Abstract
Background Conflict in Nigeria displaced millions of people, and some settled in camp-like locations within the country. Evidence on the association between living conditions and health outcomes among these populations are limited. This study investigated the risk factors associated with illnesses among camp-dwelling internally displaced persons (IDPs) in northern Nigeria. Methods A cross-sectional study was conducted in nine camps in 2016. Self-reported data on socio-demography, resource utilization and disease outcomes were collected. Association between health conditions and various factors, including sanitation and healthcare access, was investigated. Results Data from 2253 IDPs showed 81.1% (CI=79.5-82.7) experienced one or more health conditions; however, over 20% did not access healthcare services. Most common diseases were malaria, fever, typhoid and diarrhoea. Multivariable logistic regression presented as adjusted odds ratios(aOR) and 95% confidence intervals(CIs) showed factors significantly associated with increased likelihood of illnesses included being female (aOR=1.53;CI=1.19-1.96), overcrowding (aOR=1.07;CI=1.00-1.36), long-term conditions (aOR=2.72;CI=1.88-3.94), outdoor defecation (aOR=2.37;CI=1.14-4.94) and presence of disease-causing vectors (aOR=3.71;CI=1.60-8.60). Conclusion Most diseases in the camps were communicable. Modifiable risk factors such as overcrowding and poor toilet facilities were associated with increased poor health outcomes. This evidence highlights areas of high priority when planning humanitarian public health interventions.
Highlights
An increase in conflict-related human displacement has prompted the need to consider conflict as a determinant of health.[1,2] Over 40 million people have been internally displaced by conflict and violence globally, including approximately two million from the Boko Haram crisis in northern Nigeria.[3,4] Most displaced populations remain within the affected countries as internally displaced persons (IDPs) or migrate to other countries as refugees and asylum seekers.[5]
Participant characteristics A total of 2,253 IDPs were included in the study and gender representation was similar [Table 1]
What is already known on this topic? These observations corroborate with the findings reported in the review by Connolly et al which outlined the risk factors for communicable diseases in complex emergencies.[12]
Summary
An increase in conflict-related human displacement has prompted the need to consider conflict as a determinant of health.[1,2] Over 40 million people have been internally displaced by conflict and violence globally, including approximately two million from the Boko Haram crisis in northern Nigeria.[3,4] Most displaced populations remain within the affected countries as internally displaced persons (IDPs) or migrate to other countries as refugees and asylum seekers.[5]. This study investigated the risk factors associated with illnesses among camp-dwelling internally displaced persons (IDPs) in northern Nigeria. Association between health conditions and various factors, including sanitation and healthcare access, was investigated Results: Data from 2,253 IDPs showed 81.1% (CI=79.5–82.7) experienced one or more health conditions; over 20% did not access healthcare services. Multivariable logistic regression presented as adjusted odds ratios(aOR) and 95% confidence intervals(CIs) showed factors significantly associated with increased likelihood of illnesses included being female (aOR=1.53;CI=1.19–1.96), overcrowding (aOR=1.07;CI=1.00–1.36), long-term conditions (aOR=2.72;CI=1.88–3.94), outdoor defecation (aOR=2.37;CI=1.14–4.94), and presence of disease-causing vectors (aOR= 3.71;CI=1.60–8.60). Conclusion: Most diseases in the camps were communicable Modifiable risk factors such as overcrowding and poor toilet facilities were associated with increased poor health outcomes. This evidence highlights areas of high priority when planning humanitarian public health interventions
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