Hepatitis A Virus Genotype IB Outbreak among Internally Displaced Persons, Syria.
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SUBMITTER: Kaddoura M
PROVIDER: S-EPMC6986849 | biostudies-literature | 2020 Feb
REPOSITORIES: biostudies-literature
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Hepatitis A Virus Genotype IB Outbreak among Internally Displaced Persons, Syria.
Kaddoura Malak M Allaham Rasmieh R Abubakar Abdinasir A Ezzeddine Amani A Barakat Amal A Mala Peter P Zaraket Hassan H
Emerging infectious diseases 20200217 2
In 2018, a hepatitis A virus outbreak was identified among internally displaced persons in Syria. Sequence analysis based on the viral protein 1/2A junction revealed that the causative virus belonged to genotype IB. A high displacement rate, deteriorated sanitary and health conditions, and poor water quality likely contributed to this outbreak. ...[more]
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Project description:BackgroundGeorgia is leading one of the world's first hepatitis C (HCV) elimination programs alongside interventions to combat a HIV epidemic concentrated among high-risk groups. Although progress has been substantial, neither strategy accounts for the nearly 150,000 internally displaced persons residing in collective centers (CC-IDPs) who are susceptible to deeply integrated risk environments that could promote infection. Achieving dedicated goals for HCV elimination and HIV suppression requires a clear understanding of the risks facing CC-IDPs.ObjectivesThis literature review aims to consolidate what is known about the socio-economic and physical/mental health status of IDPs living in collective centers in Georgia, and to assess their vulnerability to HIV and HCV in light of local and global epidemiological trends.MethodsSources were compiled from journal publications, reports by government ministries and transnational organizations, and the Integrated Household Survey database (2009-2018; updated annually by the National Statistics Office of Georgia) through manual searches in PUBMED, Google Scholar and Search, ProQuest, and digital repositories of government offices.FindingsReports indicate that CC-IDPs are more susceptible to poverty, poor living conditions, mental illness, disability, substance use, and in some cases infectious disease; although, the correlation is not always present and subject to variability. These factors were linked to increased transmission and acquisition of HIV/HCV in both displacement and non-displacement contexts abroad. The geographic concentration of HIV/HCV in areas with greater clusters of CC-IDPs, and shared characteristics with local high-risk groups, indicate the possibility of inordinate transmission among CC-IDPs in Georgia.ConclusionsThe disproportionate prevalence of psychosocial and clinical harms among CC-IDPs testifies to the serious potential of a greater burden of HIV and hepatitis C. Going forward, targeted research is needed to inform interventions and clarify the health status of CC-IDPs in Georgia.
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Project description:BackgroundThere are an estimated 55 million internally displaced persons (IDPs) globally. IDPs commonly have worse health outcomes than host populations and other forcibly displaced populations such as refugees. Official development assistance (ODA) is a major source of the global financial response for health in low- and middle-income countries (LMICs), including for populations affected by armed conflict and forced displacement. Analysis of ODA supports efforts to improve donor accountability, transparency and the equitable use of ODA. The aim of this study is to examine international donor support and responsiveness to IDP health needs through analysis of ODA disbursements to LMICs between 2010 and 2019.MethodsODA disbursement data to LMICs from 2010 to 2019 were extracted from the Creditor Reporting System (CRS) database and analysed with Stata software using a combination of: (i) text searching for IDP and refugee related terms; and (ii) relevant health and humanitarian CRS purpose codes. Descriptive analysis was used to examine patterns of ODA disbursement, and nonlinear least squared regression analysis was used to examine responsiveness of ODA disbursement to recipient country IDP population size and health system capacity and health characteristics.FindingsThe study highlighted declining per IDP capita health ODA from USD 5.34 in 2010 to USD 3.72 in 2019 (with annual average decline of -38% from the 2010 baseline). In contrast, health ODA for refugees in LMICs increased from USD 18.55 in 2010 to USD 23.31 in 2019 (with an annual average increase of +14%). Certain health topics for IDPs received very low ODA, with only 0.44% of IDP health ODA disbursed for non-communicable diseases (including mental health). There was also weak evidence of IDP health ODA being related to recipient country IDP population size, and health system capacity and health characteristics. The paper highlights the need for increased investment by donors in IDP health ODA and to ensure that it is responsive to their health needs.
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Project description:AbstractLarge protracted outbreaks of hepatitis E virus (HEV) have been documented in displaced populations in Africa over the past decade though data are limited outside these exceptional settings. Serological studies can provide insights useful for improving surveillance and disease control. We conducted an age-stratified serological survey using samples previously collected for another research study from 206 residents of an internally displaced person camp in Juba, South Sudan. We tested serum for anti-HEV antibodies (IgM and IgG) and estimated the prevalence of recent and historical exposure to the virus. Using data on individuals' serostatus, camp arrival date, and state of origin, we used catalytic transmission models to estimate the relative risk of HEV infection in the camp compared with that in the participants' home states. The age-adjusted seroprevalence of anti-HEV IgG was 71% (95% confidence interval = 63-78), and 4% had evidence of recent exposure (IgM). We estimated HEV exposure rates to be more than 2-fold (hazard ratio = 2.3, 95% credible interval = 0.3-5.8) higher in the camp than in the participants' home states, although this difference was not statistically significant. HEV transmission may be higher than previously appreciated, even in the absence of reported cases. Improved surveillance in similar settings is needed to understand the burden of disease and minimize epidemic impact through early detection and response.
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