Connolly Máire A, Gayer Michelle, Ryan Michael J, Salama Peter, Spiegel Paul, Heymann David L
World Health Organization, Geneva, Switzerland.
Lancet. 2004;364(9449):1974-83. doi: 10.1016/S0140-6736(04)17481-3.
Communicable diseases, alone or in combination with malnutrition, account for most deaths in complex emergencies. Factors promoting disease transmission interact synergistically leading to high incidence rates of diarrhoea, respiratory infection, malaria, and measles. This excess morbidity and mortality is avoidable as effective interventions are available. Adequate shelter, water, food, and sanitation linked to effective case management, immunisation, health education, and disease surveillance are crucial. However, delivery mechanisms are often compromised by loss of health staff, damage to infrastructure, insecurity, and poor co-ordination. Although progress has been made in the control of specific communicable diseases in camp settings, complex emergencies affecting large geographical areas or entire countries pose a greater challenge. Available interventions need to be implemented more systematically in complex emergencies with higher levels of coordination between governments, UN agencies, and non-governmental organisations. In addition, further research is needed to adapt and simplify interventions, and to explore novel diagnostics, vaccines, and therapies.
在复杂紧急情况下，传染病单独或与营养不良共同导致了大多数死亡。促进疾病传播的因素相互协同作用，导致腹泻、呼吸道感染、疟疾和麻疹的高发病率。由于有有效的干预措施，这种过高的发病率和死亡率是可以避免的。与有效的病例管理、免疫接种、健康教育和疾病监测相关的充足住所、水、食物和卫生设施至关重要。然而，卫生人员流失、基础设施受损、不安全和协调不力常常损害了提供机制。尽管在营地环境中控制特定传染病方面已取得进展，但影响大片地理区域或整个国家的复杂紧急情况带来了更大挑战。在复杂紧急情况下，需要更系统地实施现有干预措施，加强政府、联合国机构和非政府组织之间的协调。此外，还需要进一步开展研究，以调整和简化干预措施，并探索新的诊断方法、疫苗和疗法。
