Journal Article > ResearchFull Text
Confl Health. 11 July 2019 (Issue 1)
Vernier L, Cramond V, Hoetjes M, Lenglet AD, Hoare T
Confl Health. 11 July 2019 (Issue 1)
BACKGROUND:
War in Syria has lasted for more than eight years, causing population displacement, collapse of medical and public health services, extensive violence and countless deaths. Since November 2016, military operations in Northeast Syria intensified. In October 2017 a large influx of internally displaced persons (IDPs) arrived to Ein Issa camp, Raqqa governate. Médecins Sans Frontières (MSF) assessed the health status of recently arrived IDPs in Ein Issa camp.
METHODS:
MSF carried out a cross-sectional survey using simple random sampling between 8 and 18 November 2017, enrolling households who had arrived to Ein Issa camp since 1 October 2017. A questionnaire collected data on demographics, history of displacement, retrospective one-year mortality, two-week morbidities, non-communicable diseases, exposure to violence in the last year and two-week psychological distress symptoms among all household members as well as vaccination status in children aged 6 to 59 months. The latter were also screened for malnutrition. Prevalence estimates and mortality rates were calculated with their 95% confidence interval. Mortality rates were calculated as the number of deaths/10,000 persons/day using the individual person-day contribution of all household members.
RESULTS:
MSF surveyed 257 households (1482 participants). They reported 31 deaths in the previous year, resulting in a crude mortality rate of 0.56 deaths/10,000 persons/day (95%CI: 0.39-0.80). Conflict-related violence was the most frequently reported cause of death (64.5%). In the previous year, 31.7% (95%CI: 29.4-34.2) of the participants experienced at least one violent episode. The most frequent type of violence reported was witnessing atrocities (floggings, executions or public body displays); 18.9% (95%CI: 17.0-21.0) of the population and 9.8% (95%CI: 7.9-12.0) of the children under 15 years had witnessed such atrocities. In men over 14 years, 15.8% (95%CI: 11.9-20.8) were detained/kidnapped and 11.3% (95%CI: 8.0-15.8) tortured/beaten/attacked. In the two weeks prior to interview, 14.4% (95%CI: 10.6-19.3) of the respondents felt so hopeless that they did not want to carry on living most of the time.
CONCLUSIONS:
High levels of mortality, exposure to violence and psychological distress were reported. These survey results increase understanding of the impact of the conflict on the IDP population in Northeast Syria.
War in Syria has lasted for more than eight years, causing population displacement, collapse of medical and public health services, extensive violence and countless deaths. Since November 2016, military operations in Northeast Syria intensified. In October 2017 a large influx of internally displaced persons (IDPs) arrived to Ein Issa camp, Raqqa governate. Médecins Sans Frontières (MSF) assessed the health status of recently arrived IDPs in Ein Issa camp.
METHODS:
MSF carried out a cross-sectional survey using simple random sampling between 8 and 18 November 2017, enrolling households who had arrived to Ein Issa camp since 1 October 2017. A questionnaire collected data on demographics, history of displacement, retrospective one-year mortality, two-week morbidities, non-communicable diseases, exposure to violence in the last year and two-week psychological distress symptoms among all household members as well as vaccination status in children aged 6 to 59 months. The latter were also screened for malnutrition. Prevalence estimates and mortality rates were calculated with their 95% confidence interval. Mortality rates were calculated as the number of deaths/10,000 persons/day using the individual person-day contribution of all household members.
RESULTS:
MSF surveyed 257 households (1482 participants). They reported 31 deaths in the previous year, resulting in a crude mortality rate of 0.56 deaths/10,000 persons/day (95%CI: 0.39-0.80). Conflict-related violence was the most frequently reported cause of death (64.5%). In the previous year, 31.7% (95%CI: 29.4-34.2) of the participants experienced at least one violent episode. The most frequent type of violence reported was witnessing atrocities (floggings, executions or public body displays); 18.9% (95%CI: 17.0-21.0) of the population and 9.8% (95%CI: 7.9-12.0) of the children under 15 years had witnessed such atrocities. In men over 14 years, 15.8% (95%CI: 11.9-20.8) were detained/kidnapped and 11.3% (95%CI: 8.0-15.8) tortured/beaten/attacked. In the two weeks prior to interview, 14.4% (95%CI: 10.6-19.3) of the respondents felt so hopeless that they did not want to carry on living most of the time.
CONCLUSIONS:
High levels of mortality, exposure to violence and psychological distress were reported. These survey results increase understanding of the impact of the conflict on the IDP population in Northeast Syria.
Journal Article > CommentaryAbstract
N Z Med J. 3 March 2017
Cramond V, Reid M
N Z Med J. 3 March 2017
Journal Article > ResearchFull Text
Confl Health. 20 June 2019; Volume 13; 28.; DOI:10.1186/s13031-019-0214-0
OKeeffe J, Vernier L, Cramond V, Majeed S, Carrion Martin AI, et al.
