世界経済・社会統計 = World development indicators

The global burden of disease.

Critical care and the global burden of critical illness in adults

The relationship between natural disasters and communicable diseases is frequently misconstrued. The risk for outbreaks is often presumed to be very high in the chaos that follows natural disasters, a fear likely derived from a perceived association between dead bodies and epidemics. However, the risk factors for outbreaks after disasters are associated primarily with population displacement. The availability of safe water and sanitation facilities, the degree of crowding, the underlying health status of the population, and the availability of healthcare services all interact within the context of the local disease ecology to infl uence the risk for communicable diseases and death in the affected population. We outline the risk factors for outbreaks after a disaster, review the communicable diseases likely to be important, and establish priorities to address communicable diseases in disaster settings.

/pdf/epidemics-after-natural-disasters-36r7j8g190.pdf

Epidemics after natural disasters.

https://usiraq.procon.org/sourcefiles/MortalityCrossSectional.pdf

Mortality after the 2003 invasion of Iraq: a cross-sectional cluster sample survey

http://conflict.lshtm.ac.uk/media/DRC_mort_2003_2004_Coghlan_Lancet_2006.pdf

Mortality in the Democratic Republic of Congo: a nationwide survey.

Complex humanitarian emergencies have been a major political, security and public health feature of the post-Cold War world. These man-made disasters account for more morbidity and mortality than all natural and technological disasters combined. In order to deliver effective aid during complex humanitarian emergencies, international relief agencies must have a solid understanding of the political and social climates in which they are operating. In addition, they should base their health interventions on objective epidemiological data, especially standardized rates of morbidity and mortality. Most deaths during complex humanitarian emergencies are due to preventable causes, especially increased rates of infectious diseases malnutrition and violent trauma. The most appropriate health interventions are therefore based on the models of public health and primary health care, emphasizing disease prevention and health promotion. The field of humanitarian assistance has become increasingly professionalized in recent years, with its own professional standards, literature, research agenda and training opportunities. It is an unfortunate reflection on the current state of international affairs that the number of complex humanitarian emergencies and the enormous levels of suffering associated with them are unlikely to decline in the foreseeable future.

Complex humanitarian emergencies: A major global health challenge

BACKGROUND: The humanitarian crisis in the Democratic Republic of Congo (DRC) has been among the world's deadliest in recent decades. We conducted our third nationwide survey to examine trends in mortality rates during a period of changing political, security, and humanitarian conditions. METHODS: We used a 3-stage, household-based cluster sampling technique to compare east and west DRC. Sixteen east health zones and 15 west zones were selected with a probability proportional to population size. Four east zones were purposely selected to allow historical comparisons. The 20 smallest population units were sampled in each zone, 20 households in each unit. The number and distribution of households determined whether they were selected using systematic random or random walk sampling. Respondents were asked about deaths of household members during the recall period: January 2006-April 2007. FINDINGS: In all, 14,000 households were visited. The national crude mortality rate of 2.2 deaths per 1000 population per month (95% confidence interval [CI] 2.1-2.3) is almost 70% higher than that documented for DRC in the 1984 census (1.3) and is unchanged since 2004. A small but significant decrease in mortality since 2004 in the insecure east (rate ratio: 0.96, P = .026) was offset by increases in the western provinces and a transition area in the center of the country. Nonetheless, the crude mortality rate in the insecure east (2.6) remains significantly higher than in the other regions (2.0 and 2.1, respectively). Deaths from violence have declined since 2004 (rate ratio 0.7, P = .02). CONCLUSIONS: More than 4 years after the official end of war, the crude mortality rate remains elevated across DRC. Slight but significant improvements in mortality in the insecure east coincided temporally with recent progress on security, humanitarian, and political fronts. Language: en

Update on mortality in the Democratic Republic of Congo: results from a third nationwide survey.

Objectives: To rapidly determine the public health impact of the Asian tsunami on the population of three communities in Aceh Jaya District, Indonesia, and to prioritize health interventions.

Methods:  Rapid health assessment, utilizing direct observations, interviews with key informants, a single focus group discussion, town mapping, a review of medical records and a systematic random sample of the entire town of Calang, capital of Aceh Jaya District, Indonesia.

Results:  Almost 100% of dwellings were destroyed in all three communities. For the town of Calang: only 18.2% of the pre-tsunami population remained 2 weeks following the disaster, with an estimated 70% of the population having died at the time of impact; government estimates of the remaining population were inflated by approximately 250%; mortality rates were not elevated post-tsunami; 100% of the population lacked access to sanitation and clean water; 85% of children under 5 years reported diarrhoea over the preceding 2 week period; 95% of individuals with a medical complaint reported satisfactory access to clinical care; acute malnutrition was not a significant problem; and over one-fifth of households were hosting an orphan. For the villages of Rigah and Sayeung: approximately 46.2 and 86.0% of the population survived the tsunami impact, respectively; mortality rates were not elevated post tsunami; 100% of the population lacked access to sanitation and clean water; diarrhoea was the main cause of morbidity; primary care services were available only in Rigah; and only Rigah had received external assistance.

Conclusions:  Almost two-thirds of the population of the three communities died as a result of the tsunami's impact. Although mortality rates were not elevated post tsunami, significant threats to public health persisted, especially water-borne diseases. Priority activities included emergent environmental health interventions, mobile clinics to the two villages and a more detailed assessment of the needs of orphans. Data were shared with agencies better placed to address needs in the areas of shelter and food aid.

Rapid health assessment in Aceh Jaya District, Indonesia, following the December 26 tsunami

The magnitude 7.6 earthquake that struck northern Pakistan and India on October 8, was the world's third-deadliest natural disaster of the past 25 years. Today only 66 percent of the “flash appeal” issued by the United Nations has been funded. Drs. Richard Brennan and Ronald Waldman write that important needs remain unmet.

Richard J Brennan

Papers

Mortality in the Democratic Republic of Congo: a nationwide survey.

Complex humanitarian emergencies: A major global health challenge

Update on mortality in the Democratic Republic of Congo: results from a third nationwide survey.

Rapid health assessment in Aceh Jaya District, Indonesia, following the December 26 tsunami

The South Asian Earthquake Six Months Later — An Ongoing Crisis