scholarly journals Comparing alternative cholera vaccination strategies in Maela refugee camp using a transmission model

2019 ◽  
Author(s):  
Joshua Havumaki ◽  
Rafael Meza ◽  
Christina R Phares ◽  
Kashmira Date ◽  
Marisa C Eisenberg
Keyword(s):  
Dose Schedule ◽  
Refugee Camp ◽  
Health Concern ◽  
Transmission Model ◽  
Refugee Camps ◽  
Incidence Data ◽  
Immunization Strategies ◽  
Sanitation And Hygiene ◽  
Vaccine Availability ◽  
Reactive Vaccination

AbstractBackgroundCholera remains a major public health concern, particularly in refugee camps, which may contend with overcrowding and scarcity of resources. Maela, the largest long-standing refugee camp in Thailand, experienced four cholera outbreaks between 2005 and 2010. In 2013, a cholera vaccine campaign was implemented in the camp. To assist in the evaluation of the campaign and planning for subsequent campaigns, we developed a mathematical model of cholera in Maela.MethodsWe formulated a Susceptible-Infectious-Water-Recovered-based cholera transmission model and estimated parameters using incidence data from 2010. We next evaluated the reduction in cases conferred by several immunization strategies, varying timing, effectiveness, and resources (i.e., vaccine availability). Finally, we generated post-campaign case forecasts, to determine whether a booster campaign was needed.ResultsWe found that preexposure vaccination can substantially reduce the risk of cholera even when the < 50% of the population is given the full two-dose series. Additionally, the preferred number of doses per person should be considered in the context of one vs. two dose effectiveness and vaccine availability. For reactive vaccination, a trade-off between timing and effectiveness was revealed, indicating that it may be beneficial to give one dose to more people rather than two doses to fewer people, given that a two-dose schedule would incur a delay in administration of the second dose. Forecasting using realistic coverage levels predicted that there was no need for a booster campaign in 2014 (consistent with our predictions, there was not a cholera epidemic in the 2014 season).ConclusionsOur analyses suggest that vaccination in conjunction with ongoing water sanitation and hygiene efforts provides an effective strategy for cholera outbreaks in refugee camps. Effective preexposure vaccination depends on timing and effectiveness. If a camp is facing an outbreak, delayed distribution of vaccines can substantially alter the effectiveness of reactive vaccination, suggesting that quick distribution of vaccines may be more important than ensuring every individual receives both vaccine doses.

scholarly journals Comparing alternative cholera vaccination strategies in Maela refugee camp: using a transmission model in public health practice

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Joshua Havumaki ◽  
Rafael Meza ◽  
Christina R. Phares ◽  
Kashmira Date ◽  
Marisa C. Eisenberg
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Public Health Practice ◽  
Dose Schedule ◽  
Refugee Camp ◽  
Health Concern ◽  
Transmission Model ◽  
Health Practice ◽  
Vaccine Availability ◽  
Reactive Vaccination

Abstract Background Cholera is a major public health concern in displaced-person camps, which often contend with overcrowding and scarcity of resources. Maela, the largest and longest-standing refugee camp in Thailand, located along the Thai-Burmese border, experienced four cholera outbreaks between 2005 and 2010. In 2013, a cholera vaccine campaign was implemented in the camp. To assist in the evaluation of the campaign and planning for subsequent campaigns, we developed a mathematical model of cholera in Maela. Methods We formulated a Susceptible-Infectious-Water-Recovered-based transmission model and estimated parameters using incidence data from 2010. We next evaluated the reduction in cases conferred by several immunization strategies, varying timing, effectiveness, and resources (i.e., vaccine availability). After the vaccine campaign, we generated case forecasts for the next year, to inform on-the-ground decision-making regarding whether a booster campaign was needed. Results We found that preexposure vaccination can substantially reduce the risk of cholera even when <50% of the population is given the full two-dose series. Additionally, the preferred number of doses per person should be considered in the context of one vs. two dose effectiveness and vaccine availability. For reactive vaccination, a trade-off between timing and effectiveness was revealed, indicating that it may be beneficial to give one dose to more people rather than two doses to fewer people, given that a two-dose schedule would incur a delay in administration of the second dose. Forecasting using realistic coverage levels predicted that there was no need for a booster campaign in 2014 (consistent with our predictions, there was not a cholera epidemic in 2014). Conclusions Our analyses suggest that vaccination in conjunction with ongoing water sanitation and hygiene efforts provides an effective strategy for controlling cholera outbreaks in refugee camps. Effective preexposure vaccination depends on timing and effectiveness. If a camp is facing an outbreak, delayed distribution of vaccines can substantially alter the effectiveness of reactive vaccination, suggesting that quick distribution of vaccines may be more important than ensuring every individual receives both vaccine doses. Overall, this analysis illustrates how mathematical models can be applied in public health practice, to assist in evaluating alternative intervention strategies and inform decision-making.

