Journal Article > ResearchFull Text
Am J Trop Med Hyg. 2004 April 1; Volume 70 (Issue 4); 390-394.
Hutin Y, Legros D, Owini V, Brown V, Lee EC, et al.
Am J Trop Med Hyg. 2004 April 1; Volume 70 (Issue 4); 390-394.
We estimated the pre-intervention prevalence of Trypanosoma brucei gambiense (Tbg) trypanosomiasis using the lot quality assurance sampling (LQAS) methods in 14 parishes of Terego County in northern Uganda. A total of 826 participants were included in the survey sample in 1996. The prevalence of laboratory confirmed Tbg trypanosomiasis adjusted for parish population sizes was 2.2% (95% confidence interval =1.1-3.2). This estimate was consistent with the 1.1% period prevalence calculated on the basis of cases identified through passive and active screening in 1996-1999. Ranking of parishes in four categories according to LQAS analysis of the 1996 survey predicted the prevalences observed during the first round of active screening in the population in 1997-1998 (P < 0.0001, by chi-square test). Overall prevalence and ranking of parishes obtained with LQAS were validated by the results of the population screening, suggesting that these survey methods may be useful in the pre-intervention phase of sleeping sickness control programs.
Journal Article > LetterFull Text
Lancet. 2004 April 24; Volume 363 (Issue 9418); 1402.; DOI:10.1016/S0140-6736(04)16070-4
Nathan N, Tatay M, Piola P, Lake S, Brown V
Lancet. 2004 April 24; Volume 363 (Issue 9418); 1402.; DOI:10.1016/S0140-6736(04)16070-4
Journal Article > ResearchFull Text
PLOS One. 2014 August 11; Volume 9 (Issue 8); DOI:10.1371/journal.pone.0101017
Ronat JB, Kakol J, Khoury M, Yun O, Brown V, et al.
PLOS One. 2014 August 11; Volume 9 (Issue 8); DOI:10.1371/journal.pone.0101017
In low- and middle-income countries, bloodstream infections are an important cause of mortality in patients with burns. Increasingly implicated in burn-associated infections are highly drug-resistant pathogens with limited treatment options. We describe the epidemiology of bloodstream infections in patients with burns in a humanitarian surgery project in Iraq.
Journal Article > ResearchFull Text
Disasters. 2006 September 1; Volume 30 (Issue 3); 364-376.; DOI:10.1111/j.0361-3666.2005.00326.x
Grais RF, Coulombier D, Ampuero J, Lucas MES, Barretto AT, et al.
Disasters. 2006 September 1; Volume 30 (Issue 3); 364-376.; DOI:10.1111/j.0361-3666.2005.00326.x
Emergencies resulting in large-scale displacement often lead to populations resettling in areas where basic health services and sanitation are unavailable. To plan relief-related activities quickly, rapid population size estimates are needed. The currently recommended Quadrat method estimates total population by extrapolating the average population size living in square blocks of known area to the total site surface. An alternative approach, the T-Square, provides a population estimate based on analysis of the spatial distribution of housing units taken throughout a site. We field tested both methods and validated the results against a census in Esturro Bairro, Beira, Mozambique. Compared to the census (population: 9,479), the T-Square yielded a better population estimate (9,523) than the Quadrat method (7,681; 95% confidence interval: 6,160-9,201), but was more difficult for field survey teams to implement. Although applicable only to similar sites, several general conclusions can be drawn for emergency planning.
Journal Article > LetterSubscription Only
JAMA. 2002 September 11; Volume 288 (Issue 10); 1233-1234.; DOI:10.1001/jama.288.10.1233-a
Piola P, Tachon JL, Brown V, Ligozat L, Veyrier E, et al.
JAMA. 2002 September 11; Volume 288 (Issue 10); 1233-1234.; DOI:10.1001/jama.288.10.1233-a
To the Editor: In November 2001 the possibility of widespread malnutrition was reported in Ghor province, Afghanistan, particularly in the Chaghcharan district, which had received no external assistance for 3 months. We performed a rapid health assessment in Chaghcharan town in December 2001 to assess general mortality and acute malnutrition among children younger than 5 years.
Journal Article > ResearchFull Text
Ann Trop Paediatr. 2008 March 1; Volume 28 (Issue 1); DOI:10.1179/146532808X270635
Dubray C, Ibrahim SA, Abdelmutalib M, Guerin PJ, Dantoine F, et al.
