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1.
BMC Public Health ; 21(1): 296, 2021 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-33546652

RESUMO

BACKGROUND: Effective COVID-19 pandemic management requires adequate understanding of factors that influence behavioral changes. This study aims to assess knowledge, attitudes and practices towards COVID-19 among Syrians in a post-conflict context. METHOD: A cross sectional web-based survey was conducted on the Syrian residents of 16 years and above. It contains questions on knowledge, attitudes and practices (KAP) with respect to COVID-19. Participants' demographic characteristics are recorded and analyzed. The study is conducted during the global outbreak of COVID-19. RESULTS: A total of 706 participants (female, 444; male, 262) were enrolled. This study included 405 participants aged between 16 and 29, 204 aged between 30 and 49, and 97 aged above 60 years. There were 642 who have a university degree and 61 who have high school degree. Among the participants 253 were students, 316 were employed, 75 work as freelancers, and 62 were unemployed. Results showed that overall knowledge score towards the disease was about 60% (mean score 3.54 ± 1.20; range 0-6). Knowledge scores significantly differed across age groups (P < 0.05), education levels (P = 0.001), and occupations (P < 0.05). Attitude and practice scores were 2.45 ± 0.81 (range 0-4), 5.90 ± 1.52 (range 0-8), respectively. Attitude scores were significantly different between males and females (P < 0.05), whereas practice scores varied significantly across gender (P < 0.05), age groups (P = 0.01), education levels (P = 0.015), occupations (P < 0.05), and according to knowledge score (P = 0.000). Results from multiple linear regression indicated that lower knowledge scores were significantly associated with lower education level (P < 0.05), whereas poor preventive practices were common among male, young and unemployed participants with significance levels of P < 0.01, P = .000, P < 0.01, respectively. CONCLUSION: The findings of this study suggest that the Syrian residents demonstrate modest knowledge, attitudes and practices towards COVID-19 at the time of its global outbreak. Efforts should be directed towards raising the awareness of the disease to improve their practices in the current COVID-19 pandemic, as well as for future epidemics.


Assuntos
/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Pandemias , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Inquéritos e Questionários , Síria/epidemiologia , Adulto Jovem
3.
Community Dent Health ; 38(1): 53-58, 2021 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-33507649

RESUMO

OBJECTIVES: Lack of data regarding the oral health of Syrian refugees represents a crucial gap in the literature. This study aimed to investigate the oral health status of Syrian refugees and related socio and behavioral factors. BASIC RESEARCH DESIGN: Cross-sectional study from June to September 2019 at Zaatari refugee camp, Jordan. METHODS: An experienced, calibrated field investigator performed an oral clinical examination of 505 Syrian refugees (18-60 years) using the WHO criteria. DMFT, SiC, oral health indices and socio-demographic variables were recorded. RESULTS: A total of 264 males and 241 females were included. The prevalence of caries was 96.0%, of which 76.0% had 4-17 carious lesions. The mean number of decayed, missing and filled teeth was 5.76, 2.55 and 1.88 respectively. The mean DMFT score was 10.19 (100% had DMFT⟩0), SiC was 17.09, and the mean simplified Oral hygiene index score was 2.18. The most common chief complaint was pain (92.7%). Nearly half of the participants were smokers (45.7%). There was a negative association between level of education and oral health (P=0.011). Most participants did not brush their teeth regularly (87.5%). Females had better oral hygiene practices than males (P=0.015). CONCLUSIONS: Syrian refugees had a high prevalence of caries, high unmet dental treatment needs and poor oral hygiene practices. Preventive programs and focused interventions may reduce the burden of disease in this underprivileged population, on funding agencies and host countries as well.


