Diagnoses, infections and injuries in Northern Syrian children during the civil war: A cross-sectional study

Abstract

BackgroundThe civil war in Syria including the deliberate targeting of healthcare services resulted in a complex humanitarian emergency, seriously affecting children's health. The objectives of this study are to document diagnoses and disease categories in Northern Syrian children after four years of conflict, and to document infectious diseases and injuries in this vulnerable population.MethodsIn a prospective cross-sectional observational sample study conducted in May 2015, healthcare workers registered demographics, comorbidities, and diagnoses (categorised according to the International Classification of Diseases version 10) in children visited at home and in internally displaced persons camps in four Syrian governorates.ResultsOf 1080 filled-out records, 1002 were included. Children originated from Aleppo (41%), Idleb (36%), Hamah (15%) and Lattakia (8%). Median age was 6 years (0–15; IQR 3–11), 61% were boys, 40% were younger than 5 years old. Children suffered from respiratory (29%), neurological (19%), digestive (17%), eye (5%) and skin (5%) diseases. Clinical malnutrition was seen in 4%, accidental injury in 3%, intentional injury in 1%, and mental disorders in 2%. Overall, 64% had features of infectious diseases (OR 0.635; CI 0.605–0.665). Most common comorbidities were chronic respiratory diseases (14, malnutrition (5%), acute flaccid paralysis (5%), and epilepsy (4%). Logistic regression analysis indicated that the risk for children to have communicable diseases was higher in Aleppo than in Idleb (OR 1.7; CI 1.2–2.3), Hamah (OR 4.9; CI 3.3–7.5), or Lattakia (OR 5.5; CI 3.3–9.3). Children in Aleppo and Lattakia were more at risk to be injured than in Idleb (OR 5.6; CI 2.1–14.3), or in Hamah (OR 5.9; CI 1.4–25.6), but more often from intentional violence in Lattakia. Mental problems were more prominent in Hamah.ConclusionsFour years far in the conflict, 64% of the studied children in four Northern Syrian governorates suffer from infections, mostly from respiratory, neurological and digestive origin, while 4% was injured or victim of intentional aggression. Substandard living conditions and the lack of paediatric healthcare put Syrian children at risk for serious infections, epidemics and morbidity, and ask for urgent international humanitarian relief efforts.

Understanding the health needs of internally displaced persons: A scoping review

“…Research from northern Syria found 28.4% of adults had an NCD diagnosis ( Vernier et al., 2019 ). Other studies have explored NCDs among populations known to comprise IDPs but have not explicitly disaggregated displaced from non-displaced populations ( van Berlaer et al., 2017 ; Ansbro et al., 2019 ).…”

Frugal Medical Technologies and Adaptive Solutions: Field-Based Applications

“…The impact of humanitarian emergencies on a population's health is severe and exacerbated by increases in food insecurity, population displacement, crowding and poor access to water and sanitation, lack of resistance to infection, the physical and psychological effects of weapons and exposure to violence, and the collapse of basic healthcare services (Van Berlaer et al 2017). The impact of humanitarian emergencies on health workers and service provision is also extensive and includes the destruction of health facilities, infrastructure, shortages in drugs and equipment, loss of health staff, and restricted access to healthcare (Van Berlaer et al 2017). Very often during periods of humanitarian crisis, particularly in that of resource-poor settings, we see a catastrophic failure in healthcare provisional services.…”

Effectiveness of Community Nutrition-Specific Interventions on Improving Malnutrition of Children under 5 Years of Age in the Eastern Mediterranean Region: A Systematic Review and Meta-Analysis

“…Another review from six selected countries in the region showed different ranges of wasting (1.1 to 11.8%), stunting (7.3 to 9.3%), and underweight (1.6 to 5.3%) across these countries [13]. In the meantime, there are many children in the region who are suffering from poor nutrition because of war and conflicts, as well as poverty, specifically in Iraq, Syria, Yemen, Palestine, and Afghanistan [21][22][23]. A number of efforts have been made to combat child malnutrition in the region.…”