Ann Trop Paediatr. 2008 March 1; Volume 28 (Issue 1); DOI:10.1179/146532808X270635
BACKGROUND: Systemic antibiotics are routinely prescribed for severe acute malnutrition (SAM). However, there is no consensus regarding the most suitable regimen. In a therapeutic feeding centre in Khartoum, Sudan, a randomised, unblinded, superiority-controlled trial was conducted, comparing once daily intramuscular injection with ceftriaxone for 2 days with oral amoxicillin twice daily for 5 days in children aged 6-59 months with SAM. METHODS: Commencing with the first measured weight gain (WG) following admission, the risk difference and 95% confidence interval (95% CI) for children with a WG > or = 10 g/kg/day were calculated over a 14-day period. The recovery rate and case fatality ratio (CFR) between the two groups were also calculated. RESULTS: In an intention-to-treat analysis of 458 children, 53.5% (123/230) in the amoxicillin group and 55.7% (127/228, difference 2.2%, 95% CI -6.9-11.3) in the ceftriaxone group had a WG > or = 10 g/kg/day during a 14-day period. Recovery rate was 70% (161/230) in the amoxicillin group and 74.6% (170/228) in the ceftriaxone group (p=0.27). CFR was 3.9% (9/230) and 3.1% (7/228), respectively (p=0.67). Most deaths occurred within the 1st 2 weeks of admission. CONCLUSION: In the absence of severe complications, either ceftriaxone or amoxicillin is appropriate for malnourished children. However, in ambulatory programmes, especially where there are large numbers of admissions, ceftriaxone should facilitate the work of medical personnel.
Journal Article > ResearchFull Text
Emerg Infect Dis. 2007 January 1
Guthmann JP, Bonnet MMB, Ahoua L, Dantoine F, Balkan S, et al.
Emerg Infect Dis. 2007 January 1
Death rates exceeded emergency thresholds at 4 sites during epidemics of Plasmodium falciparum malaria in Burundi (2000-2001) and in Ethiopia (2003-2004). Deaths likely from malaria ranged from 1,000 to 8,900, depending on site, and accounted for 52% to 78% of total deaths. Earlier detection of malaria and better case management are needed.
Journal Article > ResearchFull Text
Ann Trop Med Parasitol. 1988 October 1; Volume 82 (Issue 5); 499-502.; DOI:10.1080/00034983.1988.11812282
Brown V, Larouze B, Desve G, Rousset JJ, Thibon M, et al.
Ann Trop Med Parasitol. 1988 October 1; Volume 82 (Issue 5); 499-502.; DOI:10.1080/00034983.1988.11812282
Louse-borne relapsing fever (LBRF) is still endemic among Ethiopian populations. In order to assess the clinical presentation of LBRF in an Ethiopian refugee camp in northern Somalia, a referral system was organized for all pyrexias of unknown origin. Among the 134 patients referred, 37 showed Borrelia in fresh and stained blood smears. Common clinical features were: high fever (above 39 degrees C in 73% of the cases), headache and general body pain (88%), liver tenderness (62%), petechia (54%), nausea and vomiting (46%), chills and rigors (30%) and epistaxis (11%). Jaundice was absent. No fatalities were observed. The clinical picture was less severe than in previous studies on LBRF. This difference might be due to the fact that the present study was community-based as opposed to the previous studies which were hospital-based.
Journal Article > ResearchFull Text
Bull Soc Pathol Exot. 2002 December 1; Volume 95 (Issue 5); 351-354.
Brown V, Jacquier G, Bachy C, Bitar D, Legros D
Bull Soc Pathol Exot. 2002 December 1; Volume 95 (Issue 5); 351-354.
Cholera epidemics in refugee camps represent a major public health emergency. In camps, precarious living conditions contribute to the transmission of the vibrio. Among the major epidemics reported in camps, we note as well those which have affected Africa in the last two decades. These epidemics are characterized by high attack rates and high case fatality ratios. Attack rates in refugee camps can exceed 5%. Appropriate control measures are adopted at international level. Actions carried out urgently must allow the proper supply of water, the control of excreta, and the improvement of general sanitary conditions and individual hygiene. Efficient management of cases in specialized cholera treatment centres (CTC) should decrease the case fatality ratio to less than 1%. Treatment is mainly based on the prompt rehydration of patients. For wide camps, rapid access to oral rehydration units is essential. Availability of all necessary equipment in kit form is required.