Confl Health. 20 June 2019; Volume 13; 28.; DOI:10.1186/s13031-019-0214-0
BACKGROUND:
In June 2017, the U.S.-backed Syrian Democratic Forces (SDF) launched a military operation to retake the city of Raqqa, Syria, from the so-called Islamic State. The city population incurred mass numbers of wounded. In the post-offensive period, the population returned to a city (Raqqa) contaminated with improvised explosive devices (IEDs) and explosive remnants of war (ERWs), resulting in a second wave of wounded patients. Médecins Sans Frontières (MSF) supported a hospital in Tal-Abyad (north of Raqqa) and scaled up operations in response to this crisis. We describe the cohort of blast-wounded cases admitted to this hospital in order help prepare future humanitarian responses.
METHODS:
We retrospectively extracted data from clinical charts in the MSF-supported hospital. We included all new admissions for blast-wounded patients with key data elements documented. We performed comparative analyses from the offensive period (June 6, 2017 to October 17, 2017) and the post-offensive period (October 18, 2017 to March 17, 2018).
RESULTS:
We included 322 blast related injuries. There were more than twice the number of cases with blast injuries in the post-offensive period as the offensive period (225 vs. 97, p = <.001). The offensive period saw a significantly higher proportion of female patients (32.0%, n = 31 vs. 11.1%, n = 25, p < 0.001) and paediatric patients (42.3%, n = 41 vs 24.9%, n = 56, p = 0.002). Blast-injured patients in the post-offensive period included more cases with multiple traumatic injuries (65.8%, n = 148 vs. 39.2%, n = 38, p < 0.001). The treatment of the blast-injured cases in the post-offensive period was more labor intensive with those patients having a higher median number of interventions (2 vs 1, p = <0.001) and higher median number of days in hospital (7 vs 4, p = < 0.001).
CONCLUSIONS:
In the wake of the Raqqa offensive, the MSF-supported district hospital received an unpredicted second, larger and more complex wave of blast-wounded cases as the population returned to a city strewn with IEDs and ERWs. These findings indicate the high risk of traumatic injury to the population even after warring factions have vacated conflict zones. Medical humanitarian actors should be prepared for a continued and scaled up response in areas known to be highly contaminated with explosive ordnance.
In June 2017, the U.S.-backed Syrian Democratic Forces (SDF) launched a military operation to retake the city of Raqqa, Syria, from the so-called Islamic State. The city population incurred mass numbers of wounded. In the post-offensive period, the population returned to a city (Raqqa) contaminated with improvised explosive devices (IEDs) and explosive remnants of war (ERWs), resulting in a second wave of wounded patients. Médecins Sans Frontières (MSF) supported a hospital in Tal-Abyad (north of Raqqa) and scaled up operations in response to this crisis. We describe the cohort of blast-wounded cases admitted to this hospital in order help prepare future humanitarian responses.
METHODS:
We retrospectively extracted data from clinical charts in the MSF-supported hospital. We included all new admissions for blast-wounded patients with key data elements documented. We performed comparative analyses from the offensive period (June 6, 2017 to October 17, 2017) and the post-offensive period (October 18, 2017 to March 17, 2018).
RESULTS:
We included 322 blast related injuries. There were more than twice the number of cases with blast injuries in the post-offensive period as the offensive period (225 vs. 97, p = <.001). The offensive period saw a significantly higher proportion of female patients (32.0%, n = 31 vs. 11.1%, n = 25, p < 0.001) and paediatric patients (42.3%, n = 41 vs 24.9%, n = 56, p = 0.002). Blast-injured patients in the post-offensive period included more cases with multiple traumatic injuries (65.8%, n = 148 vs. 39.2%, n = 38, p < 0.001). The treatment of the blast-injured cases in the post-offensive period was more labor intensive with those patients having a higher median number of interventions (2 vs 1, p = <0.001) and higher median number of days in hospital (7 vs 4, p = < 0.001).
CONCLUSIONS:
In the wake of the Raqqa offensive, the MSF-supported district hospital received an unpredicted second, larger and more complex wave of blast-wounded cases as the population returned to a city strewn with IEDs and ERWs. These findings indicate the high risk of traumatic injury to the population even after warring factions have vacated conflict zones. Medical humanitarian actors should be prepared for a continued and scaled up response in areas known to be highly contaminated with explosive ordnance.
