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The burden of acute respiratory infections in crisis-affected populations: a systematic review

Bellos, Anna, Mulholland, E. Kim, O`Brien, Katherine L., Qazi, Shamim A., Gayer, Michelle and Checchi, Francesco (2010). The burden of acute respiratory infections in crisis-affected populations: a systematic review. Conflict and Health,4(1):3-14.

Document type: Journal Article
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IRMA ID 81704288xPUB328
Title The burden of acute respiratory infections in crisis-affected populations: a systematic review
Author Bellos, Anna
Mulholland, E. Kim
O`Brien, Katherine L.
Qazi, Shamim A.
Gayer, Michelle
Checchi, Francesco
Journal Name Conflict and Health
Publication Date 2010
Volume Number 4
Issue Number 1
ISSN 1752-1505   (check CDU catalogue open catalogue search in new window)
Start Page 3
End Page 14
Total Pages 12
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Crises due to armed conflict, forced displacement and natural disasters result in excess morbidity and mortality due to infectious diseases. Historically, acute respiratory infections (ARIs) have received relatively little attention in the humanitarian sector. We performed a systematic review to generate evidence on the burden of ARI in crises, and inform prioritisation of relief interventions. We identified 36 studies published since 1980 reporting data on the burden (incidence, prevalence, proportional morbidity or mortality, case-fatality, attributable mortality rate) of ARI, as defined by the International Classification of Diseases, version 10 and as diagnosed by a clinician, in populations who at the time of the study were affected by natural disasters, armed conflict, forced displacement, and nutri- tional emergencies. We described studies and stratified data by age group, but did not do pooled analyses due to heterogeneity in case definitions. The published evidence, mainly from refugee camps and surveillance or patient record review studies, suggests very high excess morbidity and mortality (20-35% proportional mortality) and case-fatality (up to 30-35%) due to ARI. However, ARI disease burden comparisons with non-crisis  settings are difficult because of non-comparability of data. Better epidemiological studies with clearer case definitions are needed to provide the evidence base for priority setting and programme impact assessments. Humanitarian agencies should include ARI prevention and control among infants, children and adults as priority activities in crises. Improved data collection, case management and vaccine strategies will help to reduce disease burden.
Keywords acute respiratory infections (ARIs)
crisis-affected populations
infectious diseases
natural disasters
armed conflict
DOI http://dx.doi.org/10.1186/1752-1505-4-3   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)


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