Journal Article > ResearchFull Text
JAMA. 2005 March 23; Volume 293 (Issue 12); 1490-1494.; DOI:10.1001/jama.293.12.1490
Grandesso F, Sanderson F, Kruijt J, Koene T, Brown V
JAMA. 2005 March 23; Volume 293 (Issue 12); 1490-1494.; DOI:10.1001/jama.293.12.1490
CONTEXT
Mass violence against civilians in the west of Sudan has resulted in the displacement of more than 1.5 million people (25% of the population of the Darfur region). Most of these people are camped in 142 settlements. There has been increasing international concern about the health status of the displaced population.
OBJECTIVE
To perform rapid epidemiological assessments of mortality and nutritional status at 3 sites in South Darfur for relief efforts.
DESIGN, SETTING, AND PARTICIPANTS
In August and September 2004, mortality surveys were conducted among 137,000 internally displaced persons (IDPs) in 3 sites in South Darfur (Kass [n = 900 households], Kalma [n = 893 households], and Muhajiria [n = 900 households]). A nutritional survey was performed concomitantly among children aged 6 to 59 months using weight for height as an index of acute malnutrition (Kass [n = 894], Kalma [n = 888], and Muhajiria [n = 896]). A questionnaire detailing access to food and basic services was administered to a subset of households (n = 210 in each site). MAIN
OUTCOME MEASURES
Crude and under 5-year mortality rates and nutritional status of IDPs in Kass, Kalma, and Muhajiria, South Darfur. RESULTS: Crude mortality rates, expressed as deaths per 10,000 per day, were 3.2 (95% confidence interval [CI], 2.2-4.1) in Kass, 2.0 (95% CI, 1.3-2.7) in Kalma, and 2.3 (95% CI, 1.2-3.4) in Muhajiria. Under 5-year mortality rates were 5.9 (95% CI, 3.8-8.0) in Kass, 3.5 (95% CI, 1.5-5.7) in Kalma, and 1.0 (95% CI, 0.03-1.9) in Muhajiria. During the period of displacement covered by our survey in Muhajiria, violence was reported to be responsible for 72% of deaths, mainly among young men. Diarrheal disease was reported to cause between 25% and 47% of deaths in camp residents and mainly affected the youngest and oldest age groups. Acute malnutrition was common, affecting 14.1% of the target population in Kass, 23.6% in Kalma, and 10.7% in Muhajiria.
CONCLUSION
This study provides epidemiological evidence of the high rates of mortality and malnutrition among the displaced population in South Darfur and reinforces the need to mount appropriate and timely humanitarian responses.
Mass violence against civilians in the west of Sudan has resulted in the displacement of more than 1.5 million people (25% of the population of the Darfur region). Most of these people are camped in 142 settlements. There has been increasing international concern about the health status of the displaced population.
OBJECTIVE
To perform rapid epidemiological assessments of mortality and nutritional status at 3 sites in South Darfur for relief efforts.
DESIGN, SETTING, AND PARTICIPANTS
In August and September 2004, mortality surveys were conducted among 137,000 internally displaced persons (IDPs) in 3 sites in South Darfur (Kass [n = 900 households], Kalma [n = 893 households], and Muhajiria [n = 900 households]). A nutritional survey was performed concomitantly among children aged 6 to 59 months using weight for height as an index of acute malnutrition (Kass [n = 894], Kalma [n = 888], and Muhajiria [n = 896]). A questionnaire detailing access to food and basic services was administered to a subset of households (n = 210 in each site). MAIN
OUTCOME MEASURES
Crude and under 5-year mortality rates and nutritional status of IDPs in Kass, Kalma, and Muhajiria, South Darfur. RESULTS: Crude mortality rates, expressed as deaths per 10,000 per day, were 3.2 (95% confidence interval [CI], 2.2-4.1) in Kass, 2.0 (95% CI, 1.3-2.7) in Kalma, and 2.3 (95% CI, 1.2-3.4) in Muhajiria. Under 5-year mortality rates were 5.9 (95% CI, 3.8-8.0) in Kass, 3.5 (95% CI, 1.5-5.7) in Kalma, and 1.0 (95% CI, 0.03-1.9) in Muhajiria. During the period of displacement covered by our survey in Muhajiria, violence was reported to be responsible for 72% of deaths, mainly among young men. Diarrheal disease was reported to cause between 25% and 47% of deaths in camp residents and mainly affected the youngest and oldest age groups. Acute malnutrition was common, affecting 14.1% of the target population in Kass, 23.6% in Kalma, and 10.7% in Muhajiria.
CONCLUSION
This study provides epidemiological evidence of the high rates of mortality and malnutrition among the displaced population in South Darfur and reinforces the need to mount appropriate and timely humanitarian responses.