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War and infectious diseases: challenges of the Syrian civil war.

Sharara SL, Kanj SS - PLoS Pathog. (2014)

View Article: PubMed Central - PubMed

Affiliation: Curriculum in Global Studies, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, United States of America.

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Syria's ongoing three-year civil war has displaced 6.5 million Syrians, left hundreds of thousands wounded or killed by violence, and created a vacuum in basic infrastructures that will reverberate throughout the region for years to come... Beyond such devastation, the civil war has introduced epidemics of infections that have spread through vulnerable populations in Syria and neighboring countries... In this article, we discuss the growing epidemics of poliomyelitis, measles, and cutaneous leishmaniasis in Syria and the region to examine the impact of conditions of war on the spread of infectious diseases in a public health emergency of global concern... In March 2011, unrest from the Arab Spring found its way to Syria, interrupting over 40 years of political stability and igniting a civil war that continues to ravage the country with no end in sight... Measles, hepatitis A, leishmaniasis, poliomyelitis, meningitis, and scabies have spread through vulnerable populations in Syria and refugee camps in neighboring countries, creating a health crisis that will require immense resources to address (Table 1)... Prior to the conflict, the health care system in Syria consisted of a government-run public system that provided mostly primary care services, with the private sector concentrated in urban areas providing the majority of advanced care services... The past three decades were characterized by an improved capacity of the health system, as well as rapidly improving national health indicators such as a falling infant mortality rate and an increased child immunization rate... Yet the onset of the civil war led to the complete deterioration of the health infrastructure through the wide destruction of facilities, the shortage in health care personnel and medicines, and a lack of secure routes and transportation... Rather than providing a safe place of care and refuge, the Syrian health care system has been integrated into the civil war battlefield... At least 160 doctors have been killed and hundreds jailed, leading to the emigration of an estimated 80,000 doctors... The 90% of pharmaceutical needs that were locally produced prior to the conflict has now been reduced to only 10%, contributing to significant drug shortages in essential medications... This has significantly strained local health care systems with insurmountable demands ranging from continued chronic care to the management of spreading communicable diseases... The underfunding of UNHCR (United Nations High Commissioner for Human Rights) and other humanitarian organizations has reduced the medical subsidies to refugees, leading many to forgo necessary yet unaffordable treatment... In response to this outbreak, the biggest immunization campaign in the region's history led to the vaccination of over 2.7 million Syrian children and 23 million in neighboring countries... However, the Syrian conflict and vast population displacement has significantly increased the incidence of the vector-borne disease within Syria and spread this epidemic into neighboring countries.

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Syrian child from a Lebanon refugee camp, presenting multiple lesions from cutaneous leishmaniasis, courtesy of Dr. Ibrahim Khalifeh
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ppat-1004438-g001: Syrian child from a Lebanon refugee camp, presenting multiple lesions from cutaneous leishmaniasis, courtesy of Dr. Ibrahim Khalifeh

Mentions: Lebanon had no cases of cutaneous leishmaniasis before 2008 and sporadic cases in the following years. By 2013, 1,033 cases were confirmed, 96.6% (998) of which were among Syrian refugees [26]. In recently published data on 1,275 patients from 213 displaced Syrian families in Lebanon, the average age among infected individuals was 17 years, with many patients presenting with multiple disfiguring lesions (Figure 1). 77% of the patients manifested the disease after being in Lebanon for more than eight weeks, which is the known incubation period for cutaneous leishmaniasis, suggesting that the sand fly vector was transported to Lebanon with the incoming refugees [31]. Speciation by PCR showed that 85% of cases were caused by Leishmania tropica, with 15% of cases as Leishmania major[31].


War and infectious diseases: challenges of the Syrian civil war.

Sharara SL, Kanj SS - PLoS Pathog. (2014)

Syrian child from a Lebanon refugee camp, presenting multiple lesions from cutaneous leishmaniasis, courtesy of Dr. Ibrahim Khalifeh
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4231133&req=5

ppat-1004438-g001: Syrian child from a Lebanon refugee camp, presenting multiple lesions from cutaneous leishmaniasis, courtesy of Dr. Ibrahim Khalifeh
Mentions: Lebanon had no cases of cutaneous leishmaniasis before 2008 and sporadic cases in the following years. By 2013, 1,033 cases were confirmed, 96.6% (998) of which were among Syrian refugees [26]. In recently published data on 1,275 patients from 213 displaced Syrian families in Lebanon, the average age among infected individuals was 17 years, with many patients presenting with multiple disfiguring lesions (Figure 1). 77% of the patients manifested the disease after being in Lebanon for more than eight weeks, which is the known incubation period for cutaneous leishmaniasis, suggesting that the sand fly vector was transported to Lebanon with the incoming refugees [31]. Speciation by PCR showed that 85% of cases were caused by Leishmania tropica, with 15% of cases as Leishmania major[31].

View Article: PubMed Central - PubMed

Affiliation: Curriculum in Global Studies, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, United States of America.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Syria's ongoing three-year civil war has displaced 6.5 million Syrians, left hundreds of thousands wounded or killed by violence, and created a vacuum in basic infrastructures that will reverberate throughout the region for years to come... Beyond such devastation, the civil war has introduced epidemics of infections that have spread through vulnerable populations in Syria and neighboring countries... In this article, we discuss the growing epidemics of poliomyelitis, measles, and cutaneous leishmaniasis in Syria and the region to examine the impact of conditions of war on the spread of infectious diseases in a public health emergency of global concern... In March 2011, unrest from the Arab Spring found its way to Syria, interrupting over 40 years of political stability and igniting a civil war that continues to ravage the country with no end in sight... Measles, hepatitis A, leishmaniasis, poliomyelitis, meningitis, and scabies have spread through vulnerable populations in Syria and refugee camps in neighboring countries, creating a health crisis that will require immense resources to address (Table 1)... Prior to the conflict, the health care system in Syria consisted of a government-run public system that provided mostly primary care services, with the private sector concentrated in urban areas providing the majority of advanced care services... The past three decades were characterized by an improved capacity of the health system, as well as rapidly improving national health indicators such as a falling infant mortality rate and an increased child immunization rate... Yet the onset of the civil war led to the complete deterioration of the health infrastructure through the wide destruction of facilities, the shortage in health care personnel and medicines, and a lack of secure routes and transportation... Rather than providing a safe place of care and refuge, the Syrian health care system has been integrated into the civil war battlefield... At least 160 doctors have been killed and hundreds jailed, leading to the emigration of an estimated 80,000 doctors... The 90% of pharmaceutical needs that were locally produced prior to the conflict has now been reduced to only 10%, contributing to significant drug shortages in essential medications... This has significantly strained local health care systems with insurmountable demands ranging from continued chronic care to the management of spreading communicable diseases... The underfunding of UNHCR (United Nations High Commissioner for Human Rights) and other humanitarian organizations has reduced the medical subsidies to refugees, leading many to forgo necessary yet unaffordable treatment... In response to this outbreak, the biggest immunization campaign in the region's history led to the vaccination of over 2.7 million Syrian children and 23 million in neighboring countries... However, the Syrian conflict and vast population displacement has significantly increased the incidence of the vector-borne disease within Syria and spread this epidemic into neighboring countries.

No MeSH data available.


Related in: MedlinePlus