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Early detection of cholera epidemics to support control in fragile states: estimation of delays and potential epidemic sizes.

BACKGROUND: Cholera epidemics continue to challenge disease control, particularly in fragile and conflict-affected states. Rapid detection and response to small cholera clusters is key for efficient control before an epidemic propagates. To understand the capacity for early response in fragile states, we investigated delays in outbreak detection, investigation, response, and laboratory confirmation, and we estimated epidemic sizes. We assessed predictors of delays, and annual changes in response time. METHODS: We compiled a list of cholera outbreaks in fragile and conflict-affected states fro

Public health response to large influx of asylum seekers: implementation and timing of infectious disease screening.

BACKGROUND: Infectious disease screening of migrants at increased risk is a feature of national infection prevention and control measures. Asylum seekers in Finland are offered screening of tuberculosis (TB), hepatitis B, human immunodeficiency virus infection (HIV) and syphilis based on individual risk assessment. We aimed to evaluate the public health response to a large influx of asylum seekers to Finland in 2015-2016 with respect to national guidelines on initial health services and infectious disease screening. METHODS: We used immigration and healthcare procurement data for all 38,134 a

Trauma memories, mental health, and resilience: a prospective study of Afghan youth.

BACKGROUND: Studies of war-affected youth have not yet examined how trauma memories relate to prospective changes in mental health and to subjective or social experiences. METHODS: We interviewed a gender-balanced, randomly selected sample of Afghan child-caregiver dyads (n = 331, two waves, 1 year apart). We assessed lifetime trauma with a Traumatic Event Checklist, past-year events with a checklist of risk and protective events, and several child mental health outcomes including posttraumatic distress (Child Revised Impact of Events Scale, CRIES) and depression. We examined the consistency

Living in exile when disaster strikes at home.

As the number of migrants,- forced or voluntary,- increases, there is a growing need to understand how negative events in the country of origin influence those residing abroad. This issue has been actualized by the recent earthquakes in Haiti and Chile. Persons in exile have frequently been exposed to severe human rights violations and other stressors prior to emigration. The present study explored possible associations between ongoing and former stressors and mental health problems among persons living in exile as the Tsunami disaster of 2004 struck their country of origin. The contribution o

Use of state cancer surveillance data to estimate the cancer burden in disaster-affected areas--Hurricane Katrina, 2005.

PURPOSE: The objective of this study was to estimate the burden of cancer in counties affected by Hurricane Katrina using population-based cancer registry data, and to discuss issues related to cancer patients who have been displaced by disasters. METHODS: The cancer burden was assessed in 75 counties in Louisiana, Alabama, and Mississippi that were designated by the Federal Emergency Management Agency as eligible for individual and public assistance. Data from the National Program of Cancer Registries were used to determine three-year average annual age-adjusted incidence rates and case coun

Health status of returnees to Kosovo: do living conditions during asylum make a difference?

OBJECTIVE: From August 1999 to July 2001, asylum seekers who had come to Switzerland from Kosovo were repatriated. The present study aimed to assess the relationship between living conditions during asylum in Switzerland and health status among returnees. STUDY DESIGN: Cross-sectional survey of 319 ethnic Albanian families in Kosovo, selected from a list of 12900 heads of households who had received repatriation aid. METHODS: Consenting household members aged 16 years or more who had received asylum in Switzerland were interviewed during the autumn of 2001. Questions explored living conditio

Health profile and disease determinants among asylum seekers: a cross-sectional retrospective study from an Italian reception centre.

BACKGROUND: Data on diseases' determinants and health status of asylum seekers (ASs) are limited. METHODS: We performed a cross-sectional retrospective study in a large ASs centre in Italy. Data were collected during a 1-year period. Descriptive statistics were calculated. A χ(2) test was used to assess the association between socio-demographics characteristics of ASs and screening test results. A multiple logistic regression analysis was performed to identify diseases' predictors by using ICD-10 diagnoses classification as outcome variable, socio-demographic characteristics as independent va

The mental health of internally displaced persons: an epidemiological study of adults in two settlements in Central Sudan.

AIMS: There is a scarcity of data on mental health problems among Sudanese internally displaced persons (IDPs). This study aims to assess the prevalence of mental disorders of IDPs in Sudan, and to determine and compare the association between mental disorders and socio-demographic variables between the rural and urban long-term IDP populations. METHODS: This cross-sectional study was implemented in two IDP areas in Central Sudan. Data were collected during face-to-face interviews using structured questionnaires to assess socio-demographic factors and the Mini International Neuropsychiatric I

A pilot study of abuse among Vietnamese Amerasians.

This report describes a pilot study of the prevalence of physical and sexual abuse, and current levels of psychological distress correlated with a history of abuse, in a group of Vietnamese Amerasians bound for the United States. A sample of Vietnamese Amerasians, part of a larger cohort originally selected in Vietnam, was assessed in the Philippines. Subjects completed a self-administered questionnaire regarding a history of physical and/or sexual abuse and three other self-administered questionnaires: the Hopkins Symptom Checklist-25, the Vietnamese Depression Scale, and the Youth Self Repor

An assessment of vulnerability to HIV infection of boatmen in Teknaf, Bangladesh.

