Burden of Acute Respiratory Infections among Refugees 5 years and older in Dadaab, Kenya Público

Mohamed, Gedi Abdi (2013)

Permanent URL: https://etd.library.emory.edu/concern/etds/x346d473s?locale=es
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Abstract

ABSRACT

Burden of Acute Respiratory Infections among Refugees 5 years and older in Dadaab, Kenya

By

Gedi Abdi Mohamed

Background

Acute Respiratory Infections (ARIs) are a leading cause of morbidity and mortality worldwide with people in developing countries having the highest burden. Refugees and other displaced populations are even at a higher risk of contracting infections. There are no reliable estimates of burden and etiology of ARIs among children and adults 5 years and older in refugees camps.

Objective

To determine the burden of Lower Respiratory Tract Infections (LRTI) and the etiology of viral ARIs among children and adults 5 years and older in Hagadera Refugee Camp in Dadaab, Kenya

Methods

Data from the Hagadera Mortality Register, the United Nations High Commissioner for Refugees (UNHCR) Health Information Systems (HIS) database and the ARI Surveillance were used to determine the burden and etiology of ARI in the camp. Cause of death in the mortality register for 2012 was compared with the deaths captured in the UNHCR HIS. The burden of LRTI was estimated from those captured in the HIS database. All the cases fulfilling the World Health Organization (WHO) case definition for Influenza-like illnesses (ILI) and Severe Acute Respiratory Infections (SARI) between 2010 and 2011 were analyzed to determine etiology, seasonality, demographic characteristics and common presenting complaints. To calculate the rates, population estimates was obtained from the HIS and from the CIA World Factbook. Data analysis was done using Epi-Info 7 from the Centers for Disease Control and Prevention.

Results

The overall mortality attributed to LRTI was 21.3%. Among children and adults aged 5 years and older, 12.4% of deaths and 11% of hospital admissions were attributable to LRTI. In the ARI surveillance data for 2010 and 2011, 410 patients aged 5 years and older met the case definition of ILI and SARI. Among the 361 samples tested, 158 (43.8%) tested positive for at least one virus. Of those tested positive, 58 patients (37.4%) had Influenza A, 45 (29.2%) Adenovirus (AdV), 34 (21.9%) Influenza B, 16 (10.0%) Respiratory syncytial virus (RSV), 4 (5.0%) parainfluenza 1 (PIV1), 3 (1.9%) parainfluenza 2 (PIV2), 16 (10.3%) parainfluenza 3 (PIV3) and 9 (5.8%) human metapneumovirus (hMPV); 27 (17%) patients had more than one virus isolated. Persons between the ages of 5-14 years were 6.5 times more likely to be hospitalized as a result of SARI than those above the age of 24 years (P-value <0.001). Headache, lethargy, nausea and muscle/joint pains were all significantly higher in patients with SARI compared with those with a diagnosis of ILI. Muscle/joint pains was associated with Influenza A isolation (P-value 0.002).

Conclusion

Respiratory tract infections are a substantial burden in refugee camps among children and adults 5 years and older, with the younger age groups affected significantly more. Influenza A and B as well as Adenovirus are the leading viral causes of ARI in the refugee camps among older children and adults.

Table of Contents

Table of Contents

ABSRACT.. 2

ACKNOWLEDGEMENTS. 3

INTRODUCTION.. 5

LITERATURE REVIEW... 7

METHODS. 15

RESULTS. 20

DISCUSSION.. 29

PUBLIC HEALTH IMPLICATION.. 33

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