Moss William J, Ramakrishnan Meenakshi, Storms Dory, Henderson Siegle Anne, Weiss William M, Lejnev Ivan, Muhe Lulu
Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Bull World Health Organ. 2006 Jan;84(1):58-64. doi: 10.2471/blt.04.019570. Epub 2006 Feb 23.
Coordinated and effective interventions are critical for relief efforts to be successful in addressing the health needs of children in situations of armed conflict, population displacement, and/or food insecurity. We reviewed published literature and surveyed international relief organizations engaged in child health activities in complex emergencies. Our aim was to identify research needs and improve guidelines for the care of children. Much of the literature details the burden of disease and the causes of morbidity and mortality; few interventional studies have been published. Surveys of international relief organizations showed that most use World Health Organization (WHO), United Nations Children's Fund (UNICEF), and ministry of health guidelines designed for use in stable situations. Organizations were least likely to have formal guidelines on the management of asphyxia, prematurity, and infection in neonates; diagnosis and management of children with human immunodeficiency virus (HIV) infection; active case-finding and treatment of tuberculosis; paediatric trauma; and the diagnosis and management of mental-health problems in children. Guidelines often are not adapted to the different types of health-care workers who provide care in complex emergencies. Evidence-based, locally adapted guidelines for the care of children in complex emergencies should be adopted by ministries of health, supported by WHO and UNICEF, and disseminated to international relief organizations to ensure appropriate, effective, and uniform care.
协调且有效的干预措施对于救援行动成功满足武装冲突、人口流离失所和/或粮食不安全状况下儿童的健康需求至关重要。我们查阅了已发表的文献，并对参与复杂紧急情况下儿童健康活动的国际救援组织进行了调查。我们的目的是确定研究需求并改进儿童护理指南。大部分文献详细阐述了疾病负担以及发病和死亡原因；已发表的干预性研究很少。对国际救援组织的调查表明，大多数组织采用世界卫生组织（WHO）、联合国儿童基金会（UNICEF）以及卫生部制定的适用于稳定状况的指南。各组织最不可能拥有关于新生儿窒息、早产和感染管理；人类免疫缺陷病毒（HIV）感染儿童的诊断和管理；结核病的主动病例发现和治疗；儿科创伤；以及儿童心理健康问题的诊断和管理的正式指南。指南往往未针对在复杂紧急情况下提供护理的不同类型医护人员进行调整。卫生部应采用基于证据的、因地制宜的复杂紧急情况下儿童护理指南，在世卫组织和联合国儿童基金会的支持下，向国际救援组织传播，以确保提供适当、有效和统一的护理。
