Ahmed Fawzi ISMAEL, Abdel Hady El GILANY

Çad'da ki Orta Afrikalı mülteciler arasında cilt hastalıkları seyri

Amaç: :Bu çalışmada Güney Çad'da bulunan kamplarındaki dermatoloji kliniğine başvuran mülteciler arasındaki cilt hastalıklarının seyrini tanımlamak amaçlanmıştır. Yöntem: Klinik tabanlı bir tanımlayıcı olan bu çalışma ,Güney Çad'da Orta Afrika Cumhuriyeti'nden gelen mültecilerin bulunduğu iki kampta gerçekleştirilmiştir. Tanılar klinik muayene ile bir dermatolog tarafından el lensi ve aydınlatma kullanılarak konulmuştur. ileri tetkiklerin ve başka tanı aletlerinin olmaması tanıların bunlarla da doğrulanmasını önlemiştir.veriler manuel olrak analiz edilmiş ve tanılar WHO ICD10 kodu kullanılarak kaydedilmiştir. Bulgular: muayene ediln 361 kişide toplam 366 cilt hastalığı tespit edilmiştir. Diğer enfeksiyon hastalıklarına bağlı cilt bulguları ve dermatitler en yaygın görülen hastalıklardı.(%39,9 ve %22,5).Cilt bozuklukları (%15) cilt ve cilt altı enfeksiyonlar(13,1) diğer sık hastalıklardı. En sık görülen cilt enfeksiyonları Tinea barbea/capitis ve impetigo idi.(sırasıyla %11,5,%10,1,%7,9)Malarya ve akneye bağlı cilt bozuklukları en sık görülen cilt bozukluklarıydı. Sonuç: mülteciler arasında cilt enfeksiyonları oldukça yaygındır.personelin hijyen ve sanitasyon konusunda eğitimi ve sağlık promosyonu uygulamaları ile tanı olanaklarına ulaşımın sağlanması acil ihtiyaçlar arasındadır

Pattern of skin diseases among Central African refugees in Chad

Aim: to describe the pattern of skin diseases among refugees attending the dermatology clinic in refugee camps in southern Chad. Methods: A descriptive clinic-based cross-sectional study was done in two refugee camps of people from Republic of Central Africa in Southern Chad. Diagnosis of skin diseases was done through clinical examination by a single dermatologist along with the help of hand lens provided with illumination. Lack of investigations and other skin diagnostic tools prevented further confirmation of diagnosis. Data was manually analyzed and diagnosis was presented as number and percent using the ICD -10 of the World Health Organization. Results: A total of 366 dermatologic diseases were diagnosed in 361 patients. Certain infectious and parasitic diseases and dermatitis/eczema were the commonest diagnostic categories (39.9% and 22.45; respectively) followed by disorders of skin appendices (15%) and infections of skin and subcutaneous tissues (13.1%). Tinea barbae /capitis, ringworm and impetigo are the commonest recorded infections (11.5%, 10.1% and 7.9%; respectively). Miliaria and acne vulgaris were the most frequent disorders of skin appendages. Conclusions: Infectious skin diseases are common among refugees. There are urgent needs for health education and promotion of personal hygiene with adequate sanitation as well as availability of diagnostic tests.