Assuntos
Cárie Dentária , Refugiados , Adulto , Estudos Transversais , Cárie Dentária/epidemiologia , Feminino , Humanos , Jordânia/epidemiologia , Masculino , Saúde Bucal , Síria/epidemiologia
5.
J Public Health (Oxf) ; 42(3): 642-643, 2020 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-32490518

RESUMO

BACKGROUND: During the outbreak of coronavirus COVID-19, social media platforms have shown effectiveness in information dissemination. Delivering evidence-based medical knowledge and trustworthy recommendations is a difficult mission for classical entities, especially in a war-torn country with a fragile health system. In this context, the role of non-governmental scientific organizations was proven, filling the gap between original scientific sources and a non-English speaking population. METHODS: We reviewed an example of an organization named Syrian Researchers, which publishes based-on-reliable-sources of scientific content and has massive reachability across Middle East and beyond. RESULTS: We strongly believe that this model is a simple and suitable approach that may be helpful for other low-income or war-torn countries in the context of health-related disasters. CONCLUSIONS: This subject is of high importance and we believe that this approach may ameliorate public health knowledge, thus, participate in defying the COVID-19 consequences.


Assuntos
Infecções por Coronavirus/prevenção & controle , Países em Desenvolvimento/estatística & dados numéricos , Surtos de Doenças/prevenção & controle , Disseminação de Informação/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Mídias Sociais , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia , Síria/epidemiologia
6.
Lancet Oncol ; 21(5): 637-644, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32359488

RESUMO

BACKGROUND: Cancer represents a substantial health burden for refugees and host countries. However, no reliable data on the costs of cancer care for refugees are available, which limits the planning of official development assistance in humanitarian settings. We aimed to model the direct costs of cancer care among Syrian refugee populations residing in Jordan, Lebanon, and Turkey. METHODS: In this population-based modelling study, direct cost per capita and per incident case for cancer care were estimated using generalised linear models, informed by a representative dataset of cancer costs drawn from 27 EU countries. A range of regression specifications were tested, in which cancer costs were modelled using different independent variables: gross domestic product (GDP) per capita, crude or age-standardised incidence, crude or age-standardised mortality, and total host country population size. Models were compared using the Akaike information criterion. Total cancer care costs for Syrian refugees in Jordan, Lebanon, and Turkey were calculated by multiplying the estimated direct cancer care costs (per capita) by the total number of Syrian refugees, or by multiplying the estimated direct cancer costs (per incident case [crude or age-standardised]) by the number of incident cancer cases in Syrian refugee populations. All costs are expressed in 2017 euros (€). FINDINGS: Total cancer care costs for all 4·74 million Syrian refugees in Jordan, Lebanon, and Turkey in 2017 were estimated to be €140·23 million using the cost per capita approach, €79·02 million using the age-standardised incidence approach, and €33·68 million using the crude incidence approach. Under the lowest estimation, and with GDP and total country population as model predictors, the financial burden of cancer care was highest for Turkey (€25·18 million), followed by Lebanon (€6·40 million), and then Jordan (€2·09 million). INTERPRETATION: Cancer among the Syrian refugee population represents a substantial financial burden for host countries and humanitarian agencies, such as the UN Refugee Agency. New ways to provide financial assistance need to be found and must be coupled with clear, prioritised pathways and models of care for refugees with cancer. FUNDING: UK Research and Innovation Global Challenges Research Fund: Research for Health in Conflict-Middle East and North Africa region (R4HC-MENA).


Assuntos
Efeitos Psicossociais da Doença , Neoplasias/economia , Aceitação pelo Paciente de Cuidados de Saúde , Refugiados , África do Norte/epidemiologia , Humanos , Jordânia/epidemiologia , Líbano/epidemiologia , Neoplasias/epidemiologia , Neoplasias/terapia , Síria/epidemiologia , Turquia/epidemiologia
7.
PLoS One ; 15(5): e0232588, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32379836

