Abstract
BackgroundThe United Nations Refugee Agency (UNHCR) estimates the number of forcibly displaced people increased from 22.7 million people in 1996 to 67.7 million people in 2016. Human mobility is associated with the introduction of infectious disease pathogens. The aim of this study was to describe the range of pathogens in forcibly displaced populations over time using an informal event monitoring system.MethodsWe conducted a retrospective analysis of ProMED, a digital disease monitoring system, to identify reports of outbreak events involving forcibly displaced populations between 1996 and 2016. Number of outbreak events per year was tabulated. Each record was assessed to determine outbreak location, pathogen, origin of persons implicated in the outbreak, and suspected versus confirmed case counts.ResultsOne hundred twenty-eight independent outbreak events involving forcibly displaced populations were identified. Over 840,000 confirmed or suspected cases of infectious diseases such as measles, cholera, cutaneous leishmaniasis, dengue, and others were reported in 48 destination countries/territories. The average rate of outbreak events concerning forcibly displaced persons per total number of reports published on ProMED per year increased over time. The majority of outbreak events (63%) were due to acquisition of disease in the destination country.ConclusionThis study found that reports of outbreak events involving forcibly displaced populations have increased in ProMED. The events and outbreaks detected in this retrospective review underscore the importance of capturing displaced populations in surveillance systems for rapid detection and response.
Highlights
The United Nations Refugee Agency (UNHCR) estimates the number of forcibly displaced people increased from 22.7 million people in 1996 to 67.7 million people in 2016
The average rate of outbreak events per total number of reports published on Program for Monitoring Emerging Diseases (ProMED) each year increased by 322% (p < 0.05)
Outbreak events reported on ProMED and outbreak events involving displaced populations reported on ProMED per total number of ProMED reports from 1996 to 2016 are shown in Fig. 2a and b
Summary
The United Nations Refugee Agency (UNHCR) estimates the number of forcibly displaced people increased from 22.7 million people in 1996 to 67.7 million people in 2016. Human mobility is associated with the introduction of infectious disease pathogens. The aim of this study was to describe the range of pathogens in forcibly displaced populations over time using an informal event monitoring system. Human mobility has long been associated with the introduction of infectious disease pathogens, transmission, and propagation globally. Severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and Zika virus are contemporary examples of Infectious disease surveillance among forcibly displaced populations is challenging. Disease surveillance methodologies for displaced populations vary; some recent studies have assessed outbreaks using formal, laboratory-based, and syndromic surveillance to identify events in specific locations and over defined time periods [6,7,8,9]. A comprehensive analysis regarding the occurrence and extent of outbreaks of infectious diseases in forcibly displaced populations over time is lacking in the published literature
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