl-33530961

RESUMO

BACKGROUND: Understanding the burden of common mental health disorders, such as depressive disorder, is the first step in strengthening prevention and treatment in humanitarian emergencies. However, simple random sampling methods may lead to a high risk of coercion in settings characterized by a lack of distinction between researchers and aid organizations, mistrust, privacy concerns, and the overarching power differential between researchers and populations affected by crises. This case analysis describes a sampling approach developed for a survey study of depressive disorder in a Syrian refugee camp in Greece (n = 135). DISCUSSION: Syrian refugees face an extraordinarily high burden of depressive disorder during the asylum process (43%), necessitating population screening, prevention, and treatment. In order to preserve the informed consent process in this refugee camp setting, the research team developed a two-phase sampling strategy using a map depicting the geographical layout of the housing units within the camp. In the first phase, camp management announced a research study was being undertaken and individuals were invited to volunteer to participate. The participants' container (housing) numbers were recorded on the map, but were not linked to the survey data. Then, in the second phase, the camp map was used for complementary sampling to reach a sample sufficient for statistical analysis. As a result of the two phases of the sampling exercise, all eligible adults from half the containers in each block were recruited, producing a systematic, age- and sex-representative sample. CONCLUSIONS: Combining sampling procedures in humanitarian emergencies can reduce the risk of coerced consent and bias by allowing participants to approach researchers in the first phase, with a second phase of sampling conducted to recruit a systematic sample. This case analysis illuminates the feasibility of a two-phase sampling approach for drawing a quasi-random, representative sample in a refugee camp setting.


Assuntos
Transtorno Depressivo , Refugiados , Adulto , Grécia/epidemiologia , Humanos , Prevalência , Campos de Refugiados
7.
J Food Prot ; 84(5): 876-884, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33411925

RESUMO

ABSTRACT: Refugee camps provide basic necessities such as food, water, shelter, and medical treatment for displaced persons. Unsanitary conditions in refugee camps due to overcrowding, poor sanitation systems, lack of clean water, and minimal ways to cook and store food can lead to an increased risk of foodborne illness. This article reviews the limited literature on the epidemiology of foodborne illness in refugee camps, effective risk mitigation strategies, and opportunities for future research. Eleven relevant articles were identified, suggesting that research in this area is limited. Identified research focused on three pathogens-Vibrio cholerae, Salmonella, and hepatitis E virus-that can cause serious diseases such as cholera, salmonellosis, typhoid fever, and hepatitis E. Storage and handling of clean water for personal hygiene and food preparation were critical components for ensuring food safety. Knowledge pertaining to best practices for hygiene and food preparation also were identified as important. Gaps in current research include determination of the prevalence of pathogens in food sold in refugee camps and development of culturally relevant food safety supply chain quality management systems. More research that focuses on burden and attribution of foodborne illness and food safety interventions in refugee camps is necessary.


Assuntos
Campos de Refugiados , Refugiados , Inocuidade dos Alimentos , Humanos , Higiene , Saneamento
8.
PLoS One ; 15(12): e0244214, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33362236

RESUMO

BACKGROUND: Following an influx of an estimated 742,000 Rohingya refugees in Bangladesh, Médecins sans Frontières (MSF) established an active indicator-based Community Based Surveillance (CBS) in 13 sub-camps in Cox's Bazar in August 2017. Its objective was to detect epidemic prone diseases early for rapid response. We describe the surveillance, alert and response in place from epidemiological week 20 (12 May 2019) until 44 (2 November 2019). METHODS: Suspected cases were identified through passive health facility surveillance and active indicator-based CBS. CBS-teams conducted active case finding for suspected cases of acute watery diarrhea (AWD), acute jaundice syndrome (AJS), acute flaccid paralysis (AFP), dengue, diphtheria, measles and meningitis. We evaluate the following surveillance system attributes: usefulness, Positive Predictive Value (PPV), timeliness, simplicity, flexibility, acceptability, representativeness and stability. RESULTS: Between epidemiological weeks 20 and 44, an average of 97,340 households were included in the CBS per surveillance cycle. Household coverage reached over 85%. Twenty-one RDT positive cholera cases and two clusters of AWD were identified by the CBS and health facility surveillance that triggered the response mechanism within 12 hours. The PPV of the CBS varied per disease between 41.7%-100%. The CBS required 354 full-time staff in 10 different roles. The CBS was sufficiently flexible to integrate dengue surveillance. The CBS was representative of the population in the catchment area due to its exhaustive character and high household coverage. All households consented to CBS participation, showing acceptability. DISCUSSION: The CBS allowed for timely response but was resource intensive. Disease trends identified by the health facility surveillance and suspected diseases trends identified by CBS were similar, which might indicate limited additional value of the CBS in a dense and stable setting such as Cox's Bazar. Instead, a passive community-event-based surveillance mechanism combined with health facility-based surveillance could be more appropriate.