RESUMO

Raqqa Governorate has been grappling with dual crisis-related burdens from the civil conflict and ISIS occupation. As part of a response to support households within this area, a three-month, unconditional cash assistance program was implemented by the International Rescue Committee to help households meet their basic needs. A quantitative, pre-posttest with 512 women at baseline (n = 456 at endline) was conducted in northern Raqqa Governorate between March-August 2018 to determine their experiences in this cash assistance program and to understand perceived change over time in food insecurity, perceived household serious needs and daily stressors, and depressive symptoms before and after cash was delivered. Forty women also completed in-depth interviews using a life line history technique at endline. Linear household fixed effects models demonstrated significant reductions in food insecurity (ß = -0.95; 95%CI: -1.19--0.71), no change in perceived serious household needs and daily stressors (ß = 0.12; 95%CI: -0.24-0.48), and increases in depressive symptoms (ß = 0.89; 95%CI: 0.34-1.43) before and after the period of cash distribution. Although no causality can be inferred, short-term emergency cash assistance programming yielded significant improvements in food security, was highly acceptable and viewed favorably, and assisted women and their families to meet their basic needs in this emergency setting. However, before and after this form of cash assistance was implemented, no meaningful changes in the perceived levels of serious needs and stressors amongst households were observed, but potential increases in depressive symptoms for women were reported during this time period. Further work is needed to determine appropriate targeting, length, and dosage of cash, alongside any potential livelihood, psychosocial, or structural complementary programming to yield potential positive mental health benefits of a cash assistance program focused on meeting a population's basic needs while not inadvertently delaying or decreasing reach of life-saving cash assistance programming in emergencies.


Assuntos
Conflitos Armados , Depressão/epidemiologia , Apoio Financeiro , Financiamento Governamental , Assistência Alimentar , Abastecimento de Alimentos , Adolescente , Adulto , Depressão/diagnóstico , Características da Família , Feminino , Programas Governamentais , Humanos , Saúde Mental , Pessoa de Meia-Idade , Estresse Psicológico/epidemiologia , Síria/epidemiologia , Adulto Jovem
8.
Pediatr Cardiol ; 41(5): 877-884, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32377891

RESUMO

BACKGROUND: There are many challenges facing Syrian refugee children with heart disease. In this report, we present the spectrum, management, and outcome of heart disease in Syrian refugee children over six-year period, highlighting challenges in management and availability of funding. METHODS: Data on Syrian refugee children with heart disease diagnosed between 2012 and 2017 were collected. Patients were followed until January 2019. Data reported included age, diagnosis, recommended treatment, types of procedures done, mortality, cost, financial sources for procedures, and outcome. RESULTS: 415 Syrian refugee children were diagnosed with heart disease at our institution. Median age was 1·9 years (0·4-6·05) years. Children were either born in Syria and fled to Jordan with their families (224, 54%), or born in Jordan to refugee parents (191, 46%). Follow-up was established for 335 patients (81%). Of 196 patients needing surgery, 130 (72%) underwent Surgery, and of 97 patients needing interventional catheterization, 95 underwent the procedure. Waiting time was 222(± 272) days for surgery and 67(± 75) days for catheterizations. Overall mortality was 17% (56 patients), of which 28 died while waiting for surgery. Cost of surgical and interventional catheterization procedures was $7820 (± $4790) and $2920 (± $2140), respectively. Funding was obtained mainly from non-government organizations, private donors, and United Nations fund. CONCLUSION: Despite local and international efforts to manage Syrian refugee children with heart disease, there is significant shortage in providing treatment resulting in delays and mortality. More organized efforts are needed to help with this ongoing crisis.


Assuntos
Cardiopatias/epidemiologia , Cardiopatias/terapia , Refugiados , Cateterismo Cardíaco/métodos , Procedimentos Cirúrgicos Cardíacos/métodos , Criança , Pré-Escolar , Feminino , Cardiopatias Congênitas/epidemiologia , Cardiopatias Congênitas/terapia , Cardiopatias/economia , Cardiopatias/mortalidade , Hospitais Universitários , Humanos , Lactente , Jordânia/epidemiologia , Masculino , Síria/epidemiologia , Resultado do Tratamento
9.
J Public Health (Oxf) ; 42(3): 504-509, 2020 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-32436578

