Dynamics of Socioeconomic Risk Factors for Neglected Tropical Diseases and Malaria in an Armed Conflict
Dynamics of Socioeconomic Risk Factors for Neglected Tropical Diseases and Malaria in an Armed Conflict
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DOI：
10.1371/journal.pntd.0000513
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发表时间：
2009-09-01
影响因子：
3.8
通讯作者：
Utzinger, Juerg
中科院分区：
文献类型：
--
作者：
Fuerst, Thomas;Raso, Giovanna;Utzinger, Juerg
背景：武装冲突和战争是导致残疾和过早死亡的主要原因之一，在武装冲突中丧生或受伤的平民所占比例越来越大。平民苦难的主要原因是间接影响或附带影响，例如传染病风险状况的改变。我们重点关注2002/2003年科特迪瓦内战期间发生战斗的科特迪瓦西部农村社区，并评估了被忽视的热带病和疟疾的社会经济风险因素动态。方法：在2002/2003年武装冲突前后不久，对科特迪瓦西部曼地区25个村庄随机选择的182个家庭的户主发放了相同的标准化和预测试问卷。主要调查结果：以每个卧室的人数衡量，拥挤程度没有差别，但冲突前卫生基础设施不足的情况进一步恶化，防止蚊虫叮咬的保护措施的提供和使用情况恶化，卫生保健基础设施的可及性恶化。尽管这些调查结果与冲突之间的直接因果链不完整（部分原因在于在冲突地区工作的性质），但调查的时间和程序、其他来源和轶事证据表明，被忽视热带病和疟疾的风险增加与武装冲突之间存在关系。结论：需要新的研究来加深我们对武装冲突和战争的间接影响的理解，这些间接影响往往是分散的和被忽视的，它们可能比更明显的直接影响更糟糕。
Background: Armed conflict and war are among the leading causes of disability and premature death, and there is a growing share of civilians killed or injured during armed conflicts. A major part of the civilian suffering stems from indirect effects or collateral impact such as changing risk profiles for infectious diseases. We focused on rural communities in the western part of Cote d'Ivoire, where fighting took place during the Ivorian civil war in 2002/2003, and assessed the dynamics of socioeconomic risk factors for neglected tropical diseases (NTDs) and malaria.Methodology: The same standardized and pre-tested questionnaires were administered to the heads of 182 randomly selected households in 25 villages in the region of Man, western Cote d'Ivoire, shortly before and after the 2002/2003 armed conflict.Principal Findings: There was no difference in crowding as measured by the number of individuals per sleeping room, but the inadequate sanitation infrastructure prior to the conflict further worsened, and the availability and use of protective measures against mosquito bites and accessibility to health care infrastructure deteriorated. Although the direct causal chain between these findings and the conflict are incomplete, partially explained by the very nature of working in conflict areas, the timing and procedures of the survey, other sources and anecdotal evidence point toward a relationship between an increased risk of suffering from NTDs and malaria and armed conflict.Conclusion: New research is needed to deepen our understanding of the often diffuse and neglected indirect effects of armed conflict and war, which may be worse than the more obvious, direct effects.