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DENGUE EPIDEMICS IN REFUGEE CAMPS PREVENTION AND DISEASE MANAGEMENT. PUBH-6165-2 Environmental Health Walden University Online Dr. Jalal Ghaemghami Student: Mercedes Z Rafiq. WHAT IS DENGUE?. DENGUE IS A MOSQUITO-BORNE DISEASE ENDEMIC TO TROPICAL REGIONS.
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DENGUE EPIDEMICSIN REFUGEE CAMPSPREVENTION AND DISEASE MANAGEMENT PUBH-6165-2 Environmental Health Walden University Online Dr. Jalal Ghaemghami Student: Mercedes Z Rafiq
WHAT IS DENGUE? • DENGUE IS A MOSQUITO-BORNE DISEASE ENDEMIC TO TROPICAL REGIONS. • THE PRINCIPAL VECTOR IS THE Aedes aegypti MOSQUITO. • THERE ARE FOUR TYPES OF DENGUE VIRUSES. (WHO, 2009; ROBERTS AND KEMP, 2001)
SYMPTOMS • FEVER, CHILLS, RASH, SORE THROAT. • VOMITING, SEVERE HEADACHES. • PAIN BEHIND THE EYES. • MUSCLE AND JOINT PAIN. • COMPLICATIONS INCLUDE DHF & DSS. • DHF: DENGUE HEMORRHAGIC FEVER CHARACTERIZED BY INTERNAL BLEEDING. • DSS: DENGUE SHOCK SYNDROME RESULTS FROM THE INTERNAL BLEEDING SUFFERED BY THE PATIENTS. (WHO, 2009; ROBERTS AND KEMP, 2001)
GEOGRAPHICAL DISTRIBUTION • DENGUE WAS FIRST DETECTED IN ASIA. • TODAY DENGUE HAS BECOME ENDEMIC TO MOST COUNTRIES IN THE TROPICS. • IT OCCURS MOSTLY IN URBAN SETTINGS. • THERE HAVE BEEN SPORADIC CASES IN REFUGEE CAMPS IN ASIA AND AFRICA. (WHO, 2009)
DISTRIBUTION AS OF 2002 WHO, 2002
POPULATIONS AFFECTED • APPROXIMATELY 50 MILLION PEOPLE WORLDWIDE. • 12,500 PEOPLE (MOSTLY CHILDREN) DIE FROM DHS EACH YEAR. • OVERALL 2.5 BILLION PEOPLE ARE EXPOSED TO DENGUE FEVER, DHF, AND DSS AROUND THE GLOBE. (WHO, 2009)
INTERNALLY DISPLACED PERSONS AND REFUGEES • PEOPLE THAT HAVE BEEN DISPLACED BY ARMED CONFLICT OR NATURAL DISASTERS, BUT REMAIN IN THEIR COUNTRY ARE COUNTED AS IDPS. • PEOPLE THAT HAVE BEEN FORCED OUT OF THEIR OWN COUNTRY DUE TO POLITICAL, SOCIAL, ETHNIC, OR RELIGIOUS INSTABILITY ARE CONSIDERED REFUGEES.
PEOPLE DISPLACED BY ARMED CONFLICTS OR NATURAL DISASTERS FACE: • OVERCROWDED CONDITIONS IN REFUGEE CAMPS. • UNSAFE ENVIRONMENT. • LACK OF PROPER SANITATION. • UNAVAILABILITY OF WATER. • POOR NUTRITION. • PSYCHOLOGICAL STRESS. • INAPPROPRIATE BASIC HEALTH CARE. • THREAT OF EPIDEMIC DISEASES.
CHALLENGES • PROVIDING SHELTER FROM THE ELEMENTS • PROVIDING CLEAN DRINKING WATER • PROVIDING NUTRITIONAL FOOD • DELIVERING BASIC HEALTHCARE • COMMUNICABLE DISEASE SURVEILLANCE Lin, Yoon, Jung, Kim, and Lee (2005); Gayer, Legros, Formenty, and Connolly (2007).
LIVING CONDITIONS IN CAMPS Refugee camp. Photograph by Exile Images
ACTIONS • MANY INTERNATIONAL ORGANIZATIONS SUCH AS WHO, UN, MEDICINS SANS FRONTIERS, AND THE RED CROSS PARTICIPATE IN THE PROVISION OF TEMPORARY SHELTERS, FOOD, WATER, EMERGENCY HEALTHCARE, AND EDUCATION. • COORDINATION OF PROGRAMS IS AN IMPORTANT PART OF ASSISTING THE REFUGEES OR IDPs.
