Journal Article > LetterFull Text
Lancet. 2013 March 16; Volume 381 (Issue 9870); 901.; DOI:10.1016/S0140-6736(13)60664-9
Fernandez G, Boulle P
Lancet. 2013 March 16; Volume 381 (Issue 9870); 901.; DOI:10.1016/S0140-6736(13)60664-9
Conference Material > Poster
Gohy B, Brodin N, Musambi M, Mafuko JM, Ndiramiye E, et al.
MSF Scientific Days International 2021: Research. 2021 May 18
Conference Material > Abstract
Croft LA, Puig-García M, Silver C, Pearlman J, Stellmach DUS, et al.
MSF Scientific Days International 2022. 2022 May 9; DOI:10.57740/b641-d608
INTRODUCTION
Between 2020 and 2021, MSF’s social sciences team designed and supported implementation of qualitative assessments to better understand community-level outbreak responses and well-being in the context of Covid-19. Assessments were conducted in seven sites, specifically Nigeria, Sierra Leone, Chad, Iraq, Tajikistan, Syria, and Somaliland. Although a single protocol was designed and followed, each site was unique in terms of its setting (e.g. camp, conflict, urban, or rural), who implemented assessments (e.g. field epidemiologists, health promotion staff), timing of implementation (early phase of the pandemic versus late phase), and community involvement. Here we present a synthesis of the assessments to inform future public health responses.
METHODS
Synthesis involved secondary analysis of qualitative reports over five iterative phases. Phase 1 involved in-depth reading of each report, during which analytic annotation and note-taking took place. In Phase 2, each report was coded inductively. In Phase 3, codes were reviewed, defined, and clustered into initial categories and themes. Phase 4 involved reviewing and refining codes, categories, and themes, and establishing connections. In Phase 5, synthesis findings were organised and written up. The process was managed using the software ATLAS.ti.
ETHICS
This synthesis is an a posteriori analysis of secondary data. Ethics approval for primary data was granted by officials in Nigeria, Sierra Leone, Chad, Iraq, Tajikistan, Syria, and Somaliland and the MSF Ethics Review Board.
RESULTS
Overall 138, people participated in the assessments, of which 21 (15%) were women. Participants included health workers, community members, traditional healers, chiefs, young people, women’s leaders and local staff. Four themes were identified: 1) exacerbation of pre-existing vulnerabilities and inequalities; 2) disruption of coping mechanisms; 3) awareness of the risks of Covid-19; 4) community as a public health enabler. The pandemic was seen to magnify existing social inequalities and overall health burden. Public health measures to control the spread of Covid-19 often disrupted community coping mechanisms by causing fear of separation and practical challenges around compliance. Awareness of the risks of Covid-19 and understanding of prevention measures were high, with socio-economic costs of compliance relying on external funding and relief. A community led intervention for effective public health controls varied between sites, depending on previous outbreak experiences (e.g. Ebola and tuberculosis), and/or settings experiencing protracted conflict (e.g. Syria, and Iraq).
CONCLUSION
Our synthesis illustrates syndemic effects of the pandemic. From an operational perspective, there is a need to diversify humanitarian, social, and health interventions, and strengthen approaches to working with communities to identify how best to take forward public health measures in humanitarian settings.
CONFLICTS OF INTEREST
None declared.
Between 2020 and 2021, MSF’s social sciences team designed and supported implementation of qualitative assessments to better understand community-level outbreak responses and well-being in the context of Covid-19. Assessments were conducted in seven sites, specifically Nigeria, Sierra Leone, Chad, Iraq, Tajikistan, Syria, and Somaliland. Although a single protocol was designed and followed, each site was unique in terms of its setting (e.g. camp, conflict, urban, or rural), who implemented assessments (e.g. field epidemiologists, health promotion staff), timing of implementation (early phase of the pandemic versus late phase), and community involvement. Here we present a synthesis of the assessments to inform future public health responses.
METHODS
Synthesis involved secondary analysis of qualitative reports over five iterative phases. Phase 1 involved in-depth reading of each report, during which analytic annotation and note-taking took place. In Phase 2, each report was coded inductively. In Phase 3, codes were reviewed, defined, and clustered into initial categories and themes. Phase 4 involved reviewing and refining codes, categories, and themes, and establishing connections. In Phase 5, synthesis findings were organised and written up. The process was managed using the software ATLAS.ti.
