Epidemiology Program, University of Delaware, Suite 614 Tower at STAR 100 Discovery Boulevard Newark, Newark, DE, 19713, USA.
Department of Geography and Spatial Sciences, University of Delaware, 225 Pearson Hall 125 Academy Street Newark, Newark, DE, 19716, USA.
BMC Public Health. 2023 Sep 4;23(1):1715. doi: 10.1186/s12889-023-16472-3.
Despite the importance of baseline health data for evidence-informed decision-making, these data are rarely available for displaced populations. At the height of the European refugee crisis, most of those seeking asylum in Europe were from regions with high prevalences of communicable and non-communicable diseases. To create an epidemiologic profile for refugees in camps on mainland Greece, this study assessed the prevalence of 11 communicable and non-communicable diseases among refugees utilizing Médecins du Monde (MdM) in-camp clinics.
The proportional morbidity of selected diseases among individuals utilizing MdM services were determined from data collected at refugee camp clinics on mainland Greece from April 2016 - July 2017. Overall and age-specific proportional morbidities were reported. Differences in disease burden among refugees from the largest sending countries - Afghanistan and Syria - were compared using proportional morbidity ratios and 95% confidence intervals. Patterns in results were compared with disease burden estimates in sending countries and with findings from comparable settings.
Respiratory tract infections (RTIs) were the most prevalent outcome. Among RTIs, upper RTIs were most common, with a proportional morbidity of nearly 40%; throughout the study period, over 46% of children under 18 years had at least one upper RTI consultation. Musculoskeletal conditions (3.64%), were the most prevalent non-communicable outcome, followed by hypertension (2.21%) and asthma (1.28%). Afghans were 31.68% more likely than Syrians to have a consultation for at least one condition (PR: 1.32; 95% CI: 1.25, 1.39). The proportional morbidity of RTIs was comparable to sending countries, but there was a comparatively lower burden of other conditions among refugees than literature estimates from sending countries.
Refugees utilizing MdM clinics in camps had higher burdens of communicable diseases - predominantly RTIs - relative to non-communicable diseases. Non-communicable disease burdens were comparatively lower than reported prevalences from in-country populations. These findings can be attributed to a range of considerations including differences in demographic profiles between sending countries and refugee populations and missed opportunities for utilizing clinical care. Further investment is needed to capture the health profiles of displaced populations to support evidence-informed decision-making processes in humanitarian emergency responses.
尽管基线健康数据对于循证决策至关重要，但这些数据对于流离失所人群很少可用。在欧洲难民危机最严重的时候，大多数在欧洲寻求庇护的人来自传染病和非传染性疾病流行率高的地区。为了为在希腊大陆难民营中的难民创建流行病学概况，本研究利用无国界医生组织（MdM）营地诊所评估了难民中 11 种传染病和非传染性疾病的患病率。
从 2016 年 4 月至 2017 年 7 月在希腊大陆难民营诊所收集的数据中确定了利用 MdM 服务的个体中选定疾病的比例发病率。报告了总体和年龄特异性比例发病率。利用比例发病率比和 95％置信区间比较了最大来源国（阿富汗和叙利亚）的难民之间的疾病负担差异。将结果与来源国的疾病负担估计值和类似环境中的发现进行了比较。
呼吸道感染（RTIs）是最常见的结果。在 RTIs 中，上呼吸道感染最为常见，比例发病率接近 40％；在整个研究期间，超过 46％的 18 岁以下儿童至少有一次上呼吸道感染就诊。肌肉骨骼疾病（3.64％）是最常见的非传染性疾病，其次是高血压（2.21％）和哮喘（1.28％）。与叙利亚人相比，阿富汗人至少有一种疾病就诊的可能性高 31.68％（PR：1.32；95％CI：1.25，1.39）。RTIs 的比例发病率与来源国相当，但难民中非传染性疾病的负担与来源国的文献估计相比要低。
利用 MdM 营地诊所的难民与非传染性疾病相比，传染病的负担更高-主要是呼吸道感染。非传染性疾病的负担与来自国内人群的报告发病率相比要低。这些发现归因于一系列考虑因素，包括来源国和难民人口的人口统计特征差异以及利用临床护理的机会错失。需要进一步投资来捕捉流离失所人口的健康概况，以支持人道主义应急响应中的循证决策过程。