BACKGROUND: Mobile population groups are at high risk for contracting HIV infection. Many factors contribute to this risk including high pre … oup. Interventions need to address issues on both sides of the border, other vulnerable groups, and refugees. Strong political will and cross border collaboration is mandatory for such interventions.

Utilizing Gamification, Artificial Intelligence, and mHealth for the Professional Development of Maternal Care Providers: Exploratory Pilot Cross-Sectional Study Assessing Providers' Satisfaction in Primary Health Care Centers in Lebanon.

BACKGROUND: High maternal morbidity and mortality rates globally, especially in low-income and lower-middle-income countries, highlight the critical role of skilled health care providers (HCPs) in preventing pregnancy-related complications among disadvantaged populations. Lebanon, hosting over 1.5 million refugees, is no exception. HCPs face significant challenges, including resource constraints and limited professional development opportunities, underscoring the need for continuous learning and innovative educational interventions. Artificial intelligence (AI) and gamification show promise in…

[Infectious disease outbreaks in centralized homes for asylum seekers in Germany from 2004-2014].

BACKGROUND: Migration and imported infections are changing the distribution of infectious diseases in Europe. However little is known about the extent of transmission of imported diseases within Europe. Asylum seekers are of increasing importance for infectious disease epidemiology and can be particularly vulnerable for infections and disease progression due to stressful conditions of migration and incomplete vaccination status. OBJECTIVES: The aim is to analyse transmission of infectious diseases in centralized homes for asylum seekers in national infectious disease surveillance data to iden

Adverse health consequences of the Iraq War.

The adverse health consequences of the Iraq War (2003-11) were profound. We conclude that at least 116,903 Iraqi non-combatants and more than 4800 coalition military personnel died over the 8-year course. Many Iraqi civilians were injured or became ill because of damage to the health-supporting infrastructure of the country, and about 5 million were displaced. More than 31,000 US military personnel were injured and a substantial percentage of those deployed suffered post-traumatic stress disorder, traumatic brain injury, and other neuropsychological disorders and their concomitant psychosocial

Mortality among displaced former UNITA members and their families in Angola: a retrospective cluster survey.

OBJECTIVE: To measure retrospectively mortality among a previously inaccessible population of former UNITA members and their families displaced within Angola, before and after their arrival in resettlement camps after ceasefire of 4 April 2002. DESIGN: Three stage cluster sampling for interviews. Recall period for mortality assessment was from 21 June 2001 to 15-31 August 2002. SETTING: Eleven resettlement camps over four provinces of Angola (Bié, Cuando Cubango, Huila, and Malange) housing 149 000 former UNITA members and their families. PARTICIPANTS: 900 consenting family heads of househo

One-year follow-up study of posttraumatic stress disorder among survivors of Cambodian concentration camps.

One year after receiving a diagnosis of posttraumatic stress disorder, five of 12 Cambodian concentration camp survivors who entered a treatment program no longer met the diagnostic criteria for the disorder, and symptoms in three others had improved. The intrusive symptoms of nightmares, sleep disorders, and startle reactions showed the most consistent improvement. Avoidance behavior, shame, and caring for others improved the least. The authors advocate use of tricyclic antidepressant medication and a consistent, supportive long-term psychotherapeutic commitment in treating this severely trau

A Case of Leprosy in Italy: A Multifaceted Disease Which Continues to Challenge Medical Doctors.

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, characterized by a very long incubation period, confounding signs and symptoms and difficulty to establish the onset time. Considering the stigma associated with the diagnosis and the difficulties in detecting asymptomatic leprosy, the incidence and prevalence of this disease are underestimated. In Italy, leprosy is currently included among the rare diseases and can occur as an imported pathology in native individuals or extra-EU immigrants. Currently, given its exceptional appearance in Italy, leprosy is extremely difficu

Bridging the gap - Establishing a dental-oncology service in a cancer centre.

Dental disease remains the most common non-communicable disease worldwide. It predisposes patients to significant morbidities following bone modifying agents or radiation therapy to the head and neck. Preventative dental regimes effectively reduce the risk of both medication-related osteonecrosis of the jaw (MRONJ) and osteoradionecrosis (ORN) in these patients. Co-ordination of routine dental care as a component of mainstream oncology treatment optimises long term outcomes for oncology patients. This case series offers insights into patient, institutional and social difficulties that challeng

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… Based on Data from the United Nations High Commissioner for Refugees (UNHCR), 110 million people had been forcibly displaced, and 36.4 million people were refugees in mid-2023 [ 69 ]. … Language barriers significantly impact the quality of care in refugees. …

Immunogenicity of a killed bivalent whole cell oral cholera vaccine in forcibly displaced Myanmar nationals in Cox's Bazar, Bangladesh.

After the large influx of Rohingya nationals (termed Forcibly Displaced Myanmar National; FDMN) from Rakhine State of Myanmar to Cox's Bazar in Bangladesh, it was apparent that outbreaks of cholera was very likely in this setting where people were living under adverse water and sanitation conditions. Large campaigns of oral cholera vaccine (OCV) were carried out as a preemptive measure to control cholera epidemics. The aim of the study was to evaluate the immune responses of healthy adults and children after administration of two doses of OCV at 14 days interval in FDMN population and compare