Assuntos
Surtos de Doenças/estatística & dados numéricos , Indicadores Básicos de Saúde , Vigilância em Saúde Pública/métodos , Campos de Refugiados/estatística & dados numéricos , Refugiados/estatística & dados numéricos , Bangladesh , Dengue/epidemiologia , Diarreia/epidemiologia , Humanos , Sarampo/epidemiologia , Meningite/epidemiologia , Mianmar , Campos de Refugiados/normas , Sociedades Médicas
10.
Ann Glob Health ; 86(1): 129, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33102149

RESUMO

In August 2017, Bangladesh saw a massive influx of Rohingya refugees following their violent persecution by the Myanmar authorities. Since then, the district of Cox's Bazar has been home to nearly 900,000 Rohingya refugees living in the densely populated and unhygienic camps. The refugees have been living in makeshift settlements which are cramped into one another, making it extremely difficult to maintain "social distance". The overcrowded conditions coupled with the low literacy level, lack of basic sanitation facilities, face masks and gloves and limited communication make these camps an ideal place for the virus to spread rapidly. As nations struggle to contain the SARS-CoV-2 virus, refugees are one such population who are extremely vulnerable to the effects of this outbreak. If issues are not addressed at an early stage, its effects can be catastrophic.


Assuntos
Infecções por Coronavirus , Aglomeração , Transmissão de Doença Infecciosa/prevenção & controle , Controle de Infecções , Pandemias , Pneumonia Viral , Campos de Refugiados , Refugiados/estatística & dados numéricos , Bangladesh/epidemiologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Acesso aos Serviços de Saúde/normas , Necessidades e Demandas de Serviços de Saúde , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Controle de Infecções/normas , Mianmar/epidemiologia , Pandemias/prevenção & controle , Equipamento de Proteção Individual/provisão & distribuição , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Campos de Refugiados/normas , Campos de Refugiados/provisão & distribuição , Saneamento/normas
11.
PLoS One ; 15(9): e0239187, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32941533

RESUMO

OBJECTIVES: Sexual violence can have a destructive impact on the lives of people. It is more common in unstable conditions such as during displacement or migration of people. On the Greek island of Lesvos, Médecins Sans Frontières provided medical care to survivors of sexual violence among the population of asylum seekers. This study describes the patterns of sexual violence reported by migrants and asylum seekers and the clinical care provided to them. METHODS: This is a descriptive study, using routine program data. The study population consisted of migrants and asylum seekers treated for conditions related to sexual violence at the Médecins Sans Frontières clinic on Lesvos Island (September 2017-January 2018). RESULTS: There were 215 survivors of sexual violence who presented for care, of whom 60 (28%) were male. The majority of incidents reported (94%) were cases of rape; 174 (81%) of survivors were from Africa and 185 (86%) of the incidents occurred over a month before presentation. Half the incidents (118) occurred in transit, mainly in Turkey, and 76 (35%) in the country of origin; 10 cases (5%) occurred on Lesvos. The perpetrator was known to the survivor in 23% of the cases. The need for mental health care exceeded the capacity of available mental care services. CONCLUSION: Even though the majority of cases delayed seeking medical care after the incident, it is crucial that access to mental health services is guaranteed for those in need. Such access and security measures for people in transit need to be put in place along migration routes, including in countries nominally considered safe, and secure routes need to be developed.


Assuntos
Refugiados/estatística & dados numéricos , Delitos Sexuais/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Adolescente , Adulto , Criança , Feminino , Grécia , Humanos , Masculino , Saúde Mental/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Campos de Refugiados/estatística & dados numéricos , Refugiados/psicologia , Sociedades Médicas/estatística & dados numéricos , Migrantes/psicologia
13.
Public Health ; 186: 101-106, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32795768