RESUMO

Despite lacking capacity and resources, the health system in the northwest Syria is using innovative approaches for the containment of COVID-19. Lessons drawn from previous outbreaks in the region, such as the polio outbreak in 2013 and the annual seasonal influenza, have enabled the Early Warning and Response Network, a surveillance system to develop mechanisms of predicting risk and strengthening surveillance for the new pandemic. Social media tools such as WhatsApp are effectively collecting health information and communicating health messaging about COVID-19. Community engagement has also been scaled up, mobilizing local resources and encouraging thousands of volunteers to join the 'Volunteers against Corona' campaign. Bottom-up local governance technical entities, such as Idleb Health Directorate and the White Helmets, have played key leadership role in the response. These efforts need to be scaled up to prevent the transmission of COVID-19 in a region chronically affected by a complex armed conflict.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Surtos de Doenças/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Serviços Preventivos de Saúde/normas , Saúde Pública/normas , Betacoronavirus , Programas Governamentais , Humanos , Síria/epidemiologia
10.
Int J Infect Dis ; 96: 192-195, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32389845

RESUMO

INTRODUCTION: Two thirds of countries globally are unprepared to respond to a health emergency as per the International Health Regulations (2005), with conflict-affected countries like Syria being particularly vulnerable. Political influences on outbreak preparedness, response and reporting may also adversely affect control of SARS-CoV-2 in Syria. Syria reported its first case on 22 March 2020; however, concerns were raised that this was delayed and that underreporting continues. DISCUSSION: Syria's conflict has displaced more than half of its pre-war population, leaving 6.7 million people internally displaced. The consequent overcrowding - with insufficient water, sanitation and healthcare (including laboratory capacity) - could lead to conditions that are ideal for spread of SARS-CoV-2 in Syria. Political changes have led to the formation of at least three health systems within Syria's borders, each with its own governance, capacity and planning. This fragmentation, with little interaction between them, could lead to poor resource allocation and adversely affect control. As such, COVID-19 could overwhelm the health systems (particularly intensive care capacity), leading to high deaths across the population, particularly for the most vulnerable such as detainees. CONCLUSIONS: Locally implementable interventions that rapidly build WASH and health system capacity are required across Syria to ensure early detection and management of COVID-19 cases.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Assistência à Saúde , Humanos , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Síria/epidemiologia
11.
Sci Rep ; 10(1): 6756, 2020 04 21.
Artigo em Inglês | MEDLINE | ID: mdl-32317670

RESUMO

Acute lymphoblastic leukaemia (ALL) is the most common childhood cancer and has a high survival rate when properly managed. Prognosis is correlated with many factors such as age, gender, white blood cell (WBC) count, CD10, French-American-British (FAB) classification, and many others. Many of these factors are included in this study as they play a major role in establishing the best treatment protocol. This study aims to demonstrate clinical and laboratory features of childhood ALL in Syria. They were treated at Children's University Hospital, the only working major cancer centre in Syria at the time of the study. Data of 203 patients who aged 0-14 years were obtained for this study. Most patients (48.8%) aged (5-9) years with a male predominance (60.9%). The major features for ALL included lymphadenopathy (82.9%), presenting with systemic symptoms (74.9%), T-ALL subclass (20.2%), L2 FAB classification (36.1%), low educational levels for fathers (53%) and mothers (56.2%), having a high risk (48.4%), and having a duration of symptoms before evaluation for more than 4 weeks (42.6%). Only three (1.5%) patients had normal full blood counts (FBC) and only one (0.5%) patient had an isolated high WBC count at time of presentation. Most patients had either abnormal platelet count (89.3%) or low haemoglobin level (88.8%) when presenting with only (2.0%) having normal levels for both. This suggests that having normal haemoglobin and platelet count can be used for quick screening in crisis time like in Syria for prioritising patients. Many prognostic factors were significantly different from medical literature which emphasises the importance of local studies in the developping countries. This study included a high prevalence of T-all, L2 FAB classification, high-risk and other variables which require further studies to evaluate the aetiology of these features, especially that treatment protocols may have a higher mortality in developing countries when not adjusted to local variables.