Protocol > Research Protocol
Siddiqui MR, Cramond V, Goldberg J, Guzek J
1 July 2018
2. OBJECTIVES
2.1. PRIMARY OBJECTIVES
To estimate the scale of the emergency through measurement of crude mortality rate for the total population and for children under five years of age
2.2. SECONDARY OBJECTIVES
To estimate the size of the population in Palorinya settlement camp
To describe the population in terms of age, sex and household composition;
To determine the coverage of measles, polio, MenAfriVac, DPT-Hib-HepB (Pentavalent) and pneumococcal virus (PCV) vaccination in 6-59 month olds;
To determine the rate of severe and global acute malnutrition in 6-59 month olds;
To identify the most prevalent morbidities in the population in the two weeks preceding the survey;
To describe the health seeking behaviour in terms of access to primary and secondary care;
To estimate crude mortality rate for the total population and for children under five years of age before and after the SPLA advance into Equatoria, South Sudan;
To identify major causes of death, by age group and sex;
To gain knowledge of violence-related events
To determine the coverage of Long-Lasting Insecticide Treated bedNets (LLITNs)
2.1. PRIMARY OBJECTIVES
To estimate the scale of the emergency through measurement of crude mortality rate for the total population and for children under five years of age
2.2. SECONDARY OBJECTIVES
To estimate the size of the population in Palorinya settlement camp
To describe the population in terms of age, sex and household composition;
To determine the coverage of measles, polio, MenAfriVac, DPT-Hib-HepB (Pentavalent) and pneumococcal virus (PCV) vaccination in 6-59 month olds;
To determine the rate of severe and global acute malnutrition in 6-59 month olds;
To identify the most prevalent morbidities in the population in the two weeks preceding the survey;
To describe the health seeking behaviour in terms of access to primary and secondary care;
To estimate crude mortality rate for the total population and for children under five years of age before and after the SPLA advance into Equatoria, South Sudan;
To identify major causes of death, by age group and sex;
To gain knowledge of violence-related events
To determine the coverage of Long-Lasting Insecticide Treated bedNets (LLITNs)
Journal Article > ResearchFull Text
PLoS Curr. 2 February 2018; Volume 10; ecurrents.dis.bb5f22928e631dff9a80377309381feb.; DOI:10.1371/currents.dis.bb5f22928e631dff9a80377309381
Pereira AL, Southgate R, Ahmed H, Oconner P, Cramond V, et al.
PLoS Curr. 2 February 2018; Volume 10; ecurrents.dis.bb5f22928e631dff9a80377309381feb.; DOI:10.1371/currents.dis.bb5f22928e631dff9a80377309381
In 2015, following an influx of population into Kobanê in northern Syria, Médecins Sans Frontières (MSF) in collaboration with the Kobanê Health Administration (KHA) initiated primary healthcare activities. A vaccination coverage survey and vaccine-preventable disease (VPD) risk analysis were undertaken to clarify the VPD risk and vaccination needs. This was followed by a measles Supplementary Immunization Activity (SIA). We describe the methods and results used for this prioritisation activity around vaccination in Kobanê in 2015.
Protocol > Research Protocol
Hitchman E, Slewa-Younan S, Cramond V, White K, Carrion-Martin I, et al.
1 July 2018
Protocol > Research Protocol
Lenglet AD, Monge S, Ndumbi P, Nyarwangu J, Hamdan M, et al.
1 July 2018
Protocol > Research Protocol
Siddiqui MR, Cramond V, Barre I, Johnson DC
1 July 2018
OBJECTIVES
2.1. PRIMARY OBJECTIVES
To estimate the scale of the emergency through measurement of crude mortality rate for the total population and for children under five years of age
2.2. SECONDARY OBJECTIVES
To estimate the size of the population in Rhino (Ofua) settlement camp
To describe the population in terms of age, sex and household composition;
To determine the coverage of measles, polio, MenAfriVac, DPT-Hib-HepB (Pentavalent) and pneumococcal virus (PCV) vaccination in 6-59 month olds;
To determine the rate of severe and global acute malnutrition in 6-59 month olds;
To identify the most prevalent morbidities in the population in the two weeks preceding the survey;
To describe the health seeking behaviour in terms of access to primary and secondary care;
To estimate crude mortality rate for the total population and for children under five years of age before and after the SPLA advance into Equatoria, South Sudan;
To identify major causes of death, by age group and sex;
To gain knowledge of violence-related events
To determine the coverage of Long-Lasting Insecticide Treated bedNets (LLITNs)
2.1. PRIMARY OBJECTIVES
To estimate the scale of the emergency through measurement of crude mortality rate for the total population and for children under five years of age
2.2. SECONDARY OBJECTIVES
To estimate the size of the population in Rhino (Ofua) settlement camp
To describe the population in terms of age, sex and household composition;
To determine the coverage of measles, polio, MenAfriVac, DPT-Hib-HepB (Pentavalent) and pneumococcal virus (PCV) vaccination in 6-59 month olds;
To determine the rate of severe and global acute malnutrition in 6-59 month olds;
To identify the most prevalent morbidities in the population in the two weeks preceding the survey;
To describe the health seeking behaviour in terms of access to primary and secondary care;
To estimate crude mortality rate for the total population and for children under five years of age before and after the SPLA advance into Equatoria, South Sudan;
To identify major causes of death, by age group and sex;
To gain knowledge of violence-related events
To determine the coverage of Long-Lasting Insecticide Treated bedNets (LLITNs)