Health Management and Policy Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
J Glob Health. 2021 Oct 9;11:17001. doi: 10.7189/jogh.11.17001. eCollection 2021.
Refugees are susceptible to various types of injury mechanisms associated with their dire living conditions and settlements. This study aims to compare and characterize the emergency department admissions due to physical trauma and injuries among local residents and refugees in greater Beirut.
This epidemiological study analyzes injury incidence and characteristics of patients presenting to Emergency Departments of 5 sentinel hospitals between 2017 and 2019. Using the WHO Injury Surveillance Guidelines and Pan-Asia Trauma Outcomes Study form, an injury data surveillance form was designed and used in hospital settings to collect data on injuries. Chi-square test analysis was performed to compare differences in injury characteristics between local residents and refugees. Regression models were constructed to assess the effect of being a refugee on the characteristics of injuries and outcomes of interest.
A total of 4847 injuries (3933 local residents and 914 refugees) were reported. 87.4% of the total injuries among refugees were sustained by the younger age groups 0-45 years compared to 68.8% among local residents. The most prevalent injury mechanism was fall (39.4%) for locals and road traffic injury (31.5%) for refugees. The most injured body part was extremities for both populations (78.2% and 80.1%). Injuries mostly occurred at home or its vicinity (garden or inside the camp) for both populations (29.3% and 23.1%). Refugees sustained a higher proportion of injuries at work (6%) compared to locals (1.3%). On multivariate analysis, refugee status was associated with higher odds of having an injury due to a stab/gunshot (odds ratio (OR) = 3.392, 95% confidence interval (CI) = 2.605-4.416), having a concussion injury (OR = 1.718, 95% CI = 1.151-2.565), and being injured at work (OR = 4.147, 95% CI = 2.74-6.278). Refugee status was associated with increased odds of leaving the hospital with injury-related disability (OR = 2.271, 95% CI = 1.891-2.728)].
Injury remains a major public health problem among resident and refugee communities in Beirut, Lebanon. Refugees face several injury-related vulnerabilities, which adversely affect their treatment outcomes and long-term disabilities. The high prevalence of occupational and violence-related injuries among refugees necessitates the introduction of targeted occupational safety and financial security interventions, aiming at reducing injuries while enhancing social justice among residents.
难民易遭受各种与恶劣生活条件和定居点相关的损伤机制。本研究旨在比较和描述贝鲁特地区当地居民和难民因躯体创伤而到急诊就诊的情况。
本项基于人群的研究分析了 2017 年至 2019 年间 5 家哨点医院急诊收治的创伤患者的发生率和损伤特征。使用世卫组织伤害监测指南和泛亚创伤结局研究表格，设计了一份伤害数据监测表格，并在医院环境中用于收集伤害数据。采用卡方检验分析比较当地居民和难民的损伤特征差异。构建回归模型评估难民身份对感兴趣的损伤特征和结局的影响。
共报告了 4847 例损伤（3933 例当地居民和 914 例难民）。与当地居民的 68.8%相比，难民中 87.4%的总损伤发生在 0-45 岁的年轻人群中。最常见的损伤机制是坠落（39.4%），当地居民中最常见的损伤机制是道路交通损伤（31.5%）。最易受伤的身体部位是四肢（当地居民为 78.2%，难民为 80.1%）。损伤大多发生在当地居民的家中或附近（花园或营地内）（29.3%）和难民（23.1%）。与当地居民（1.3%）相比，难民因工作受伤的比例更高（6%）。多变量分析显示，难民身份与因刺伤/枪击（比值比（OR）=3.392，95%置信区间（CI）=2.605-4.416）、脑震荡（OR=1.718，95%CI=1.151-2.565）和工作中受伤（OR=4.147，95%CI=2.74-6.278）的可能性更高有关。难民身份与受伤后相关残疾（OR=2.271，95%CI=1.891-2.728）的出院风险更高有关。
在黎巴嫩贝鲁特，损伤仍然是当地居民和难民社区的一个主要公共卫生问题。难民面临着若干与损伤相关的脆弱性，这对他们的治疗结果和长期残疾产生了不利影响。难民中职业和暴力相关损伤的高发生率需要引入有针对性的职业安全和财务安全干预措施，目的是减少损伤，同时增强居民的社会公平。