Assuntos
Plaquetas/patologia , Hemoglobinas/metabolismo , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiologia , Adolescente , Fatores Etários , Biomarcadores/sangue , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Contagem de Leucócitos , Masculino , Contagem de Plaquetas , Leucemia-Linfoma Linfoblástico de Células Precursoras/sangue , Leucemia-Linfoma Linfoblástico de Células Precursoras/mortalidade , Prognóstico , Fatores de Risco , Análise de Sobrevida , Síria/epidemiologia
12.
BMC Public Health ; 20(1): 433, 2020 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-32245425

RESUMO

BACKGROUND: Child and adolescent injury is one of the leading causes of child death globally with a large proportion occurring in Low- and Middle-Income Countries (LMICs). Similarly, the Eastern Mediterranean Region (EMR) countries borne a heavy burden that largely impact child and adolescent safety and health in the region. We aim to assess child and adolescent injury morbidity and mortality and estimate its burden in the Eastern Mediterranean Region based on findings from the Global Burden of Disease (GBD), Injuries and Risk Factors study 2017. METHODS: Data from the Global Burden of Disease GBD 2017 were used to estimate injury mortality for children aged 0-19, Years of Life Lost (YLLs), Years lived with Disability (YLDs) and Disability Adjusted Life Years (DALYs) by age and sex from 1990 to 2017. RESULTS: In 2017, an estimated 133,117 (95% UI 122,587-143,361) children died in EMR compared to 707,755 (95% UI 674401.6-738,166.6) globally. The highest rate of injury deaths was reported in Syria at 183.7 (95% UI 181.8-185.7) per 100,000 population. The leading cause of injury deaths was self-harm and interpersonal violence followed by transport injury. The primary cause of injury DALYs in EMR in 2017 was self-harm and interpersonal violence with a rate of 1272.95 (95% UI 1228.9 - 1319.2) almost 3-times the global rate. CONCLUSION: Almost 19% of global child injury related deaths occur in the EMR. Concerted efforts should be integrated to inform policies and adopt injury preventive strategies to reduce injury burden and promote child and adolescent health and well-being in EMR countries.


Assuntos
Carga Global da Doença/estatística & dados numéricos , Ferimentos e Lesões/mortalidade , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Região do Mediterrâneo/epidemiologia , Morbidade , Pobreza , Anos de Vida Ajustados por Qualidade de Vida , Fatores de Risco , Comportamento Autodestrutivo/mortalidade , Síria/epidemiologia , Violência/estatística & dados numéricos , Adulto Jovem
13.
Eur Arch Paediatr Dent ; 21(6): 711-717, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32266665

RESUMO

AIM: The objective of this research was to determine the incidence and severity of HSPM and its association with caries in 4-5 year-old children in Latakia, Syria. METHODS: A cross-sectional study was carried out with 600 preschool children. The European Academy of Pediatric Dentistry (EAPD) criteria were used for scoring HSPM. The decayed, missing and filled teeth (dmft) index was used to evaluate caries status. RESULTS: The prevalence of HSPM was 41%. The difference in HSPM prevalence between males and females was not statistically significant (p > 0.05). Children with HSPM are more likely to have dental caries (OR 6.69; CI 4.5_10; p < 0.001). CONCLUSIONS: The prevalence of HSPM was relatively high in Syrian children. HSPM increases the incidence of caries.


