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222 result(s)
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222 result(s)
Journal Article > ResearchFull Text

High caseload of Scabies amongst Rohingya refugees in Cox’s Bazar, Bangladesh: a retrospective analysis of the epidemiological and clinical characteristics of cases, July 2022 to November 2023

PLOS Glob Public Health. 9 April 2025; Volume 5 (Issue 4); e0003981.; DOI:10.1371/journal.pgph.0003981
Alhaffar BA, Islam S, Hoq MI, Das A, Shibloo SM,  et al.
PLOS Glob Public Health. 9 April 2025; Volume 5 (Issue 4); e0003981.; DOI:10.1371/journal.pgph.0003981

Scabies is a dermatological parasitic infestation prevalent in many regions worldwide. Classified as a neglected disease by World Health Organization (WHO) since 2017, it is often associated with poor living conditions and overcrowding. Towards the end of 2021, unusual high numbers of scabies cases in outpatient consultations were observed in two Médecins Sans Frontières’ (MSF) Primary Healthcare Centers (PHCs) in Rohingya refugee camps in Cox’s Bazar, Bangladesh. Here, we aimed to describe the epidemiological and clinical characteristics of patients with scabies consulting the clinics from July 2022–November 2023. A cross-sectional study using routinely collected data from scabies’ consultations at two MSF clinics located in camp 14 and 15 (total population 91,241 in 2023) was conducted. We retrospectively analyzed programmatic data of patients of all ages attending outpatient consultations and clinically diagnosed as scabies. Data were extracted from MSF clinical routine monitoring databases and descriptive statistics were reported. During the 16-month period, a total of 178,922 scabies consultations were recorded, amongst whom 57.7% were women and 42.3% men. Children <5 years constituted 20.5% of the cases, age-groups 6-14, 36.6%, and ≥15 years, 42.9%. Camp 15 had the highest number of cases (39.4%), followed by other camps (29.7%), and then camp 14 (24.4%). Most cases were simple scabies (79.5%); one in five were scabies with secondary infection cases. Patients were mainly treated with oral ivermectin (71.2%) and topical permethrin (24.3%); 19.5% of patients also received antibiotics. Our findings indicate that scabies is a significant health concern in the Cox’s Bazar refugee camp. This study recorded over 178000 cases in the above period. The scale of this outbreak warrants further actions, including a prevalence survey, quality implementation of mass drug administration, and multidisciplinary interventions related to camps’ living conditions such as water and sanitation.

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Journal Article > ResearchFull Text

Prevalence of hepatitis C virus seropositivity and active infection in a Rohingya refugee population in Cox's Bazar camps, Bangladesh: a cross-sectional study

Lancet Gastroenterol Hepatol. 1 April 2025; Online ahead of print; DOI:10.1016/S2468-1253(25)00094-9
Schramm B, Ashakin KA, Firuz W, Hadiuzzaman M, Ben-Farhat J,  et al.
Lancet Gastroenterol Hepatol. 1 April 2025; Online ahead of print; DOI:10.1016/S2468-1253(25)00094-9
Journal Article > ResearchFull Text

High confidence and demand for hepatitis E vaccine during an outbreak in Bentiu, South Sudan: A qualitative study

PLOS Glob Public Health. 6 March 2025; Volume 5 (Issue 3); e0003482.; DOI:10.1371/journal.pgph.0003482
Koyuncu A, Asilaza KV, Rumunu J, Wamala J, Gitahi P,  et al.
PLOS Glob Public Health. 6 March 2025; Volume 5 (Issue 3); e0003482.; DOI:10.1371/journal.pgph.0003482

In 2021 in response to an outbreak of hepatitis E in Bentiu internally displaced persons camp the South Sudanese Ministry of Health with support from Médecins Sans Frontières implemented the first-ever mass reactive vaccination campaign with HEV239 (Hecolin; Innovax, Xiamen, China). We conducted qualitative research to assess knowledge, attitudes, and practices related to hepatitis E and the hepatitis E vaccine. We conducted 8 focus group discussions (FGDs) with community leaders, the general population of vaccine-eligible adults, vaccine-eligible pregnant women (vaccinated and non-vaccinated), and healthcare workers. FGDs were separate by gender and were audio recorded, transcribed, and translated to English. Two coders used inductive thematic analysis to organize emergent themes. Data were collected in November 2022. Most participants had experiences with hepatitis E (e.g., infected themselves or knowing someone that had been infected) and viewed hepatitis E as a dangerous disease. Participants believed children, pregnant women, and older persons were the highest risk groups and frequently made requests for additional hepatitis E vaccination campaigns and expanded eligibility criteria for vaccination. Knowledge of the negative impacts of hepatitis E and trusted relationships with the organizations offering the vaccine were key facilitators of vaccine acceptance. The primary barriers to vaccination were practical issues related to being away from the camp during the campaign or not knowing about the campaign, but participants shared that some in the community were unvaccinated due to fears about injections, social pressure, misinformation, and concerns about why some groups were eligible for vaccination and not others (e.g., young children). Personal experiences with hepatitis E illness, perceived severity of illness, and confidence in organizations recommending the vaccine were drivers of high demand for hepatitis E vaccines in the first-ever use of the vaccine in an outbreak setting. Addressing practical issues related to population mobility can improve coverage in future campaigns.

