Politicization of water, humanitarian response, and health in Syria as a contributor to the ongoing cholera outbreak

Tarnas, Maia; Karah, Nabil; Almhawish, Naser; Aladhan, Ibrahim; Alobaid, Radwan; Abbara, Aula

doi:10.1016/j.ijid.2023.03.042

Cited by 3 publications

(2 citation statements)

References 8 publications

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“…The health system in Syria has been severely impacted by years of armed conflict and political instability, resulting in limited access to healthcare services for the population. The system is fragmented, with many healthcare facilities destroyed, damaged, or understaffed, leading to inadequate healthcare delivery, and spread of infectious diseases [1] , [2] , [3] . Moreover, On February 06, 2023, a catastrophic earthquake struck the regions of southern and central Turkey and northern and western Syria.…”

Section: Introductionmentioning

confidence: 99%

The cholera outbreak in Syria: a call for urgent actions

et al. 2023

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Section: Introductionmentioning

confidence: 99%

The cholera outbreak in Syria: a call for urgent actions

et al. 2023

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“…5 In February 2023, cholera control in the area was further affected by the severe earthquakes in southeastern Türkiye and northern Syria that caused increased forced displacement, over 8,000 deaths, and interrupted cholera control measures. 6 However, in early March 2023, an oral cholera vaccine campaign that had been delayed due to the earthquakes resumed and ultimately reached 1.7 million people in the area. 7 Our aim is to provide a detailed description of water sources and clinical status of a cohort of patients seen at a cholera treatment center (CTC) in northwest Syria during the 2022 outbreak.…”

Section: Introductionmentioning

confidence: 99%

Geographical Origin, WASH Access, and Clinical Descriptions for Patients Admitted to a Cholera Treatment Center in Northwest Syria between October and December 2022

Hmaideh,

Tarnas,

Zakaria

et al. 2023

Avicenna J Med

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Background On September 10, 2022, a cholera outbreak was declared in Syria for the first time in over a decade of protracted conflict. As of May 20, 2023, 132,782 suspected cases had been reported, primarily in northwest and northeast Syria. We aim to provide a detailed description of water sources and clinical status of a patient cohort seen at a cholera treatment center (CTC) in northwest Syria. Methods We retrospectively identified patients with confirmed cholera who presented to the CTC in Idlib governorate between October 8 and December 18, 2022. Data were obtained from clinical case records and analyzed in R v4.0.4. Results Ninety-four patients (55.3% men) were treated at the CTC. Thirty-five patients were severely dehydrated (Plan C treatment), 54 had some dehydration (Plan B), and 5 had no dehydration (Plan A). Most patients were between 11 and 20 years old (n = 25, 26.6%) or 31 and 40 years old (n = 19, 20.2%). Note that 70.2% (n = 66) of patients were seen in November 2022 and most were from Harim district (n = 44, 46.8%). Public wells (n = 46, 48.9%) and water trucking (n = 41, 43.6%) were the most commonly used water sources. Note that 76.6% (n = 72) did not have access to chlorine-treated water. Forty-seven patients (50%) had more than five water, sanitation, and hygiene (WASH)-related cholera risk factors. Following treatment, six patients were transferred to another treatment center, three died (case fatality rate: 3.2%), and the remainder were discharged. Conclusion Most patients reported WASH-related risk factors for cholera, reflecting the poor state of WASH in northwest Syria after over a decade of conflict. This relates to the direct and indirect impacts of urban and periurban violence as well as the underfunded humanitarian response. Strengthening WASH and health promotion are important components to control the outbreak.

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