The burden of acute respiratory infections in crisis-affected populations: A systematic review

Anna Bellos, Kim Mulholland, Katherine L O'Brien, Shamim A. Qazi, Michelle Gayer, Francesco Checchi

Research output: Contribution to journalArticle

Abstract

Crises due to armed conflict, forced displacement and natural disasters result in excess morbidity and mortality due to infectious diseases. Historically, acute respiratory infections (ARIs) have received relatively little attention in the humanitarian sector. We performed a systematic review to generate evidence on the burden of ARI in crises, and inform prioritisation of relief interventions. We identified 36 studies published since 1980 reporting data on the burden (incidence, prevalence, proportional morbidity or mortality, case-fatality, attributable mortality rate) of ARI, as defined by the International Classification of Diseases, version 10 and as diagnosed by a clinician, in populations who at the time of the study were affected by natural disasters, armed conflict, forced displacement, and nutritional emergencies. We described studies and stratified data by age group, but did not do pooled analyses due to heterogeneity in case definitions. The published evidence, mainly from refugee camps and surveillance or patient record review studies, suggests very high excess morbidity and mortality (20-35% proportional mortality) and case-fatality (up to 30-35%) due to ARI. However, ARI disease burden comparisons with non-crisis settings are difficult because of non-comparability of data. Better epidemiological studies with clearer case definitions are needed to provide the evidence base for priority setting and programme impact assessments. Humanitarian agencies should include ARI prevention and control among infants, children and adults as priority activities in crises. Improved data collection, case management and vaccine strategies will help to reduce disease burden.

Original languageEnglish (US)
Article number3
JournalConflict and Health
Volume4
Issue number1
DOIs
StatePublished - 2010

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Respiratory Tract Infections
mortality
morbidity
Mortality
Population
Disease
Disasters
Morbidity
natural disaster
evidence
case management
Refugees
Time and Motion Studies
Case Management
International Classification of Diseases
contagious disease
refugee
surveillance
Infection Control
age group

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health(social science)

Cite this

The burden of acute respiratory infections in crisis-affected populations : A systematic review. / Bellos, Anna; Mulholland, Kim; O'Brien, Katherine L; Qazi, Shamim A.; Gayer, Michelle; Checchi, Francesco.

In: Conflict and Health, Vol. 4, No. 1, 3, 2010.

Research output: Contribution to journalArticle

Bellos, Anna ; Mulholland, Kim ; O'Brien, Katherine L ; Qazi, Shamim A. ; Gayer, Michelle ; Checchi, Francesco. / The burden of acute respiratory infections in crisis-affected populations : A systematic review. In: Conflict and Health. 2010 ; Vol. 4, No. 1.
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