Peri-urban water, sanitation and hygiene in Lusaka, Zambia: photovoice empowering local assessment via ecological theory

2021 ◽  
pp. 175797592199571
Author(s):  
Sikopo Nyambe ◽  
Taro Yamauchi
Keyword(s):  
Public Health ◽  
Public Policy ◽  
Health Hazard ◽  
Disease Outbreaks ◽  
Ecological Theory ◽  
Urban Slum ◽  
Health Concern ◽  
Minimal Impact ◽  
Sanitation And Hygiene ◽  
Definition Of

Water, sanitation and hygiene (WASH) factors are responsible for 11.4% of deaths in Zambia, making WASH a key public health concern. Despite annual waterborne disease outbreaks in the nation’s peri-urban (slum) settlements being linked to poor WASH, few studies have proactively analysed and conceptualised peri-urban WASH and its maintaining factors. Our study aimed to (a) establish residents’ definition of peri-urban WASH and their WASH priorities; and (b) use ecological theory to analyse the peri-urban WASH ecosystem, highlighting maintaining factors. Our study incorporated 16 young people (aged 17–24) residing in peri-urban Lusaka, Zambia in a photovoice exercise. Participants took photographs answering the framing question, ‘What is WASH in your community?’ Then, through contextualisation and basic codifying, participants told the stories of their photographs and made posters to summarise problems and WASH priorities. Participant contextualisation and codifying further underwent theoretical thematic analysis to pinpoint causal factors alongside key players, dissecting the peri-urban WASH ecosystem via the five-tier ecological theory ranging from intrapersonal to public policy levels. Via ecological theory, peri-urban WASH was defined as: (a) poor practice (intrapersonal, interpersonal); (b) a health hazard (community norm); (c) substandard and unregulated (public policy, organisational); and (d) offering hope for change (intrapersonal, interpersonal). Linked to these themes, participant findings revealed a community level gap, with public policy level standards, regulations and implementation having minimal impact on overall peri-urban WASH and public health due to shallow community engagement and poor acknowledgement of the WASH realities of high-density locations. Rather than a top-down approach, participants recommended increased government–resident collaboration, offering residents more ownership and empowerment for intervention, implementation and defending of preferred peri-urban WASH standards.

The Refugee Camp as Site of Multiple Encounters and Realizations

2020 ◽  
Vol 54 (2) ◽  
pp. 215-233
Author(s):  
Ayham Dalal
Keyword(s):  
Everyday Life ◽  
Refugee Camp ◽  
Human Geography ◽  
Entry Point ◽  
Material Composition ◽  
Refugee Camps