Assuntos
Cárie Dentária , Hipoplasia do Esmalte Dentário , Pré-Escolar , Estudos Transversais , Índice CPO , Cárie Dentária/epidemiologia , Feminino , Humanos , Masculino , Dente Molar , Prevalência , Síria/epidemiologia
14.
Jt Dis Relat Surg ; 31(1): 102-8, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32160502

RESUMO

OBJECTIVES: This study aims to analyze the musculoskeletal injury types, injury mechanisms, treatment modalities, complications, and costs of 67 consecutive soldiers wounded in the battlefield in Syria civil war over a period of three months. PATIENTS AND METHODS: This retrospective study was conducted between January 2018 and March 2018 at Kilis State Hospital. The study included 67 male patients (median age 28.5 years; range, 15 to 46 years). Patients' ages, injury mechanisms, fracture types, fracture locations, injury severity scores, mangled extremity severity scores, complications, and treatment costs were evaluated. RESULTS: Twenty-three patients were injured due to handmade explosives, 21 patients due to gunshots, 16 patients due to landmines, five patients due to rockets, and two patients due to grenades. A total of 35.8% of the patients (n=24) had concomitant trauma. The mean hospitalization period was 10.2 days (range, 1-45 days). A total of 88 treatments were performed on these patients. Thirty-six of these treatments were external fixators, 21 were amputations, 12 were open reduction internal fixations, seven were closed reduction internal fixations, five were intramedullary nailings, three were cannulated screws, three were fasciotomies, and one was an arthrodesis. The treatment costs ranged from 1,577 to 296,286 Turkish Liras. Complications were observed in 17 patients and 11 of them developed infections, three of them had compartment syndrome, and three died during the hospitalization period. CONCLUSION: The increase in warfare technology is correlated with the severity of military injuries in the battlefields. These injuries still lead to high traumatic amputation rates, high-risk complications, and high costs.


Assuntos
Extremidades/lesões , Fraturas Ósseas/epidemiologia , Militares , Adolescente , Adulto , Conflitos Armados , Traumatismos por Explosões/epidemiologia , Parafusos Ósseos , Fixadores Externos , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/cirurgia , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Síria/epidemiologia , Ferimentos por Arma de Fogo/epidemiologia , Adulto Jovem
15.
Pharm. pract. (Granada, Internet) ; 18(1): 0-0, ene.-mar. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-195724

RESUMO

BACKGROUND: Syrian refugees residing in Jordan suffer from chronic illnesses, low quality of life (QoL) and anxiety. Pharmacists delivering the medication review service can have a role in improving this growing worldwide problem. OBJECTIVES: To assess the effect of the medication review service on QoL and anxiety scores for Syrian refugees living with chronic medical conditions. METHODS: This randomized single-blinded intervention control study was conducted in Jordan. Syrian refugees were recruited and randomized into intervention and control groups. Two home visits were organized with each participant, at baseline and three months later. The medication review service was delivered to the participants and questionnaires regarding QoL and anxiety were completed by all participants. As a part of the medication review service, drug-related problems (DRPs) were identified by a clinical pharmacist for all patients, but recommendations to resolve these DRPs were delivered to intervention group refugees' physicians only (control group patients did not receive this part of the service till the end of the study); DRPs were corrected and pharmacist-delivered counseling and education were provided as well. At follow-up, DRPs assessment, QoL and anxiety scores were assessed for refugees in the intervention and control groups. RESULTS: Syrian refugees (n=106) were recruited and randomized into intervention (n=53) and control (n=53) groups with no significant difference between both groups at baseline. The number of medications and diagnosed chronic diseases per participant was 5.8 (SD 2.1) and 2.97 (SD 1.16), respectively. At follow-up, a significant decrease in the number of DRPs for refugees in the intervention group was found (from 600 to 182, p < 0.001), but not for the control group (number stayed at 541 DRPs, p = 0.116). Although no significant difference between the groups was found with regards to QoL at follow-up (p = 0.266), a significant difference was found in the anxiety scores between the groups (p < 0.001). CONCLUSION: The medication review service delivered by clinical pharmacists can significantly improve refugees' DRPs and anxiety scores. As for QoL, significant improvements can be seen for all refugee patients, regardless of whether the DRPs identified were resolved or not