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Journal Article > ResearchFull Text

Protecting the safe water chain in refugee camps: An exploratory study of water handling practices, chlorine decay, and household water safety in South Sudan, Jordan, and Rwanda

Journal of the American Medical Association (JAMA). 3 December 2024; Online ahead of print; DOI:10.4269/ajtmh.24-0221
Ali SI, De Santi M, Monette G, Khan UT, Fesselet JF,  et al.
Journal of the American Medical Association (JAMA). 3 December 2024; Online ahead of print; DOI:10.4269/ajtmh.24-0221

In refugee and internally displaced person settlements, hygienic water handling and free residual chlorine (FRC) are crucial for protecting water against recontamination after distribution up to the household point-of-consumption. We conducted a secondary analysis of water quality and water handling data collected in refugee camps in South Sudan, Jordan, and Rwanda using statistical and process-based modeling to explore how water handling practices affect FRC decay and household FRC outcomes. The two practices that consistently produced a significant effect on FRC decay and household FRC were storing water in direct sunlight and transferring water between containers during household storage. Samples stored in direct sunlight had 0.22–0.31 mg/L lower household FRC and had FRC decay rates between 2 and 3.7 times higher than samples stored in the shade, and samples that were transferred between containers had 0.031–0.51 mg/L lower household FRC and decay rates 1.65–3 times higher than non-transferred samples in sites in which the effect was significant, suggesting that humanitarian responders should aim to provide additional water storage containers to prevent water transferring in households and encourage water-users not to store water in direct sunlight. By contrast, the effect of the three recommended hygienic water handling behaviors (clean, covered containers and drawing by tap or pouring) was mixed or inconclusive. These inconclusive results were likely due to imbalanced or unreliable approaches to gathering the data, and we recommend that hygienic water handling practices that mechanistically provide a physical barrier against recontamination should always be promoted in humanitarian settings.

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Journal Article > CommentaryFull Text

Barriers to care for refugees and migrants with diabetes

Lancet Diabetes Endocrinol. 1 December 2024; Online ahead of print; DOI: 10.1016/S2213-8587(24)00375-9
Jobanputra K, Fabreau G, Ansbro É
Lancet Diabetes Endocrinol. 1 December 2024; Online ahead of print; DOI: 10.1016/S2213-8587(24)00375-9
Journal Article > ReviewFull Text

Humanising and optimising HIV health care for refugees and asylum seekers

Lancet HIV. 1 November 2024; Online ahead of print; DOI:10.1016/S2352-3018(24)00233-9
Cortes CP, Sued O, Wong WCW, Borquez A, Ssonko C,  et al.
Lancet HIV. 1 November 2024; Online ahead of print; DOI:10.1016/S2352-3018(24)00233-9
Journal Article > ResearchFull Text

Evaluation of the safe water optimization tool to provide evidence-based chlorination targets in surface waters: Lessons from a refugee setting in Uganda

Environ Health Perspect. 9 October 2024; Volume 58 (Issue 42); 18531-18540.; DOI:10.1021/acs.est.4c04240
Heylen C, String G, Naliyongo D, Ali SI, Brown J,  et al.
Environ Health Perspect. 9 October 2024; Volume 58 (Issue 42); 18531-18540.; DOI:10.1021/acs.est.4c04240

The Safe Water Optimization Tool (SWOT) generates evidence-based point-of-distribution free residual chlorine (FRC) targets to adjust chlorine dosing by operators and ensure water quality at point-of-consumption. To investigate SWOT effectiveness in surface waters, we conducted two before-and-after mixed-method evaluations in a Uganda refugee settlement served by piped and trucked surface water systems. We surveyed 888 users on water knowledge, attitudes, and practices; collected 2768 water samples to evaluate FRC,Escherichia coli, and disinfection by-products (DBPs) concentrations; and conducted nine key-informant interviews with system operators about SWOT implementation. After baseline data collection, SWOT chlorination targets were generated, increasing point-of-distribution FRC targets from 0.2 to 0.7-0.8 mg/L and from 0.3 to 0.9 mg/L for piped and trucked systems, respectively. At endline, household point-of-consumption FRC ≥ 0.2 mg/L increased from 23 to 35% and from 8 to 42% in the two systems. With these increases, we did not observe increased chlorinated water rejection or DBPs concentrations exceeding international guidelines. Informants reported that SWOT implementation increased knowledge and capacity and improved operations. Overall, SWOT-generated chlorination targets increased chlorine dosage, which improved household water quality in surface waters although less than previously documented with groundwater sources. Additional operator support on prechlorination water treatment processes is needed to ensure maximally effective SWOT implementation for surface water sources.

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Journal Article > LetterFull Text

Mass containment sites for people seeking asylum must be abandoned

BMJ. 12 September 2024; Volume 386; q2002.; DOI:10.1136/bmj.q2002
Burnett A, Katona C, McCann S, Mostafanejad R, Yfantis A
BMJ. 12 September 2024; Volume 386; q2002.; DOI:10.1136/bmj.q2002
Conference Material > Video

A concern for large-scale treatment access: High prevalence of active HCV infection among forcibly displaced Myanmar nationals residing in camps, Cox’s Bazar, Bangladesh

Schramm B
Epicentre Scientific Day 2024. 1 July 2024
English
Français
Conference Material > Video

High mortality and violence among refugees and returnees from West Darfur, Sudan arriving in Chad, 2023: results from three retrospective mortality surveys

Simons E
Epicentre Scientific Day 2024. 1 July 2024
English
Français