目的:本研究旨在调查复杂紧急情况(CE)情况下具有流行潜力的传染病的影响,重点关注发病率和死亡率的流行病学概况,并探索导致流行病风险增加的潜在因素。
方法:使用系统评论和Meta分析的首选报告项目进行范围审查(PRISMA-ScR)指南,我们对1990年至2022年间发表的文章进行了范围审查.搜索包括与复杂紧急情况相关的术语,传染病,爆发,和流行病。我们确定了在32个不同国家发生的92种与CE相关的流行病。
结果:志贺氏菌病等传染病,霍乱,麻疹,脑膜炎球菌性脑膜炎,黄热病,和疟疾造成了显著的发病率和死亡率。腹泻病,特别是霍乱和志贺氏菌病,发病率最高。志贺氏菌的发病率为241.0/1000(高危人群),死亡率为11.7/1000,而霍乱的发病率为13.0/1000,死亡率为0.22/1000。随之而来的是麻疹,发病率为25.0/1000,死亡率为0.76/1000。脑膜炎球菌性脑膜炎的发病率为1.3/1000,死亡率为0.13/1000。尽管他们的发病率较低,黄热病为每1000人0.8,疟疾为每1000人0.4,它们的高病死率20.1%和0.4%在CE仍然令人担忧。定性综合显示,水等因素,卫生,和卫生,避难所和定居点,食物和营养,在复杂的紧急情况下,公共卫生和医疗保健会影响流行病的风险。
结论:复杂紧急情况下的流行病可能导致公共卫生危机。在1990年至2022年之间,发病率趋势没有统计学上的显着变化,死亡率,或CE流行病的死亡率。至关重要的是要了解,在CE中确定的所有流行病都是可以从根本上预防的。
OBJECTIVE: This study aimed to investigate the impact of communicable diseases with epidemic potential in complex emergency (CE) situations, focusing on the epidemiological profile of incidence and mortality and exploring underlying factors contributing to increased epidemic risks.
METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Review (PRISMA-ScR) guidelines, we conducted a scoping review of articles published between 1990 and 2022. The search included terms related to complex emergencies, communicable diseases, outbreaks, and epidemics. We identified 92 epidemics related to CE occurring in 32 different countries.
RESULTS: Communicable diseases like Shigellosis, Cholera, Measles, Meningococcal meningitis, Yellow Fever, and Malaria caused significant morbidity and mortality. Diarrhoeal diseases, particularly Cholera and Shigellosis, had the highest incidence rates. Shigella specifically had an incidence of 241.0 per 1000 (people at risk), with a mortality rate of 11.7 per 1000, while Cholera\'s incidence was 13.0 per 1000, with a mortality rate of 0.22 per 1000. Measles followed, with an incidence of 25.0 per 1000 and a mortality rate of 0.76 per 1000. Meningococcal Meningitis had an incidence rate of 1.3 per 1000 and a mortality rate of 0.13 per 1000. Despite their lower incidences, yellow fever at 0.8 per 1000 and malaria at 0.4 per 1000, their high case fatality rates of 20.1% and 0.4% remained concerning in CE. The qualitative synthesis reveals that factors such as water, sanitation, and hygiene, shelter and settlements, food and nutrition, and public health and healthcare in complex emergencies affect the risk of epidemics.
CONCLUSIONS: Epidemics during complex emergencies could potentially lead to a public health crisis. Between 1990 and 2022, there have been no statistically significant changes in the trend of incidence, mortality, or fatality rates of epidemic diseases in CE. It is crucial to understand that all epidemics identified in CE are fundamentally preventable.