No disponible


Assuntos
Humanos , Refugiados/psicologia , Serviços Comunitários de Farmácia/organização & administração , Qualidade de Vida/psicologia , Ansiedade/epidemiologia , Revisão de Uso de Medicamentos/organização & administração , Doença Crônica/tratamento farmacológico , Campos de Refugiados/organização & administração , Questionário de Saúde do Paciente/estatística & dados numéricos , Síria/epidemiologia , Jordânia/epidemiologia , Estudos de Casos e Controles
17.
Int J Infect Dis ; 90: 53-59, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31639519

RESUMO

OBJECTIVES: Syria's protracted conflict has resulted in ideal conditions for the transmission of tuberculosis (TB) and the cultivation of drug-resistant strains. This paper compares TB control in Syria before and after the conflict using available data, examines the barriers posed by protracted conflict and those specific to Syria, and discusses what measures can be taken to address the control of TB in Syria. RESULTS: Forced mass displacement and systematic violations of humanitarian law have resulted in overcrowding and the destruction of key infrastructure, leading to an increased risk of both drug-sensitive and resistant TB, while restricting the ability to diagnose, trace contacts, treat, and follow-up. Pre-conflict, TB in Syria was officially reported at 22 per 100 000 population; the official figure for 2017 of 19 per 100 000 is likely a vast underestimate given the challenges and barriers to case detection. Limited diagnostics also affect the diagnosis of multidrug- and rifampicin-resistant TB, reported as comprising 8.8% of new diagnoses in 2017. CONCLUSIONS: The control of TB in Syria requires a multipronged, tailored, and pragmatic approach to improve timely diagnosis, increase detection, stop transmission, and mitigate the risk of drug resistance. Solutions must also consider vulnerable populations such as imprisoned and besieged communities where the risk of drug resistance is particularly high, and must recognize the limitations of national programming. Strengthening capacity to control TB in Syria with particular attention to these factors will positively impact other parallel conditions; this is key as attention turns to post-conflict reconstruction.


Assuntos
Tuberculose/prevenção & controle , Antituberculosos/uso terapêutico , Conflitos Armados , Humanos , Refugiados/estatística & dados numéricos , Síria/epidemiologia , Tuberculose/diagnóstico , Tuberculose/tratamento farmacológico , Tuberculose/epidemiologia , Populações Vulneráveis/estatística & dados numéricos
18.
Acta Trop ; 202: 105241, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31669529

RESUMO

Brucellosis, known as Malta fever or Mediterranean fever, is one of the most common bacterial zoonotic diseases caused by Brucella spp. which can result in serious health issues. The objective of the present study was to systematically review and summarize the studies regarding the prevalence of Brucella spp. in milk and milk products in the Middle East region. Some international databases (PubMed, Web of Science, Scopus, Science Direct, and Google Scholar) were searched to retrieve relevant reports published between 1 January 2008 and 30th October 2018. After assessing for eligibility, 30 articles containing 9281 samples, were included in the current study. The highest number of publications were found in Iran and Turkey (n = 12 and 7, respectively), while Saudi Arabia, Kuwait, and Syria had the lowest number of publications (n = 1). Besides, the highest and lowest prevalence was observed in Kuwait (62%) and Egypt (15%), respectively. The highest and lowest overall prevalence of Brucella spp. in milk was found in raw cow milk 36% (95%CI: 28-54%) and raw buffalo milk 13% (95%CI: -22-48%), respectively. The overall prevalence in cheese estimated to be 9% (95%CI: -16-35%). The overall prevalence of Brucella spp. in dairy products in the Middle East was estimated to be 29% (95%CI: 23-35%). The results indicate that more risk management plans are needed to reduce the incidence of Brucella spp. in dairy products in the Middle East, especially in cow milk.


