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地震后迅速建立国内流离失所者疾病监测系统——海地,2010 年。

Rapid establishment of an internally displaced persons disease surveillance system after an earthquake --- Haiti, 2010.

出版信息

MMWR Morb Mortal Wkly Rep. 2010 Aug 6;59(30):939-45.

Abstract

On January 12, 2010, a 7.0-magnitude earthquake in Haiti disrupted infrastructure and displaced approximately 2 million persons, causing increased risk for communicable diseases from overcrowding and poor living conditions. Hundreds of nongovernmental organizations (NGOs) established health-care clinics in camps of internally displaced persons (IDPs). To monitor conditions of outbreak potential identified at NGO camp clinics, on February 18, the Haiti Ministry of Public Health and Population (MSPP), the Pan-American Health Organization (PAHO), and CDC implemented the IDP Surveillance System (IDPSS). The Inter-Agency Standing Committee (IASC) "cluster approach" was used to coordinate the Haiti humanitarian response. One of 11 clusters, the Global Health Cluster (GHC), builds global capacity, whereas the country-level cluster (in this case, the Haitian Health Cluster [HHC], led by PAHO) responds locally. During the Haiti response, HHC engaged NGOs serving large camps, established IDPSS, followed trends of reportable conditions, undertook epidemiologic and laboratory investigations, and fostered implementation of control measures. This report describes the design and implementation of IDPSS in the post-earthquake period. The primary challenges to implementing IDPSS were communication difficulties with an ever-changing group of NGO partners and limitations to the utility of IDPSS data because of lack of reliable camp population denominator estimates. The IDPSS experience reinforces the need to improve local communication and coordination strategies. Improving future humanitarian response requires advance development and distribution of easily adaptable standard surveillance tools, development of an interdisciplinary strategy for an early and reliable population census, and development of communication strategies using locally available Internet and cellular networks.

摘要

2010 年 1 月 12 日,海地发生 7.0 级地震,基础设施遭到破坏,约 200 万人流离失所,过度拥挤和恶劣的生活条件使传染病传播的风险增加。数以百计的非政府组织(NGO)在国内流离失所者(IDP)营地建立了医疗诊所。为了监测 NGO 营地诊所发现的潜在疫情暴发情况,2010 年 2 月 18 日,海地公共卫生和人口部(MSPP)、泛美卫生组织(PAHO)和美国疾病控制与预防中心(CDC)实施了 IDP 监测系统(IDPSS)。机构间常设委员会(IASC)采用“群组方法”协调海地人道主义应对工作。11 个群组之一的全球卫生群组(GHC)负责建立全球能力,而国家一级的群组(在这种情况下,是由 PAHO 领导的海地卫生群组(HHC))负责在当地做出反应。在海地应对地震灾害期间,HHC 与服务于大型营地的 NGO 合作,建立 IDPSS,跟踪可报告疾病的趋势,开展流行病学和实验室调查,并促进实施控制措施。本报告介绍了地震后时期 IDPSS 的设计和实施情况。实施 IDPSS 的主要挑战是与不断变化的 NGO 合作伙伴进行沟通困难,以及由于缺乏可靠的营地人口底数估计,IDPSS 数据的实用性受到限制。IDPSS 的经验强化了改进地方沟通和协调战略的必要性。改进未来的人道主义应对工作需要提前开发和分发易于适应的标准监测工具,制定一个用于早期和可靠人口普查的跨学科战略,并制定利用当地可用互联网和移动网络的沟通战略。

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