AbstractLiterature in Human Geography has given much attention to “encounters” and their impact on negotiating difference in everyday life. These studies, however, have focused solely on cities, while “other” spaces like refugee camps have received little attention to date. In this paper, I highlight the significance of “encounters” in camps by exposing three main types: the “refugee-refugee,” the “refugee-humanitarian,” and the “refugee-more-than-human” encounters. Using empirical examples from Zaatari camp in Jordan, I show that the “refugee-refugee” encounters cannot be fully understood without taking refugees’ culture, background, and urban identities into consideration. I also explain how the “refugee-humanitarian” encounters result in new types of behaviors and might harden the boundaries between both groups. And lastly, I demonstrate how the “refugee-more-than-human” encounters can inform us about refugees’ unique experiences with shelters, space, and materiality. Building on the examples given for each type, this article suggests that “encounters” have the ability to generate knowledge and learnings, which contributes to shaping the space of the camp by either enforcing boundaries between different groups and/or by allowing new and hybrid spatialities to emerge. This not only confirms that “encounters” are an important entry point in understanding the socio-spatial and material composition of refugee camps, but also that further studies in this regard are direly needed. It also suggests that architects and planners need to allow for the “new” to emerge as a result of these encounters and, therefore, to enable flexibility and adaptability within camps’ design and planning.

scholarly journals Combating pertussis resurgence: One booster vaccination schedule does not fit all

2015 ◽  
Vol 112 (5) ◽  
pp. E472-E477 ◽  
Author(s):  
Maria A. Riolo ◽  
Pejman Rohani
Keyword(s):  
Booster Vaccination ◽  
Cost Effective ◽  
Vaccination Schedule ◽  
Health Concern ◽  
Transmission Model ◽  
Public Health Concern ◽  
Vaccine Failure ◽  
Vaccination Strategies ◽  
Vaccine Booster ◽  
Pertussis Epidemiology

Pertussis has reemerged as a major public health concern in many countries where it was once considered well controlled. Although the mechanisms responsible for continued pertussis circulation and resurgence remain elusive and contentious, many countries have nevertheless recommended booster vaccinations, the timing and number of which vary widely. Here, using a stochastic, age-stratified transmission model, we searched for cost-effective booster vaccination strategies using a genetic algorithm. We did so assuming four hypothesized mechanisms underpinning contemporary pertussis epidemiology: (I) insufficient coverage, (II) frequent primary vaccine failure, (III) waning of vaccine-derived protection, and (IV) vaccine “leakiness.” For scenarios I–IV, successful booster strategies were identified and varied considerably by mechanism. Especially notable is the inability of booster schedules to alleviate resurgence when vaccines are leaky. Critically, our findings argue that the ultimate effectiveness of vaccine booster schedules will likely depend on correctly pinpointing the causes of resurgence, with misdiagnosis of the problem epidemiologically ineffective and economically costly.

Sensory Perceptual Experience in Balata Refugee Camp

2019 ◽  
Vol 44 (2) ◽  
pp. 36-44
Author(s):  
Shahd Adnan M. Qzeih ◽  
Rafooneh Mokhtarshahi Sani
Keyword(s):  
Content Analysis ◽  
West Bank ◽  
Middle Eastern ◽  
Mental Image ◽  
Refugee Camp ◽  
Refugee Camps ◽  
The West ◽  
Case Study Analysis ◽  
Palestinian Territories ◽  
The World

Wars and conflicts have caused millions of people to seek asylum outside their homelands and the issue of refugee camps has become a pressing subject in international policy discussions. Conflicts continue to escalate in different parts of the world, especially in Middle Eastern countries. In 1948, the Palestinian-Israeli conflict forced displacement of many Palestinian people. The resulting camps have developed into cluster camp shelters of three to four stories in the West Bank, Gaza, and other regions around historical Palestine; some are perceived to be like gated communities. Being self-sufficient environments, refugee camps have rarely been approached from the perspective of urban psychology. This research deals with sensory perceptual analysis of Balata, the largest refugee camp in the West Bank of Palestinian Territories. Balata is situated in Nablus and has raised four generations of refugees since its establishment. In order to explore the spatial characteristics of such specific environmental experiences, the research adopted a mixed-method approach – systematically evaluating the related literature on sensory perceptual spaces and applying content analysis methods. The study modified the sensory slider tool of Malnar and Vodvarka according to the framework matrix based on the content analysis. Moreover, the case study analysis consisted of observation of the chosen area and 30 in-depth interviews with refugees who were forced out of their homes and settled in the camp as well as some who were born in the camp. The research results show that investigating what camp residents perceive of the five senses can capture meaningful sensory perceptual experiences and can generate a holistic mental image of the refugee camp. Particularly, perceptions of the built environment reflect the difficulty of life experiences. The study concludes that the characteristics of camps in this seventy-year-old conflict environment may not be found in other parts of the world.

