Gesesew Hailay, Kebede Hafte, Berhe Kenfe, Fauk Nelsensius, Ward Paul
College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia.
Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, SA, Australia.
Confl Health. 2023 May 30;17(1):26. doi: 10.1186/s13031-023-00524-x.
The war in Tigray, North Ethiopia which started in November 2020, has destroyed decades of the region's healthcare success. There is some emerging published evidence on attacks on health care in the region, and we synthesized the available evidence on 'perilous medicine' in Tigray to understand the data source, subjects and content covered, and what gaps exist.
We employed a systematic review and performed a systematic search of MEDLINE, PubMed, CINHAL, Web of Science and Scopus. We included English written documents published from 4 November 2020 to 18-19 October 2022 and updated the search on 23 January 2023. HG and NF independently performed title, abstract and full-text screening. We used Joanna Briggs Institute (JBI) tools to appraise and extract data, and applied content synthesis to analyze. The PROSPERO registration number is CRD42022364964.
Our systematic review search yielded 8,039 documents, and we finally found 41 documents on conflict and health in Tigray. The areas were: (1) attacks on infrastructure, health or aid workers, patients, ambulances or aid trucks identified in 29 documents-the documents reported targeted attacks on health infrastructure and personnel; (2) interruption of health or social services in 31 documents-the documents reported medical and humanitarian siege; (3) outcomes and direct or indirect impacts in 33 documents-the documents reported increased magnitude of illnesses, and catastrophic humanitarian crises including the use of food, medicine and rape as tools of war; and (4) responses, rebuilding strategies, and recommendations in 21 documents-the documents reported improvisation of services, and calling to seize fire, accountability and allow humanitarian.
Despite promising studies on conflict and health in Tigray, the documents lack quality of designs and data sources, and depth and diversity of subjects and contents covered; calling further primary studies on a prioritized future research agenda.
始于2020年11月的埃塞俄比亚北部提格雷战争破坏了该地区数十年来在医疗保健方面所取得的成就。关于该地区医疗保健受到攻击的一些证据已逐渐公开，我们综合了提格雷地区“危险医疗”的现有证据，以了解其数据来源、涵盖的主题和内容，以及存在哪些差距。
我们进行了一项系统综述，并对MEDLINE、PubMed、CINHAL、科学网和Scopus进行了系统检索。我们纳入了2020年11月4日至2022年10月18 - 19日期间发表的英文文献，并于2023年1月23日更新了检索。HG和NF独立进行标题、摘要和全文筛选。我们使用乔安娜·布里格斯研究所（JBI）的工具来评估和提取数据，并应用内容综合分析法进行分析。国际前瞻性系统评价注册编号为CRD42022364964。
我们的系统综述检索得到8039篇文献，最终找到41篇关于提格雷冲突与健康的文献。涉及的领域包括：（1）29篇文献中提到的对基础设施、医护人员、患者、救护车或救援卡车的攻击——这些文献报道了对医疗基础设施和人员的针对性攻击；（2）31篇文献中提到的卫生或社会服务中断——这些文献报道了医疗和人道主义围困；（3）33篇文献中提到的结果及直接或间接影响——这些文献报道了疾病程度的增加，以及包括将食物、药品和强奸用作战争工具在内的灾难性人道主义危机；（4）21篇文献中提到的应对措施、重建策略和建议——这些文献报道了服务的临时安排，并呼吁停火、问责和允许人道主义援助。
尽管有关于提格雷冲突与健康的有前景的研究，但这些文献缺乏设计质量和数据来源，以及所涵盖主题和内容的深度与多样性；需要在未来优先研究议程上进一步开展初步研究。
