%0 Journal Article
%T The burden of acute respiratory infections in crisis-affected populations: a systematic review
%A Anna Bellos
%A Kim Mulholland
%A Katherine L O'Brien
%A Shamim A Qazi
%A Michelle Gayer
%A Francesco Checchi
%J Conflict and Health
%D 2010
%I BioMed Central
%R 10.1186/1752-1505-4-3
%X Health crises may be defined as the occurrence of morbidity and mortality in excess of secular trends, due to natural or man-made disasters [1]. With the exception of natural disasters and some recent wars (e.g. Iraq, Lebanon), the excess death toll in crises appears to be mainly "indirect". Excess deaths are due to an increased risk of disease and case-fatality brought about by conditions such as displacement into overcrowded camps, food insecurity, and breakdown of public health services, rather than the direct effects of the crisis [1,2].While most indirect excess mortality during crises is of infectious aetiology, data on the relative contribution of various infectious diseases are scarce. Diseases that cause a visible impact through dramatic epidemics, such as measles, cholera, dysentery and malaria [3], are usually considered the top threats during humanitarian relief operations. Accordingly, humanitarian agencies have emphasized mass measles vaccination, improved water and sanitation, and distribution of insecticide-treated materials as priority preventive interventions during the acute emergency phase [4-7].By contrast, acute respiratory infections (ARI) have received far less attention in humanitarian relief policies and programmes, despite being the largest baseline contributor to disability-adjusted life-years (DALYs) lost and the leading single cause of mortality among children under 5 y worldwide [8-11].ARIs may be classified into upper (AURI) and lower (ALRI) acute respiratory infections, depending on the main organs affected (nose, sinuses, middle ear, larynx and pharynx versus trachea, bronchi and lungs). AURIs are generally mild in nature and most often caused by viruses, sometimes with a bacterial component as in some cases of sinusitis and otitis media[12]. The overwhelming majority of ARI deaths and severe illness episodes are due to ALRIs, consisting mainly of pneumonia [13]. Nearly all severe ALRI episodes occur in children under 5 y, the elder
%U http://www.conflictandhealth.com/content/4/1/3