scholarly journals A First Review to Explore the Association of Air Pollution (PM and NO2) on Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2)

2020 ◽  
Author(s):  
Chiara Copat ◽  
Antonio Cristaldi ◽  
Maria Fiore ◽  
Alfina Grasso ◽  
Pietro Zuccarello ◽  
...  
Keyword(s):  
Air Pollution ◽  
Meteorological Data ◽  
Scientific Evidence ◽  
Epidemiological Studies ◽  
Negative Influence ◽  
Health Concern ◽  
Mortality Data ◽  
Great Effort ◽  
Incidence Data ◽  
Long Time

A new coronavirus (SARS-CoV-2) have determined a pneumonia outbreak in China (Wuhan and Hubei) on December 2019. While pharmaceutical and non-pharmaceutical intervention strategies are strengthened worldwide, the scientific community has been studying the risk factors associated with SARS-Cov-2, to enrich epidemiological information. For a long time, before the industrialized era, air pollution has been a real and big health concern and it is today a very serious environmental risk for many diseases and anticipated deaths in the world. It has long been known that air pollutants increasing the invasiveness of pathogens for humans by acting as a carrier and making people more sensitive to pathogens through a negative influence on the immune system. Based on scientific evidences, the hypothesis that air pollution, resulting from a combination of factors such as meteorological data, level of industrialization as well as regional topography, can acts both as an infection carrier as a harmful factor of the health outcomes of COVID-19 disease has been raised recently. This hypothesis is turning in scientific evidence, thanks to the numerous studies that have been launched all over the world.With this review, we want to provide a first unique view of all the first epidemiological studies relating the association between air pollution and SARS-CoV-2. The Authors, who first investigated this association, although with great effort and rapidity of analysis dictated by a global emergency, often used different research methods or not all include confounding factors whenever possible. In addition, to date incidence data are underestimated in all countries, and to a lesser extent also mortality data. For this reason, the cases included in the considered studies cannot be considered real. Although it determines important limitations for direct comparison of results, and more studies are needed to strengthen scientific evidences and support firm conclusions, major findings are consistent, highlighting the important contribution of PM2.5 and NO2 on the COVID-19 spread and with a less extent also PM10.

scholarly journals Prevalence of Stunting among 6-59 Months Children and its Association with Water, Sanitation and Hygiene Practice in Urban Slums of Kathmandu, Nepal

2020 ◽  
Vol 42 (3) ◽  
pp. 76-81
Author(s):  
Sarswoti Singh ◽  
Nil P Dhital ◽  
Rajan Paudel ◽  
Dipak K Sah ◽  
Arjun Hamal ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Study Data ◽  
Urban Slums ◽  
Health Concern ◽  
Cross Sectional ◽  
Hygiene Practices ◽  
Sanitation And Hygiene ◽  
Critical Public Health ◽  
Childhood Stunting ◽  
Purification Of Water

Introduction Childhood malnutrition is a critical public health concern in Nepal. Slums are supposed to have poor water, sanitation and hygiene practices. This study has aimed to examine association between water, sanitation and hygiene (WASH) variables and stunting among 6 to 59 months children of slums of Kathmandu metropolitan city. MethodsDescriptive cross-sectional study design was employed where 335 households were included in the study. Data were collected using standard questionnaire and observation checklist. Weight and height of children were taken using seca digital weighing scale and wooden height board of UNICEF respectively. Anthropometric analysis was done using WHO Anthro version 3.2.2 software and other statistical analysis was conducted using SPSSversion 22 software. ResultsThe prevalence of stunting was 23%. Four out of five household (80%) in slum used to drink water from unimproved source. Absence of handwashing station (AOR=2.109, 95% CI:1.05-3.27) and absence of water storage covering (AOR=2.46, 95% CI: 1.16–5.23) were found to be significantly contributing to stunting status. ConclusionThis study highlights the importance of good WASH practices, and the potential of WASH interventions, to contribute for the improved childhood stunting living in urban slums in Nepal. Also, the findings recommend the need of strategies on purification of water, improvement of toilets, behaviour change and awareness related activities to improve the stunting among children.