RESUMO

OBJECTIVES: This study investigated the magnitude of catastrophic health expenditure (CHE) among ex-Gazan households in Jerash camp in Jordan. STUDY DESIGN: This retrospective survey used a systematic sample. METHODS: A systematic sample was used wherein every fifth house in Jerash camp was invited to participate in the study. The camp represents the largest community of ex-Gazan refugees in Jerash camp. Of the 1038 households who were invited, 976 households agreed to participate (response rate = 94%) and filled the pilot-structured questionnaire with information related to their socio-economic characteristics, health status, and their healthcare and total household expenditures. van Doorslaer's method was used to calculate the frequency of CHE, wherein the expenditure on health care was considered catastrophic if it exceeded 10% of a household's total expenditure. RESULTS: Of the sample, 41.8% suffered from CHE. Moreover, we calculated the frequency of CHE using 15%, 20%, 30%, and 40% as threshold values, and the total rates were 14.7, 6.3, 1, and 0.3%, respectively. In addition, the statistical analysis of the results showed higher frequencies of CHE in households with larger number of dependents, those headed by widowed women, and those with history of hospitalizations. CONCLUSIONS: The study shows that the rate of CHE in Jerash camp is very high and mainly due to the cost of hospitalization. Special attention should be paid for the residents of that area.


Assuntos
Gastos em Saúde/estatística & dados numéricos , Campos de Refugiados/estatística & dados numéricos , Adulto , Características da Família , Feminino , Serviços de Saúde , Nível de Saúde , Hospitalização , Humanos , Jordânia , Masculino , Pessoa de Meia-Idade , Oriente Médio , Campos de Refugiados/economia , Refugiados , Estudos Retrospectivos , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
14.
PLoS Med ; 17(7): e1003148, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32673316

RESUMO

BACKGROUND: Embedded implementation research (IR) promotes evidence-informed policy and practices by involving decision-makers and program implementers in research activities that focus on understanding and solving existing implementation challenges. Although embedded IR has been conducted in multiple settings by different organizations, there are limited experiences of embedded IR in humanitarian settings. This study highlights some of the key challenges of conducting embedded IR in a humanitarian setting based on our experience with the Rohingya refugee population in Cox's Bazar, Bangladesh. METHODS AND FINDINGS: We collected qualitative data in between January and July 2019. First, we visited Rohingya refugee camps and interviewed representatives from different humanitarian organizations. Second, we conducted interviews with researchers from BRAC University who were engaged with data collection and analysis in a broader embedded IR study on maternal, newborn, child, and adolescent health (MNCAH) program implementation challenges. Data were analyzed using a thematic analysis approach. Two researchers developed and agreed on codes and relevant themes based on the objectives of this study. The findings of this study highlight several challenges encountered while conducting embedded IR in the Rohingya emergency setting in Cox's Bazar, which may have implications for other humanitarian settings. The overall context of the camps was complex, with more than 100 organizations devoted to providing health services for approximately 1 million refugees. Despite the presence of the Bangladesh government, United Nations agencies and other international organizations played key roles in making programmatic and policy decisions for the Rohingya. Because health service delivery modalities and policies and related implementation challenges for MNCAH programs for the refugees changed rapidly, the embedded IR approach used was flexible and able to adapt to changes identified, with research questions and methods modified accordingly. Access to the camps, reaching Rohingya respondents, overcoming language barriers in order to get quality information, and the limited availability of local research collaborators were additional challenges. Working with researchers or research institutes that are familiar with the context and have experience in conducting implementation and health systems research can help with collection of quality data, identifying key stakeholders and bringing them on board to ensure the execution of the project, and ensuring utilization of the research findings. Study limitations include possible constraints in generalizing our conclusions to other humanitarian settings. Implementation research conducted in additional humanitarian settings can contribute to the evidence on this topic. CONCLUSIONS: Findings indicate that embedded IR can be done effectively in humanitarian settings if the challenges are anticipated, and appropriate strategies and in-country partners put in place to address or mitigate them, before commencing the funding or starting of the project. Understanding the context and analyzing the role of relevant stakeholders prior to conducting the research, considering a simple descriptive method appropriate to answering real-time IR questions, and working with local researchers or research institutes with specific skill sets and prior experience conducting research in humanization contexts may reduce costs and time spent, and ensure collection of quality data relevant for policy and practice.


Assuntos
Atenção à Saúde/organização & administração , Pesquisa sobre Serviços de Saúde/métodos , Adolescente , Bangladesh , Criança , Pré-Escolar , Feminino , Humanos , Ciência da Implementação , Recém-Nascido , Idioma , Organizações , Avaliação de Resultados em Cuidados de Saúde , Campos de Refugiados , Refugiados , Nações Unidas
15.
Cent Eur J Public Health ; 28(2): 149-154, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32592561

