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Hoffmann, R. A wiki for the life sciences where authorship matters. Nature Genetics (2008)

Infectious disease surveillance during emergency relief to Bhutanese refugees in Nepal.

OBJECTIVE--To implement simplified infectious disease surveillance and epidemic disease control during the relocation of Bhutanese refugees to Nepal. DESIGN--Longitudinal observation study of mortality and morbidity. SETTING--Refugee health units in six refugee camps housing 73,500 Bhutanese refugees in the eastern tropical lowland between Nepal and India. INTERVENTIONS--Infectious disease surveillance and community-based programs to promote vitamin A supplementation, measles vaccination, oral rehydration therapy, and early use of antibiotics to treat acute respiratory infection. MAIN OUTCOME MEASURES--Crude mortality rate, mortality rate for children younger than 5 years, and cause-specific mortality. RESULTS--Crude mortality rates up to 1.15 deaths per 10,000 persons per day were reported during the first 6 months of surveillance. The leading causes of death were measles, diarrhea, and acute respiratory infections. Surveillance data were used to institute changes in public health management including measles vaccination, vitamin A supplementation, and control programs for diarrhea and acute respiratory infections and to ensure rapid responses to cholera, Shigella dysentery, and meningoencephalitis. Within 4 months of establishing disease control interventions, crude mortality rates were reduced by 75% and were below emergency levels. CONCLUSIONS--Simple, sustainable disease surveillance in refugee populations is essential during emergency relief efforts. Data can be used to direct community-based public health interventions to control common infectious diseases and reduce high mortality rates among refugees while placing a minimal burden on health workers.[1]


  1. Infectious disease surveillance during emergency relief to Bhutanese refugees in Nepal. Marfin, A.A., Moore, J., Collins, C., Biellik, R., Kattel, U., Toole, M.J., Moore, P.S. JAMA (1994) [Pubmed]
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