Multidrug-Resistant Pathogens in Hospitalized Syrian Children

Kassem, Diana Faour; Hoffmann, Yoav; N, Shahar; S, Ocampo; Salomon, Liora; Zonis, Zeev; Glikman, Daniel

doi:10.3201/eid2301.161204

Cited by 32 publications

(22 citation statements)

References 9 publications

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“…FETP-Frontline training for surveillance officers has been implemented throughout Africa, Latin America, and elsewhere in response to the Ebola epidemic in West Africa, the Zika virus threat in the Americas, and the adoption of the GHSA (a global initiative to strengthen capacity to prevent, detect, and respond to public health threats). As of the end of 2016, a total of 24 new Frontline programs had been established and 1,354 surveillance staff had been trained ( 16 ).…”

Section: Building Field Epidemiology Capacity Globallymentioning

confidence: 99%

Building Global Epidemiology and Response Capacity with Field Epidemiology Training Programs

Jones¹,

Dicker²,

Fontaine³

et al. 2017

Emerg. Infect. Dis.

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More than ever, competent field epidemiologists are needed worldwide. As known, new, and resurgent communicable diseases increase their global impact, the International Health Regulations and the Global Health Security Agenda call for sufficient field epidemiologic capacity in every country to rapidly detect, respond to, and contain public health emergencies, thereby ensuring global health security. To build this capacity, for >35 years the US Centers for Disease Control and Prevention has worked with countries around the globe to develop Field Epidemiology Training Programs (FETPs). FETP trainees conduct surveillance activities and outbreak investigations in service to ministry of health programs to prevent and control infectious diseases of global health importance such as polio, cholera, tuberculosis, HIV/AIDS, malaria, and emerging zoonotic infectious diseases. FETP graduates often rise to positions of leadership to direct such programs. By training competent epidemiologists to manage public health events locally and support public health systems nationally, health security is enhanced globally.

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Section: Building Field Epidemiology Capacity Globallymentioning

confidence: 99%

Building Global Epidemiology and Response Capacity with Field Epidemiology Training Programs

Jones¹,

Dicker²,

Fontaine³

et al. 2017

Emerg. Infect. Dis.

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“…Syrian refugee patients screened in Europe have shown higher rates of carbapenemase-producing Enterobacteriaceae (CPEs) compared with local populations (Kassem et al, 2017;Angeletti et al, 2016;Ravensbergen et al, 2016;Reinheimer et al, 2016;Heudorf et al, 2016;Tenenbaum et al, 2016;Heydari et al, 2015). Estimates of MDR carriage within paediatric and adult populations in these studies range from 33% to 83%, with high rates of New Delhi metallo-beta-lactamase (NDM)-producing carbapenem-resistant Enterobacteriaceae (CRE), A. baumannii, and ESBL-producing Enterobacteriaceae (Rafei et al, 2014;Kassem et al, 2017;Angeletti et al, 2016;Ravensbergen et al, 2016;Reinheimer et al, 2016;Heudorf et al, 2016;Tenenbaum et al, 2016). This is significantly greater than the background carriage rates of the local populations such as in Germany, where colonization with MDR Gram-negatives was identified in 60.8% of a refugee population (of whom 18.6% were Syrian) screened on admission to hospital versus 16.8% in the general population (Ravensbergen et al, 2016).…”

Section: Tablementioning

confidence: 99%

A summary and appraisal of existing evidence of antimicrobial resistance in the Syrian conflict

Abbara

Rawson

Karah

et al. 2018

International Journal of Infectious Diseases

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Antimicrobial resistance (AMR) in populations experiencing war has yet to be addressed, despite the abundance of contemporary conflicts and the protracted nature of twenty-first century wars, in combination with growing global concern over conflict-associated bacterial pathogens. The example of the Syrian conflict is used to explore the feasibility of using existing global policies on AMR in conditions of extreme conflict. The available literature on AMR and prescribing behaviour in Syria before and since the onset of the conflict in March 2011 was identified. Overall, there is a paucity of rigorous data before and since the onset of conflict in Syria to contextualize the burden of AMR. However, post onset of the conflict, an increasing number of studies conducted in neighbouring countries and Europe have reported AMR in Syrian refugees. High rates of multidrug resistance, particularly Gram-negative organisms, have been noted amongst Syrian refugees when compared with local populations. Conflict impedes many of the safeguards against AMR, creates new drivers, and exacerbates existing ones. Given the apparently high rates of AMR in Syria, in neighbouring countries hosting refugees, and in European countries providing asylum, this requires the World Health Organization and other global health institutions to address the causes, costs, and future considerations of conflict-related AMR as an issue of global governance.

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“…66 The first contact to antibiotics often occurs in a Syrian field hospital, where the choice of antibiotic drug mostly depends on its availability and not on the potential microorganism. 49,67 For further health care contacts along the route, the same principals of antibiotic therapy apply. Furthermore, the laboratories in these field hospitals do not have the ability to test antibiotic resistances, due to the lack of equipment and monetary resources.…”

Section: Infectious Diseasesmentioning

confidence: 99%

Understanding Refugees' Health

Mûller

Khamis²,

Srivastava

et al. 2018

Semin Neurol

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According to the United Nations Refugee Agency (UNHCR), 65.6 million people have been forcibly displaced worldwide. Several factors have a major influence on asylum seekers' health; so, their health profile is markedly different from that of the population in the country of asylum. The aim of this study is to review the major issues physicians need to be aware of when treating asylum seekers, with a special focus on the neurological problems of asylum seekers and refugees. The major impact factors on refugees' health are linked to experiences and exposure (1) in the country of origin, (2) in refugee camps and en route to Europe, and (3) in the process of immigration into the host country and living in European asylum centers. Refugees' health is also affected by psychological problems and by infectious diseases. Additionally, chronic diseases resulting in polymorbidity, cancer, and neurological diseases are easy to overlook and demand special attention. Neurological injuries/diseases may be traumatic (e.g., spinal cord injuries), posttraumatic (e.g., chronic pain syndromes), the result of cerebral infections, or the consequences of starvation (e.g., epilepsy, ataxia, and paraesthesia). The main challenges for physicians are lack of awareness of the asylum seekers' specific health care problems, language and intercultural communication problems, as well as access and integration of asylum seekers into the health care system. The health issues of asylum seekers are manifold and challenging to physicians. Awareness of these conditions is mandatory to ensure good clinical practice for this patient population, which has a huge burden in chronic, infectious, mental, and neurological diseases.

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Multidrug-Resistant Pathogens in Hospitalized Syrian Children

Cited by 32 publications

References 9 publications

Building Global Epidemiology and Response Capacity with Field Epidemiology Training Programs

Building Global Epidemiology and Response Capacity with Field Epidemiology Training Programs

A summary and appraisal of existing evidence of antimicrobial resistance in the Syrian conflict

Understanding Refugees' Health

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