Norovirus outbreaks in german refugee camps in 2015

2017 ◽  
Vol 55 (10) ◽  
pp. 997-1003 ◽  
Author(s):  
Ulrike Grote ◽  
Benjamin Schleenvoigt ◽  
Christine Happle ◽  
Christian Dopfer ◽  
Martin Wetzke ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Eating Habits ◽  
Secondary Data ◽  
Refugee Camp ◽  
Refugee Camps ◽  
Cultural Backgrounds ◽  
First Case ◽  
Hygiene Measures ◽  
Norovirus Gastroenteritis ◽  
Specific Implementation

Abstract Purpose Refugees often live in confined housing conditions with shared kitchen and sanitary facilities, rendering susceptible to communicable diseases. We here describe the outbreak, spread and self-limiting nature of a norovirus outbreak in a German refugee camp in the winter of 2015. Methods During a norovirus outbreak, data on clinical symptoms, nationality and living conditions was obtained in a refugee camp in northern Germany in the winter of 2015. Furthermore secondary data on norovirus outbreaks in 2015 was assessed. Results Amongst n = 982 refugees, n = 36 patients (3.7 %) presented with acute norovirus gastroenteritis. The vast majority of cases were children, only the first patient was admitted to the hospital. Intensified hygiene measures were implemented on day 2 of the outbreak, but new cases peaked on day 21 and occurred until one month after the first case. Different cultural backgrounds, eating habits and hygiene standards amongst the refugees made it particularly challenging to implement stringent isolation and hygiene measures. Despite these predisposing factors, only minor norovirus outbreaks were reported in refugee camps in 2015. Conclusion Adults refugees had a low attack rate of symptomatic norovirus infection, while small children are at high risk. Infection spreads despite hygiene measures and camp sites and staff should be prepared for the particular challenges of such situations with a particular focus on cultural-background specific implementation of hygiene measures.

Logistics system for drinking water distribution in post disaster humanitarian relief, Al-Za’atari camp

2018 ◽  
Vol 8 (4) ◽  
pp. 477-496 ◽  
Author(s):  
Hazem Smadi ◽  
Nader Al Theeb ◽  
Haneen Bawa’neh
Keyword(s):  
Drinking Water ◽  
Water Distribution ◽  
Phase 1 ◽  
Refugee Camp ◽  
Optimal Number ◽  
Refugee Camps ◽  
Content Type ◽  
Drinking Water Distribution ◽  
Minimum Number ◽  
Post Disaster

Purpose It is essential to provide drinking water to affected population directly after a disaster. The purpose of this paper is to develop an optimization methodology that helps in the distribution of drinking water in post-disaster situations. Design/methodology/approach The research was conducted on two phases: phase 1 aims at identifying an appropriate way to deliver drinking water to refugee camps from external sources, considering required drinking water quantities and four possible sources of water with respect to cost and risk assessments. Phase 2 investigates drinking water distribution within a refugee camp using covering models. The MCLP–optimal number of facilities model is proposed to ensure that the water is distributed and delivered to all individuals in a camp with minimum number of water storage tanks required. A control policy is proposed to ensure the fair distribution of water to all targeted individuals. Findings Al-Za’atari refugee camp, located in northeast of Jordan, was considered as the case study for this research. The result showed that the appropriate way to deliver water to the camp is by using tanker–trucks, and a minimum number of five tanks are required to distribute water to individuals inside the camp with respect to tank locations and the allocation of tank of each area. Originality/value The proposed methodology is essential in decision making for the distribution of drinking water in refugee camps in short-term needs. The model adds important value to the literature as the proposed problem has no solution in the literature before.

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