Allergic Rhinitis and Its Epidemiological Distribution in Syria: A High Prevalence and Additional Risks in War Time

Zohbi

Alyousbashi

et al. 2020

Preprint

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The Syrian crisis has entered its tenth year with incessant conflicts in many locations across Syria. Much of the population have been impacted including children who suffer the direct and indirect war effects of war. To date there has been no large scale study examining the mental health and academic impacts of the war of children in Syria. This large-scale cross-sectional study aims to evaluate the psychological profile of school students in Damascus Syria examining PTSD, anger and general mental health and examine their relationships with work, smoking and academic performance. The study included 1369 students from seven different schools. Surveys included assessment of mental and physical well-being using a measure of health related quality of life (SF8), Posttraumatic stress disorder (CRIES-13), problematic anger (DAR5) smoking, working habits, social support and academic grades. The study found that more than half of the children suffered from PTSD (53%), problematic anger (62%) with this being associated with poorer SF-8 (quality of life) scores in both mental and physical domains and more time watching TV and Internet. Around 46% declared fair or worse general health and 61% having moderate or severe mental health. War variables had an impact on PTSD, anger, and SF-8, but not an impact on grades. Worse HRQL was associated with war variables and smoking. Social support was negatively correlated with SF-8, PTSD, DAR-5 anger and declarations of close friends being the main source of support. This is the largest study of children is Syria to date that reports on the psychological ramification of war. The study demonstrates the severe impact on children across both mental health and physical health. Although direct war effect could not be observed, the high burden of PTSD and anger distress is a strong reflection of the chronic mental trauma. School students have had to work and face many hurdles in a young age which has left them severely impacted.

Section: Ptsdmentioning

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Posttraumatic stress disorder (PTSD), anger and Mental health of school students in Syria after ten years of conflict: a large scale school-based study

Zohbi

Alyousbashi

et al. 2020

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“…In patients with LPR, males comprised of 20.5% (CI 95%: 15.4-26.1), females comprised of 79.5% (CI 95%: 73.9-84.6), cigarette smoking comprised of 21.4% (CI 95%: 16.2-26.9) shisha smoking comprised of 33.3% (CI 95%: 27.4-39.7), subjects with asthma comprised of 4.3% (CI 95%: 2.1-7.3), and subjects with allergic reactions comprised of 8.1% (CI 95%: 4. [7][8][9][10][11][12].…”

Section: Resultsmentioning

confidence: 99%

“…The high prevalence of smoking may be a factor of the high prevalence of LPR in Syria (9), mainly that there are no strong regulations to prevent smoking, causing a high exposure to second-hand smoking which could not be measured in our study. Another theory is that as allergic rhinitis is very common in Syria (11), and that allergic rhinitis and LPR may be correlated (24) which could explain this nding. We also speculate that the high psychological stress that Syrians face with high prevalence of severe mental disorder from war (12), this could cause dyspepsia and exaggerating of GORD symptoms which can mimic LPR.…”

Section: Discussionmentioning

confidence: 99%

Laryngopharyngeal Reflux Disease in War-torn Syria and its Association with Smoking and other Risks.

Alhalabi

Alyousbashi

et al. 2020

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Backgrounds: Syria has entered its ninth year of conflict and as its medical sector facing major hurdles, laryngopharyngeal reflux (LPR) is often overlooked although it has an association with worsening quality of life and affecting many aspects as it is chronic and left untreated although it can lead to many complications such as dysphonia. This study is to evaluate LPR prevalence and its association with different aspects such as cigarette, and shisha smoking, and the effect of war on LPR.Methods: Cross-sectional study by using online questionnaires that included demographics, smoking, war related questions and reflux symptom index (RSI) were used online in many cities around Syria.Findings: This research included 734 responders with 75.5% being female and the mean age being 23.97 years. 31.9% of subjects had symptoms suggestive of LPR. Participants were Syrians and we included every responder who agreed and did not neglect any question. We only found that being distressed from war noises was associated with positive LPR symptoms [P=0.009 (OR, 1.562; 95% CI 1.117-2.183)], but losing someone or changing place of living due to war were not associated with LPR. LPR was associated with cigarette smoking (P<0.05). Finally, having asthma, and male gender in the younger population were associated with LPR (P<0.05). No clear association with age, or shisha and no significant associations were found with consanguinity, marital status, educational level and SES.Interpretations: About one third had LPR symptoms. War distress from war noise, cigarette smoking, asthma, and allergic were significantly correlated with LPR.

“…Other studies In Syria found that dental and genitival health deteriorated more in patients with PTSD and mental disorders (44)(45)(46). Another study found around 50% of the population had allergic rhinitis which could be from the indirect or direct effects of war or the unique environment (47). Smoking is also common among the Syrian population, mainly social shisha smoking which could a methods to get away from the daily stress, mainly among university students (48).…”

Section: Outcomes Of the Psychological Burdenmentioning

confidence: 99%

Mental disorder and PTSD in Syria during wartime: a nationwide crisis

Zohbi

Aldeen

et al. 2020

Preprint

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Background: Syria has experienced war since 2011, leaving over 80% under the poverty line and millions being displaced. War and its retaliations have significantly impacted the mental health of Syrians. This study evaluates the post-traumatic stress disorder (PTSD), and the severity of the mental distress caused by war and other factors such as low social support. This study also evaluates other variables and compare the findings with multiple studies of Syria and refugees. Methods: This is a cross-sectional study that included people who lived in Syria from different provinces. Online surveys on multiple online groups included Kessler 10 (K10) questionnaire, the Screen for Posttraumatic Stress Symptoms (SPTSS) tool, the Multidimensional Scale of Perceived Social Support, and demographic and war-related questionnaires. Results: Our study included 1951 participants, of which, 527 (27.0%) were males and 1538 (78.8%) aged (19-25) years. Among participants, 44% had severe mental disorder, 27% had both severe mental disorder and full PTSD symptoms, 36.9% had full PTSD symptoms, and only 10.8% had neither positive PTSD symptoms nor mental disorder on the K10 scale. Around 23% had low overall support. Half of the responders were internally displaced, and 27.6% were forced to change place of living three times or more due to war. Around 86.6% of the responders believed that the crisis was the main reason for their mental distress. Those with high SPTSS and K10 scores were found to take more days off from work or school due to negative feelings and having somatic symptoms. Moreover, the number of times changing places of living due to war, educational level, and being distressed by war noise were the most important factors for more sever PTSD and mental distress. No differences in PTSD and mental disorder prevalence was noted between provinces or type of job. A strong correlation (r=0.623) was found between SPTSS and K10 scores. Conclusion: The conflict in Syria has left the population at a great risk for mental distress which was more severe compared to Syrian refugees elsewhere. Many measures with an emphasis on mental health are needed to aid the people against a long-term avoidable suffering.