CONCLUSION • DENGUE OUTBREAKS ARE NOT COMMON IN REFUGEE CAMPS; HOWEVER, WHEN THESE OCCUR THEY CAUSE MORE SUFFERING TO A POPULATION THAT IS ALREADY UNDER PHYSICAL AND PSYCHOLOGICAL STRESS. • ERADICATION OF Aedes aegypi AND OTHER VECTORS, AND DENGUE CONTAINMENT SHOULD BE PRIORATIZED BY GOVERNMENTS WORLDWIDE, SO THAT WHEN A NATURAL DISASTER OCCURS OR A CONFLICT SITUATION ESCALATES DENGUE WOULD NOT BE ANOTHER EPIDEMIC THAT MUST BE FOUGHT.
REFERENCES: • Beyrer, C. & Lee, T. J. (2008). Responding to Infectious Diseases in Burma and her Border Regions. Conflict and Health. 2008, 2:2. Retrieved from http://conflictandhealth.com/content/2/1/2 on July 5, 2009. • Botros, A. M.; Watts, D. M.; Soliman, A. K.; Salib, A. W.; Moussa, M. I.; Murzal, H.; Douglas, C. and Farah, M. (1989). Serological Evidence of Dengue Fever Among Refugees, Hargeysa, Somalia. U. S. Naval Medical Research Unit No. 3. Retrieved from http://www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA241179&location=u2&doc=GetTRDoc.pdf on July 5, 2009. • Dengue and Dengue Hemorrhagic Fever: Questions and Answers for Tsunami Survivors. (2005). CDC. Retrieved from http://www.bt.cdc.gov/disasters/tsunamis on July 22, 2009. • Dengue Fact Sheet. (2005). CDC. Retrieved from http://www.cdc.gov/ncidod/dvbid/dengue on July 7, 2009. • Gayer, M.; Legros, D.; Formenty, P.; and Connolly, M. A. (2007). Conflict and Emerging Infectious Diseases. Vol. 13, No. 11, November 2007. Retrieved from http://www.cdc.gov/eid on July 17, 2009. • Gubler, D. J. (1998). Dengue and Dengue Hemorrhagic Fever. Clinical Microbiology Reviews. Vol. 11, No. 3, July 1998. Retrieved from http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=88892&blobtype=pdf on July 5, 2009. • Gubler, D. J. (2002). Epidemic dengue/dengue hemorrhagic fever as a public health, social and economic problem in the 21st century. Trends in Microbiology. Vol. 10, No. 2, February 2002. Retrieved from http://www.pdvi.org/PDFs/articles/Epidemic%20dengue%20-%20Gubler.pdf on July 16, 2009. • Sri Lanka: Dengue Outbreak Claims 168 Lives. (2009) Integrated Regional Information Networks. UN Office of the Coordination of Humanitarian Affairs. Retrieved from http://www.irinnews.org/PrintReport.aspx?ReportId=85200 on July 27, 2009. • Pakistan: Dengue Danger Returns to Punjab. (2009). Integrated Regional Information Networks. UN Office of the Coordination of Humanitarian Affairs. Retrieved from http://www.irinnews.org/PrintReport.aspx?ReportId=83683 on July 27,2009.
References Continued: • Global: Paltry Funding for Tackling Deadly Diseases. (2009). Integrated Regional Information Networks.UN Office of the Coordination of Humanitarian Affairs. Retrieved from http://www.irinnews.org/PrintReport.aspx?ReportId=82919 on July 27,2009. • Bangladesh: Cyclone Aila Recovery Slower than Sidr. (2009). IRIN. UN Office of the Coordination of Humanitarian Affairs. Retrieved from http://www.irinnews.org/PrintReport.aspx?ReportId=85396 on July 27, 2009. • Lateef, F. (2009). Cyclone Nargis and Myanmar: A Wake Up Call. Journal of Emergencies, Trauma, and Shock. Vol. 2, No. 2. May-August 2009. Retrieved from http://www.onlinejets.org/text.asp?2009/2/2/106/50745 on July 27, 2009. • Lim, J. H.; Yoon, D.; Jung, G.; Kim, W J.; and Lee, H. C. S. (2005). Medical needs of Tsunami Disaster Refugee Camps: Experience in Southern Sri Lanka. International Family Medicine. Vol. 37, No. 6. June 2005. Retrieved from http://www.stfm.org/fmhub/fm2005/June/Jie422.pdf on July 15, 2009. • Roberts, A., & Kemp, C. (2001). Dengue Fever. Retrieved from http://bearspace.baylor.edu/Charles_Kemp/www/dengue.htm on July 7, 2009. • WHO. (2002). DengueNet_WHO’s Internet-based System for the Global Surveillance of Dengue Fever and Dengue Haemorrhagic Fever (Dengue/DHF). Weekly Epidemiological Record. Vol. 36, September 6, 2002. Retrieved from http://www.who.int/wer on July 7, 2009. • WHO: Dengue and Dengue Haemorrhagic Fever. (2009). Fact Sheet No. 117. Retrieved from http://www.who.int/mediacentre/factsheets/fs117/en/print.html on July 7, 2009. • WHO. (2009). Impact of Dengue. Retrieved from http://www.who.int.csr/disease/dengue/impact/en/printhtml on July 22, 2009.