Illness in Journalists and Relief Workers Involved in International Humanitarian Assistance Efforts in Somalia, 1992-93.
Illness in Journalists and Relief Workers Involved in International Humanitarian Assistance Efforts in Somalia, 1992-93.
复制标题
参与索马里国际人道主义援助工作的记者和救援人员的疾病，1992-93 年。
DOI：
--
复制
发表时间：
1995
影响因子：
25.7
通讯作者：
M. R. Wallace
中科院分区：
文献类型：
--
作者：
T. Sharp;R. DeFraites;Scott A. Thornton;James P. Burans;M. R. Wallace
背景：1992年底外部武装部队介入后，在索马里参加国际救济工作的记者和救济工作人员的健康面临一些威胁。这些威胁主要来自地方性传染病和创伤。方法：在大部分研究期间（1992年12月15日至1993年2月15日），对美军野战医院的住院、急诊和实验室记录进行了审查，以确定接受评估的工人人数及其患病原因，这些医院在索马里提供了唯一可用的先进医疗服务。此外，还进行了两次问卷调查，以阐明这些群体的疾病危险因素。结果：主要来自欧洲和北美的138名记者和救援人员在一家医院接受了各种常见的旅行相关健康问题的评估，包括腹泻（33%）、急性呼吸道感染（21%）、其他发热性疾病（11%）、肝炎（2%）、严重创伤（6%）和轻微创伤（13%）。记录的传染病病原体包括恶性疟原虫（7例）、志贺氏菌（3例）、产肠毒素大肠杆菌（ETEC）（3例）、登革2型病毒（2例）和戊型肝炎病毒（3例）。两名救援人员死于枪伤。在对104名记者和98名救援人员进行的问卷调查中，84%的受访者报告说，他们在旅行前得到了一些医疗建议，但只有70%的人亲自寻求医疗咨询。34%的人没有接受推荐的抗疟化学预防方案，只有10%的人获得了氟喹诺酮类抗菌药物用于自我治疗腹泻。两组中有64%的人报告有腹泻，26%的人经历过非腹泻性发热性疾病。68%的人表示，他们的工作表现受到疾病的不利影响。在多因素logistic回归分析中，与腹泻风险增加相关的因素是年龄< 35岁（OR 1.5, 95% CI 1.1-1.9）；在索马里居住超过21天（OR 1.7, 95% CI 1.3-2.1）；经常食用当地食物和水（OR 3.8, 95% CI 3.4-4.2）。与非腹泻性发热性疾病相关的因素为年龄< 35岁（OR 1.4, 95% CI 1.1-1.8）；在索马里居住超过21天（OR 1.8, 95% CI 1.4-2.2）；没有在旅行前进行过亲自的医疗咨询（OR 2.0, 95% CI 1.5-3.0）。结论：这些数据表明，前往索马里应对大规模人道主义危机的记者和救济工作人员本身也遇到了严重的健康问题。改进旅行前的医疗准备可以预防或限制这些特殊群体的疾病，并提高未来救灾工作的效率。（旅游医学杂志，1995:70-76）
Background: Journalists and relief workers participating in international relief efforts in Somalia following the intervention of outside armed forces in late 1992, were faced with a number of threats to their health. Principally these threats were from endemic infectious diseases and trauma. Methods: In-patient, emergency clinic, and laboratory records of U.S. military field hospitals, which provided the only available sophisticated medical care in Somalia during most of the study period (December 15, 1992, to February 15, 1993), were reviewed to determine the number of workers evaluated and the causes of their illnesses. In addition, two questionnaire surveys were conducted to elucidate risk factors for illness in these groups. Results: One hundred and thirty-eight journalists and relief workers, primarily from Europe and North America, were evaluated at a hospital for a variety of common travel-associated health problems, including diarrhea (33%), acute respiratory infection (21%), other febrile illnesses (11%), hepatitis (2%), major trauma (6%), and minor trauma (13%). Documented infectious disease pathogens included Plasmodium falciparum (7 cases), Shigella sp (3 cases), enterotoxigenic Escherichia coli (ETEC) (3 cases), dengue virus-2 (2 cases), and hepatitis E virus (3 cases). Two relief workers were killed by gunshot wounds. In the questionnaire surveys of 104 journalists and 98 relief workers, 84% of respondents reported that they had received some pretravel medical advice, but only 70% sought a medical consultation in person. Thirty-four percent were not receiving a recommended antimalarial chemoprophylaxis regimen, and only 10% obtained a fluoroquinolone antimicrobial drug for self treatment of diarrhea. Sixty-four percent of both groups combined, reported having had diarrhea, and 26% experienced a nondiarrheal febrile illness. Sixty-eight percent reported that their work performance was adversely affected by illness. In multivariate logistic regression analyses, factors associated with an increased risk of diarrhea were age < 35 years (OR 1.5, 95% CI 1.1-1.9); residence in Somalia for more than 21 days (OR 1.7, 95% CI 1.3-2.1); and regular consumption of local food and water (OR 3.8, 95% CI 3.4-4.2). Factors associated with nondiarrheal febrile illness were age < 35 years (OR 1.4, 95% CI 1.1-1.8); residence in Somalia for more than 21 days (OR 1.8, 95% CI 1.4-2.2); and not having had an in-person pretravel medical consultation (OR 2.0, 95% CI 1.5-3.0). Conclusions: These data indicate that journalists and relief workers who traveled to Somalia in response to the massive humanitarian crisis themselves experienced substantial health problems. Improved pretravel medical preparation might prevent or limit illness in these unique groups and improve the efficiency of future disaster response efforts. (J Travel Med 2:70-76, 1995)