Assuntos
Brucella , Brucelose/epidemiologia , Prevalência , Animais , Búfalos , Bovinos , Laticínios/microbiologia , Egito/epidemiologia , Humanos , Incidência , Irã (Geográfico)/epidemiologia , Kuweit/epidemiologia , Arábia Saudita/epidemiologia , Síria/epidemiologia , Turquia/epidemiologia , Zoonoses/epidemiologia
19.
Clin Microbiol Infect ; 26(3): 307-312, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31284037

RESUMO

BACKGROUND: Since 2011, the conflict in Syria has led to over five million refugees. Turkey hosts the highest number of Syrian refugees in the world. By February 2019 over 3.6 million people had fled to Turkey to seek safety. Only 6.1% of Syrian refugees live in temporary shelters. Owing to the disrupted healthcare services, many children coming from the conflict zones are less likely to have received vaccination. In temporary shelters immunization coverage is >95% and the refugee population is receptive to vaccination. AIMS: The objective of this study was to review the infectious diseases situation among Syrian refugees in Turkey. SOURCES: We have reviewed the reports and studies provided by the governmental and non-governmental organizations and obtained more detailed data from the Ministry of Health in Turkey. CONTENT: Between 2012 and 2016, 1 299 209 cases of respiratory tract infection and 158 058 episodes of diarrhoea with 59 bloody diarrhoeas were reported; 1354 hepatitis A cases and 108 active tuberculosis cases were detected and treated in the temporary shelters for Syrian refugees. Overall in Turkey, 7794 cutaneous leishmaniasis have been reported. IMPLICATIONS: Since the influx of Syrian refugees, there has been an increase in cases of leishmaniasis and measles. No significant increase was detected for tuberculosis, other vector-borne infections, and healthcare associated or sexually transmitted infections. The Syrian refugees can be considered as a vulnerable group in Turkey due to their living and working conditions. Based on available data and our detailed analysis, the numbers show a stable situation regarding infectious diseases.


Assuntos
Doenças Transmissíveis/epidemiologia , Refugiados , Controle de Doenças Transmissíveis/estatística & dados numéricos , Doenças Transmissíveis/transmissão , Feminino , Humanos , Programas de Imunização , Masculino , Vigilância em Saúde Pública , Síria/epidemiologia , Turquia/epidemiologia , Cobertura Vacinal , Doenças Preveníveis por Vacina/epidemiologia , Doenças Preveníveis por Vacina/prevenção & controle , Doenças Preveníveis por Vacina/transmissão
20.
PLoS Negl Trop Dis ; 13(12): e0007827, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31830034

RESUMO

BACKGROUND: Cutaneous leishmaniasis (CL) has historically been reported from Syria. Since 2011, the country has been affected by a war, which has impacted health and health services. Over the same period, an increase in the number of cases of CL has been reported from several areas across the country and by a number of authors. This study aims to provide the first quantitative evidence of the epidemiological evolution of CL in Syria during the war. MATERIALS AND METHODS: Data on number of CL cases for the period 2011-2018 were extracted from three different surveillance systems: the Ministry of Health (MoH) routine surveillance system, the MoH/WHO sentinel-syndromic Early Warning Alert and Response System (EWARS), and surveillance data collected by the international nongovernmental organization (NGO) the MENTOR Initiative. Data were cleaned and merged to generate the best possible estimates on number of CL cases; incidence of CL was also calculated based on data on resident population. Data reported from the years preceding the conflict (2007-2010) were also added to the analysis for comparative purposes. RESULTS: The analysis of data from the three available sources over the period considered indicates that number of reported cases progressively grew from prewar levels to reach a peak in 2015, decreased in 2016, remained stable in 2017, and increased again in 2018. Such a trend was mirrored by changes in incidence of infection. Some governorates, which used to report low numbers of CL cases, started recording higher number of cases after the onset of the war. CONCLUSION: The war coincided with a major rise in reported number of CL cases and incidence of infection, although an increasing trend was already appreciable before its onset.


Assuntos
Conflitos Armados , Leishmaniose Cutânea/epidemiologia , Humanos , Incidência , Prevalência , Síria/epidemiologia
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