RESUMO

OBJECTIVES: Since the beginning of the civil war in Syria, over 3.5 million Syrians have fled to Turkey. Considering the massive burden of healthcare service needs of this population, the Turkish government has launched an initiative as employing Syrian doctors to provide health services to their citizens in Refugee Health Centres. In this study, we aimed to explore the social adaptation status of Syrian physicians living in Turkey using a structured questionnaire and the Social Adaptation Self Evaluation Scale (SASS). METHODS: Between November 2016 and April 2018, 799 physicians who participated in "Syrian Physicians' Adaptation Training" were enrolled in the study and underwent a structured questionnaire that questioned socio-demographic data and the SASS. The participants were divided into two groups as having poor and normal/high SASS scores. The binary SASS groups were compared with some demographic data. RESULTS: The median SASS score of the respondents was found as 43 (min. 10, max. 60, IQR 10) which can be accepted as normal. In the binary grouping, it was seen that 107 (13.39%) participants had poor social adaptation, whereas 692 (86.61%) participants had normal or high social adaptation scores. The physicians who were certain about not going back to Syria had significantly higher SASS scores. CONCLUSION: The social adaptation scores of the Syrian physicians were considerably high. The adaptation status was found to be associated with some characteristics like living in Turkey for a long time and having pre-knowledge about the Turkish healthcare system.


Assuntos
Acesso aos Serviços de Saúde/organização & administração , Serviços de Saúde/provisão & distribuição , Médicos/psicologia , Refugiados/psicologia , Ajustamento Social , Adaptação Psicológica , Adulto , Competência Cultural , Feminino , Humanos , Masculino , Atenção Primária à Saúde/organização & administração , Campos de Refugiados , Síria/etnologia , Turquia/epidemiologia
16.
PLoS Med ; 17(6): e1003144, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32544156

RESUMO

BACKGROUND: COVID-19 could have even more dire consequences in refugees camps than in general populations. Bangladesh has confirmed COVID-19 cases and hosts almost 1 million Rohingya refugees from Myanmar, with 600,000 concentrated in the Kutupalong-Balukhali Expansion Site (mean age, 21 years; standard deviation [SD], 18 years; 52% female). Projections of the potential COVID-19 burden, epidemic speed, and healthcare needs in such settings are critical for preparedness planning. METHODS AND FINDINGS: To explore the potential impact of the introduction of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the Kutupalong-Balukhali Expansion Site, we used a stochastic Susceptible Exposed Infectious Recovered (SEIR) transmission model with parameters derived from emerging literature and age as the primary determinant of infection severity. We considered three scenarios with different assumptions about the transmission potential of SARS-CoV-2. From the simulated infections, we estimated hospitalizations, deaths, and healthcare needs expected, age-adjusted for the Kutupalong-Balukhali Expansion Site age distribution. Our findings suggest that a large-scale outbreak is likely after a single introduction of the virus into the camp, with 61%-92% of simulations leading to at least 1,000 people infected across scenarios. On average, in the first 30 days of the outbreak, we expect 18 (95% prediction interval [PI], 2-65), 54 (95% PI, 3-223), and 370 (95% PI, 4-1,850) people infected in the low, moderate, and high transmission scenarios, respectively. These reach 421,500 (95% PI, 376,300-463,500), 546,800 (95% PI, 499,300-567,000), and 589,800 (95% PI, 578,800-595,600) people infected in 12 months, respectively. Hospitalization needs exceeded the existing hospitalization capacity of 340 beds after 55-136 days, between the low and high transmission scenarios. We estimate 2,040 (95% PI, 1,660-2,500), 2,650 (95% PI, 2,030-3,380), and 2,880 (95% PI, 2,090-3,830) deaths in the low, moderate, and high transmission scenarios, respectively. Due to limited data at the time of analyses, we assumed that age was the primary determinant of infection severity and hospitalization. We expect that comorbidities, limited hospitalization, and intensive care capacity may increase this risk; thus, we may be underestimating the potential burden. CONCLUSIONS: Our findings suggest that a COVID-19 epidemic in a refugee settlement may have profound consequences, requiring large increases in healthcare capacity and infrastructure that may exceed what is currently feasible in these settings. Detailed and realistic planning for the worst case in Kutupalong-Balukhali and all refugee camps worldwide must begin now. Plans should consider novel and radical strategies to reduce infectious contacts and fill health worker gaps while recognizing that refugees may not have access to national health systems.