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UNHCR (United Nations High Commissioner For Refugees). Convention and protocol relating the status of refugees: United Nations; 1951. (Available at: http://www.unhcr.org. au/pdfs/convention.pdf Accessed at August 20, 2014).
UNHCR-UNICEF-WFP Joint Supplementary Budget Appeal. Donor Relation and Resource Mobilization Service. Emergency response to the influxes of refugees from the Central African Republic into neighboring countries; 2013.
Yasuhisa K. Present situation of refugee acceptance in Japan. Social and Pastoral Bull No. 140; 2007.
New Zealand Ministry of Health. Refugee health care: a handbook for health professionals; 2012. (Available at: www.health.govt.nz Accessed August 25, 2014).
Aderinto A. Life after displacement: a study of refugees in a Nigerian refugee camp. J Human Ecol 2002;13(5):369-374.
Bhatia S, Dranyi T, Rowley D. A social and demographic study of Tibetan refugees in India. Soc Sci Med 2002 Feb;54(3):411-422. PMID:1182491
Raoult D, Foucault C, Brouqui P. Infections in the homeless. The Lancet Infectious Disease 2002 Sept;1(2):77-84. PMID:11871479
Whitaker B. Refugees in Western Tanzania: the distribution of burdens and benefits among local hosts. J Refugee Studies 2002;15(4):339-358.
Gambella Development Agency. Report on the fact-finding visit to Pochalla. Jan 2004.
Lim JH, Yoon D, Jung G, Kim WJ, Lee H. Medical needs of Tsunami disaster refugee camps: experience in Southern Sri Lanka. Fam Med 2005Jun;37(6):422-8. PMID: 15933915
Tiong AC, Patel MS, Gardiner J, Ryan R, Linton KS, Walker KA, et al. Health issues in newly arrived African refugees attending general practice clinics in Melbourne. Med J Aust 2006 Dec 4-18;185(11-12):602-606. PMID:17181501
NWHO. Free medical camp at AkoraKhattak Afghan refugee camp and NWHO distributed medicine among refugees in Afghan Camp AkoraKhattak, in Pakistan.2007. (Available at: www.newworldhope.org/health.html Accessed August 20, 2014)
Care International in Lebanon. Integrated rapid assessment report. August 2013.
Refaat MR, Mohanna K. Syrian refugees in Lebanon: facts and solutions. The Lancet 2013 Aug 31;382(9894):763-764. PMID: 23870816 doi: 10.1016/S0140-6736(13)61461-0. Epub 2013 Jul 19.
UNHCR (United Nations High Commissioner For Refugees). Lebanon Inter-Agency Response: Syrian refugees. Oct 11, 2013.
CDC. Bhutanese refugee health profile. US Department of Health and Human Services. Centers for Disease Control and Prevention. National Center for Emerging and Zoonotic Infectious Diseases. Division of Global Migration and Quarantine. March 20, 2014.
WHO. ICD-10 version. 2010. (http://apps.who.int/ classifications/icd10/browse/2010/en#/A00).
Green JP, Eagar K. The health of people in Australian immigration detention centers. Med J Aust 2010 Jan 18;192(2):65-70. PMID: 20078404
BRYCS (Bridging Refugee Youth and Children Services). Background on potential health issues for Liberian refugees. BRYCS Office of Global Health Affairs. Humanitarian and Refugee Health Affairs. US Department of Health and Human Services. Jan 30, 2004.
Valatheeswaran C, Rajan SI. Sri Lankan Tamil refugees in India: rehabilitation mechanisms, livelihood strategies, and lasting solutions. Refugee Survey Quarterly 2011;30(2):24- 44.
Integrated Regional Information Networks. Central African Republic-Chad: forgotten refugees face epidemics, food cuts. Friday 23 June, 2006.
Jacobsen LB. The material and social infrastructure, and environmental conditions of refugee camps in Jordan. Fafo Institute for Applied International Studies, Oslo, Norway. 2004.
Terry BC, Kanjah F, Sahr F, Korteque S, Dukulay I, Gbakima, AA. Sarcoptes scabiei infestation among children in a Displacement camp in Sierra Leone. Public Health 2001May;115(3):208-11. PMID: 11429717
Heukelbach J, Feldmeier H. Scabies. Lancet 2006 May 27;367(9524):1767-74. PMID:16731272
Templer S, Brito M. Bacterial skin and soft tissue infections. Hosp Physicians 2009;26:9-16.
Biagini Myers JM, Wang N, Lemasters G, Bernstein D, Bernstein D, Esstein T, Lindsey M, et al. Genetic and environmental risk factors for childhood eczema development and allergic sensitization in the CCAAPS cohorts. J Investigative Dermatol 2010 Feb;130(2):430- 437. PMID: 19759553 doi: 10.1038/jid.2009.300. Epub 2009 Sep 17.
Kanerva L. Physical causes. In Adams occupational skin disease. 3rd ed. Edited by Adams RM. Philadelphia, PA: WB Saunders Company. 1999. P. 35-58.
Wu TQ, Mei SQ, Zhang JX, Gong LF, Wu FJ, Wu WH, et al. Prevalence and risk factors of facial acne vulgaris among Chinese adolescents. Int J Adolesc Med Health 2007 Oct- Dec; 19(4):407-12. PMID: 18348416
Munawar Z, Afzal M, Aftab M, Rizvi F, Choudry M. Precipitating factors of acne vulgaris in females. Ann Pak Inst Med Sci 2009;5(2):104-107.
Tasoula E, Gregoriou S, Chalikias J, Lazarou D, Danopoulou I, Katsambas A, Rigopoulous D. The impact of acne vulgaris of quality of life and psychic health in young adolescents in Greece: results of a population survey'. Ann Bras Dermatol 2012 Nov-Dec;87(6):862-869. PMID: 23197205
Jordanian Ministry of Planning And International Cooperation And United Nations. Host community support platform. Needs assessment review of the impact of the Syrian crisis on Jordan. Nov. 2013.