Stopping a polio outbreak in the midst of war: Lessons from Syria

Mbaeyi, Chukwuma; Moran, Thomas J.; Wadood, Zubair; Ather, Fazal; Sykes, Emma; Nikulin, Joanna; Safadi, Mohammad Al; Stehling-Ariza, Tasha; Zomahoun, Laurel; Ismaili, Abdelkarim; Abourshaid, Nidal; Asghar, Humayun; Korukluoğlu, Gülay; Duizer, Erwin; Ehrhardt, Derek; Burns, Cara C.; Sharaf, Magdi

doi:10.1016/j.vaccine.2021.05.045

Cited by 9 publications

(13 citation statements)

References 33 publications

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“…Despite a decade-long civil war, Syria has successfully interrupted two major polio outbreaks within months of their identification. 29 The first, an outbreak of wild poliovirus that was first identified among a cluster of acute flaccid paralysis cases in October 2013, was controlled following a large-scale multinational vaccination drive that involved eight countries in the Middle East region. Although the outbreak spread from Syria to neighboring Iraq, it was effectively contained by April 2014, when the last case of two cases identified in Iraq was reported, the last of 36 cases in Syria having been reported in January 2014.…”

Section: Findings and Discussionmentioning

confidence: 99%

“…In these countries, special vaccination activities targeting refugee populations in camps and settlements were also conducted. 14 , 29 …”

Section: Findings and Discussionmentioning

confidence: 99%

“…Strategic responses to these outbreaks, primarily utilizing oral poliovirus vaccine (OPV), have yielded varied results. Responses in Syria and Iraq resulted in successful interruption of outbreak poliovirus transmission, 14 , 28 , 29 whereas results in places like the Democratic Republic of Congo and the Horn of Africa have been mixed, 30–32 with initial successes undercut by subsequent setbacks. Conflict, while a driver of polio outbreaks and a hindrance to responses in each of these countries, has been surmountable to varying extents.…”

Section: Introductionmentioning

confidence: 99%

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Polio vaccination activities in conflict-affected areas

Mbaeyi

2023

Human Vaccines & Immunotherapeutics

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Conflict poses a threat to the stability of health-care systems around the world. Within the context of immunization service delivery, conflict-affected geographies are often dogged by recurrent disease outbreaks due to the inability to administer life-saving vaccines to children residing in these areas. Essential immunization coverage is often poor in conflict-affected geographies, and within the specific context of the Global Polio Eradication Initiative (GPEI), multiple rounds of supplementary immunization activities are often needed to compensate for the inability to provide adequate immunization services. In order to implement polio vaccination activities, GPEI has often resorted to innovative approaches to reach and vaccinate children in security-compromised areas. This article examines the approaches adopted by the global polio program in conducting vaccination activities in conflict-affected geographies with the aim of understanding how they have influenced the successes and setbacks of the program in its bid to eradicate all polioviruses.

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Section: Findings and Discussionmentioning

confidence: 99%

“…In these countries, special vaccination activities targeting refugee populations in camps and settlements were also conducted. 14 , 29 …”

Section: Findings and Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Polio vaccination activities in conflict-affected areas

Mbaeyi

2023

Human Vaccines & Immunotherapeutics

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“…It is known that the epidemiology of infectious diseases changes when access to health services and health resources are limited in war and other conflict environments. Possible increases in the prevalence of vaccine-preventable diseases such as measles and polio in conflict situations such as Syria and recently Ukraine raise concerns all over the world [ 24 , 25 , 26 ]. Many infectious diseases, such as HIV, antibiotic resistance, multi-resistant tuberculosis, and HCV, are also expected to be affected by mass migration movements that occur under unsuitable conditions [ 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Burkholderia cepacia Complex Infections in Urgently Referred Neonates from Syrian Border Regions to a Hospital in Turkey: A Cross-Border Cluster

Çetin

Orman

2022

Children

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Burkholderia cepacia complex (BCC) is a rare cause of sepsis in neonates, but infections are usually severe. It can be encountered unexpectedly when adequate health care is not provided. In this study, 49 neonatal cases with blood culture-proven BCC bacteremia within the first 72 h following admission to the neonatal intensive care unit between June 2017 and December 2018 were retrospectively analyzed in detail. All but one of the cases were born in Jarabulus, Al Bab, or Aleppo in Syria and were referred to Turkey due to urgent medical treatment needs. The rate of BCC bacteremia among the neonates transferred from across the border was 16.1% (48/297). The most common coexisting problems in the cases were multiple congenital malformations (12.2%), gastrointestinal system atresia (8.2%), and congenital heart diseases (4.1%). The median age at the time of their admission in Turkey was three days, and the median length of stay in another center before the referral was 11.5 h. The case fatality rate was 14.3%. In this study, a high rate of BCC infection and associated mortality was seen in neonates referred from cross-border regions. For centers accepting cases from conflict-affected regions, it is crucial to be careful regarding early detection of bacteremia, planning appropriate treatments, and preventing cross-contamination risks within the unit.

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“…During wartime, infectious disease outbreaks are more likely to occur, [25][26][27][28] possibly from delayed or interrupted vaccinations or disruption to clean sources of water, as well as crowded quarters. Botulism outbreak was reported, 23 people were infected and two people died.…”

Section: Healthcare Infrastructure and Disruption To Delivery Of Heal...mentioning

confidence: 99%

The human toll and humanitarian crisis of the Russia-Ukraine war: the first 162 days

et al. 2022

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BackgroundWe examined the human toll and subsequent humanitarian crisis resulting from the Russian invasion of Ukraine, which began on 24 February 2022.MethodWe extracted and analysed data resulting from Russian military attacks on Ukrainians between 24 February and 4 August 2022. The data tracked direct deaths and injuries, damage to healthcare infrastructure and the impact on health, the destruction of residences, infrastructure, communication systems, and utility services – all of which disrupted the lives of Ukrainians.ResultsAs of 4 August 2022, 5552 civilians were killed outright and 8513 injured in Ukraine as a result of Russian attacks. Local officials estimate as many as 24 328 people were also killed in mass atrocities, with Mariupol being the largest (n=22 000) such example. Aside from wide swaths of homes, schools, roads, and bridges destroyed, hospitals and health facilities from 21 cities across Ukraine came under attack. The disruption to water, gas, electricity, and internet services also extended to affect supplies of medications and other supplies owing to destroyed facilities or production that ceased due to the war. The data also show that Ukraine saw an increase in cases of HIV/AIDS, tuberculosis, and Coronavirus (COVID-19).ConclusionsThe 2022 Russia-Ukraine War not only resulted in deaths and injuries but also impacted the lives and safety of Ukrainians through destruction of healthcare facilities and disrupted delivery of healthcare and supplies. The war is an ongoing humanitarian crisis given the continuing destruction of infrastructure and services that directly impact the well-being of human lives. The devastation, trauma and human cost of war will impact generations of Ukrainians to come.

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Stopping a polio outbreak in the midst of war: Lessons from Syria

Cited by 9 publications

References 33 publications

Polio vaccination activities in conflict-affected areas

Polio vaccination activities in conflict-affected areas

Burkholderia cepacia Complex Infections in Urgently Referred Neonates from Syrian Border Regions to a Hospital in Turkey: A Cross-Border Cluster

The human toll and humanitarian crisis of the Russia-Ukraine war: the first 162 days

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