ETHICS
This synthesis is an a posteriori analysis of secondary data. Ethics approval for primary data was granted by officials in Nigeria, Sierra Leone, Chad, Iraq, Tajikistan, Syria, and Somaliland and the MSF Ethics Review Board.
RESULTS
Overall 138, people participated in the assessments, of which 21 (15%) were women. Participants included health workers, community members, traditional healers, chiefs, young people, women’s leaders and local staff. Four themes were identified: 1) exacerbation of pre-existing vulnerabilities and inequalities; 2) disruption of coping mechanisms; 3) awareness of the risks of Covid-19; 4) community as a public health enabler. The pandemic was seen to magnify existing social inequalities and overall health burden. Public health measures to control the spread of Covid-19 often disrupted community coping mechanisms by causing fear of separation and practical challenges around compliance. Awareness of the risks of Covid-19 and understanding of prevention measures were high, with socio-economic costs of compliance relying on external funding and relief. A community led intervention for effective public health controls varied between sites, depending on previous outbreak experiences (e.g. Ebola and tuberculosis), and/or settings experiencing protracted conflict (e.g. Syria, and Iraq).
CONCLUSION
Our synthesis illustrates syndemic effects of the pandemic. From an operational perspective, there is a need to diversify humanitarian, social, and health interventions, and strengthen approaches to working with communities to identify how best to take forward public health measures in humanitarian settings.
CONFLICTS OF INTEREST
None declared.
Conference Material > Slide Presentation
Nasser H, Jha Y, Keane G, Carreño C, Mental Health Working Group
MSF Scientific Days International 2022. 2022 May 10; DOI:10.57740/74t1-zq11
Conference Material > Video (talk)
Nasser H, Jha Y, Keane G, Carreño C, Mental Health Working Group
MSF Scientific Days International 2022. 2022 June 10; DOI:10.57740/z68q-6865
Journal Article > CommentaryFull Text
ATS Sch. 2022 November 15; Volume 3 (Issue 4); 625-630.; DOI:10.34197/ats-scholar.2022-0071CM
Haj-Hassan TA, Mtaweh H, Martinez D, Mema B
ATS Sch. 2022 November 15; Volume 3 (Issue 4); 625-630.; DOI:10.34197/ats-scholar.2022-0071CM
Journal Article > LetterSubscription Only
N Engl J Med. 2008 July 24; Volume 359 (Issue 4); 431-432.; DOI: 10.1056/NEJMc080419
Luquero FJ, Grais RF
N Engl J Med. 2008 July 24; Volume 359 (Issue 4); 431-432.; DOI: 10.1056/NEJMc080419
Journal Article > LetterFull Text
Int J Tuberc Lung Dis. 2021 December 1; Volume 25 (Issue 12); 1041-1042.; DOI:10.5588/ijtld.21.0356
Tesfahun HM, Moussally K, Al-Ani NA, Al-Salhi LG, Kyi HA, et al.
Int J Tuberc Lung Dis. 2021 December 1; Volume 25 (Issue 12); 1041-1042.; DOI:10.5588/ijtld.21.0356
Journal Article > CommentaryFull Text
Lancet Global Health. 2019 December 1; Volume 7 (Issue 12); e1585-e1586.; DOI:10.1016/S2214-109X(19)30452-8
Kadir A, Garcia DM, Romero F
Lancet Global Health. 2019 December 1; Volume 7 (Issue 12); e1585-e1586.; DOI:10.1016/S2214-109X(19)30452-8
Journal Article > ResearchFull Text
PLOS One. 2014 August 11; Volume 9 (Issue 8); DOI:10.1371/journal.pone.0101017
Ronat JB, Kakol J, Khoury M, Yun O, Brown V, et al.
PLOS One. 2014 August 11; Volume 9 (Issue 8); DOI:10.1371/journal.pone.0101017
In low- and middle-income countries, bloodstream infections are an important cause of mortality in patients with burns. Increasingly implicated in burn-associated infections are highly drug-resistant pathogens with limited treatment options. We describe the epidemiology of bloodstream infections in patients with burns in a humanitarian surgery project in Iraq.