Acute respiratory infections in crisis-affected populations
Citation: Bellos A, Mulholland K, O’Brien KL, et al. The burden of acute respiratory infections in crisis-affected populations: a systematic review. Conflict and Health 2010; 4: 3
What is this? The pandemic of COVID-19, which can cause acute respiratory infections (ARIs), is predicted to disproportionately affect crisis-affected populations. Risk factors for ARIs in crisis settings include malnutrition, overcrowding, decreased coverage of immunization programs, psychological stress, preterm birth, exposure to toxic airborne particles, and lack of, or delay in diagnosis and treatment.
In this systematic review, the authors searched for quantitative studies of the burden of ARIs in populations who at the time of the study were affected by disasters caused by natural hazards, armed conflict, forced displacement and nutritional emergencies. They restricted their search to articles published between 1980 and 2009 in English, French, Spanish, Portuguese, Italian and German and did the search in June 2009. They included 36 studies, which reported on populations affected by armed conflict (25 studies), an acute emergency period (1) and a post-emergency phase (7); and there were 3 studies on internally displaced people (IDPs).
What was found: Morbidity and mortality of ARIs increase considerably in crisis settings, such as in refugee camps and settlements.
Focused community surveillance systems to detect ARIs during crisis situations are recommended, rather than relying only on data collected from health facilities.
Improving food security and stable living conditions are recommended to help reduce vulnerability to ARIs.
Boosting immunization against other diseases, particularly Pneumococcal, Hib, measles and pertussis vaccination strategies, even in older children, are recommended to reduce the burden.
What’s uncertain: In crisis-settings, it is difficult to establish Incidence of ARIs and cause-attributable deaths.
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