Assuntos
Infecções por Coronavirus/epidemiologia , Necessidades e Demandas de Serviços de Saúde , Hospitalização , Unidades de Terapia Intensiva , Pneumonia Viral/epidemiologia , Campos de Refugiados , Refugiados , Capacidade de Resposta ante Emergências , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bangladesh/epidemiologia , Betacoronavirus , Criança , Pré-Escolar , Simulação por Computador , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/transmissão , Feminino , Mão de Obra em Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Mianmar/etnologia , Pandemias , Pneumonia Viral/mortalidade , Pneumonia Viral/transmissão , Adulto Jovem
19.
Index enferm ; 29(1/2): 23-27, ene.-jun. 2020. ilus, graf, tab
Artigo em Espanhol | IBECS | ID: ibc-197421

RESUMO

OBJETIVO PRINCIPAL: Analizar la prevalencia del sobrepeso en una muestra de mujeres Saharauis en relación a la imagen corporal. METODOLOGÍA: Muestra no aleatoria (n=210), mujeres residentes en campamentos de refugiados Saharauis de Tindouf, durante 2018. Se determinó el Índice de Masa Corporal (IMC) y se aplicó el cuestionario de la Silueta de Maganto y Cruz, para determinar el Índice de Distorsión y el de Insatisfacción de la imagen corporal. RESULTADOS PRINCIPALES: Un 60,47% de las mujeres presentaban un IMC superior a 25. El 92,4% de las mujeres se identifican con una silueta más delgada de la que les corresponde, mientras que el 40,5% de la muestra se sienten satisfechas de su imagen corporal. CONCLUSIÓN PRINCIPAL: La alta tasa de obesidad detectada en las mujeres no es motivo de insatisfacción con el cuerpo en las participantes. Los índices de distorsión e insatisfacción corporal sugieren que la figura de la mujer obesa encuentra una amplia aceptación social en la sociedad saharaui


OBJECTIVE: To analyse the prevalence of overweight in a sample of Saharawi women in relationship with their body image. METHODS: Intentional sample of 210 women living in Sahrawi refugee camps in Tindouf during 2018. The BMI was determined and then the Maganto and Cruz Silhouette questionnaire was applied to each, to determine the Distortion Index and the Body Image Dissatisfaction Index. RESULTS: 60.47% of women had a BMI of over 25. The 92.4% of women identify with a slimmer silhouette than corresponds to them. The 40.5% of the sample is satisfied with their body image. CONCLUSIONS: The high rate of obesity detected isdoes not related togenerate dissatisfaction with their body in the women that took part. The indices of distortion and dissatisfaction suggest social acceptance of the figure of an obese woman in Saharawi society


Assuntos
Humanos , Feminino , Adulto , Sobrepeso/epidemiologia , Imagem Corporal/psicologia , Obesidade/epidemiologia , Beleza , Sobrepeso/psicologia , Obesidade/psicologia , Índice de Massa Corporal , Inquéritos e Questionários , África do Norte/epidemiologia , Estudos Transversais , Antropometria , Análise de Variância , Campos de Refugiados
20.
PLoS One ; 15(5): e0231694, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32384095

RESUMO

BACKGROUND: Diarrhoea is one of the most common causes of mortality and morbidity among populations displaced due to conflict. Handwashing with soap has the potential to halve the burden of diarrhoeal diseases in crisis contexts. This study aimed to identify which determinants drive handwashing behaviour in post-conflict, displacement camps. METHODS: This study was conducted in two camps for internally displaced people in the Kurdistan Region of Iraq. A Barrier Analysis questionnaire was used for assessing the determinants of hand washing behaviour. Participants were screened and classified as either 'doers' (those who wash their hands with soap at critical times) or 'non-doers' (those who do not wash their hands with soap at critical times). Forty-five doers and non-doers were randomly selected from each camp and asked about behavioural determinants. The Barrier Analysis standard tabulation sheet was used for the analysis. RESULTS: No differences were observed between doers and non-doers in relation to self-efficacy, action efficacy, the difficulties and benefits of handwashing, and levels of access to soap and water. In the first of the two camps, non-doers found it harder to remember to wash their hands (P = 0.045), had lower perceived vulnerability to diarrhoea (P = 0.037), lower perceived severity of diarrhoea (P = 0.020) and were aware of 'policies' which supported handwashing with soap (P = 0.037). In the second camp non-doers had lower perceived vulnerability to diarrhoea (P = 0.017). CONCLUSIONS: In these camp settings handwashing behaviour, and the factors that determine it, was relatively homogenous because of the homogeneity of the settings and the socio-demographics of population. Handwashing programmes should seek to improve the convenience and quality of handwashing facilities, create cues to trigger handwashing behaviour and increase perceived risk. We identify several ways to improve the validity of the Barrier Analysis method such as using it in combination with other more holistic qualitative tools and revising the statistical analysis.


Assuntos
Diarreia/prevenção & controle , Desinfecção das Mãos , Campos de Refugiados , Adulto , Feminino , Humanos , Iraque , Masculino , Campos de Refugiados/organização & administração , Campos de Refugiados/estatística & dados numéricos , Sabões/provisão & distribuição , Inquéritos e Questionários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...