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The latest medical research on Disaster Medicine

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Mortality Associated with Priority Diseases in Flood-Affected Areas Using District Health Information System (DHIS2) During September-December 2022: Pakistan Experience.

Disaster Prevention & Management

To quantify the burden of communicable diseases and characterize the most reported infections during public health emergency of floods in Pakistan.

The study's design is a descriptive trend analysis. The study utilized the disease data reported to District Health Information System (DHIS2) for the 12 most frequently reported priority diseases under the Integrated Disease Surveillance and Response (IDSR) system in Pakistan.

In total, there were 1,532,963 suspected cases during August to December 2022 in flood-affected districts (n = 75) across Pakistan; Sindh Province reported the highest number of cases (n = 692,673) from 23 districts, followed by Khyber Pakhtunkhwa (KP) (n = 568,682) from 17 districts, Balochistan (n = 167,215) from 32 districts, and Punjab (n = 104,393) from 3 districts. High positivity was reported for malaria (79,622/201,901; 39.4%), followed by acute diarrhea (non-cholera) (23/62; 37.1%), hepatitis A and E (47/252; 18.7%), and dengue (603/3245; 18.6%). The crude mortality rate was 11.9 per 10 000 population (1824/1,532,963 [deaths/cases]).

The study identified acute respiratory infection, acute diarrhea, malaria, and skin diseases as the most prevalent diseases. This suggests that preparedness efforts and interventions targeting these diseases should be prioritized in future flood response plans. The study highlights the importance of strengthening the IDSR as a Disease Early Warning System through the implementation of the DHIS2.

Wilderness Medical Society Clinical Practice Guidelines for Medical Direction of Search and Rescue Teams.

Wilderness and Environmental Medicine

The Wilderness Medical Society convened a panel to review available evidence supporting practices for medical direction of search and rescue teams....

Oxidative Stress: An Intersection Between Radiation and Sulfur Mustard Lung Injury.

Disaster Prevention & Management

Nuclear and chemical weapons of mass destruction share both a tragic and beneficial legacy in mankind's history and health. The horrific health eff...

Predictors of emergency preparedness among parents in Hawaii: A cross-sectional survey.

Disaster Medicine and Public Health

To determine factors predicting emergency preparedness (EP) behaviors among Hawaii parents.

A cross-sectional online survey of parents of children (age 0-12 years) living in Honolulu, Hawaii in March 2023 examined associations with 1) having an EP kit (supplies for use during emergencies) and 2) having a family emergency plan (what to do, where to go, how to communicate during emergencies) with demographics/household characteristics and theoretical constructs of the Health Belief Model. A multivariable regression model obtained odds ratios and 95% confidence intervals.

Participants (N=278) were mainly female (84%), college-educated (68%), and were similar in diverse racial/ethnic composure (White, 13.3%) to the overall Honolulu County. Logistic regression determined participants with lower perceived susceptibility to disasters, greater time barriers, and those who needed help to prepare for emergencies were less likely to have an EP kit. Among participants without an EP kit, a website able to create personalized instructions for household EP would be useful. Participants who needed help to prepare for emergencies were less likely to have a family emergency plan.

Future interventions should focus on evidence-based strategies that improve self-efficacy associated with developing EP kits and family emergency plans.

Screening and Analysis of SARS-CoV-2 Antibody Among Unvaccinated Blood Donors in Chongqing, China.

Disaster Medicine and Public Health

To investigate the rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody among unvaccinated voluntary blood donors in Chongqing, and to provide evidence for epidemic surveillance.

A total of 10,208 voluntary blood donors from January 5 to January 20, 2021, in the Chongqing area were collected, and the SARS-CoV-2 immunoglobulin (Ig) G and IgM antibodies were detected by chemiluminescence, and the differences of antibody-positive rate in different gender, age, ABO blood group, and different risk areas were analyzed.

Among 10208 blood donors, 10 were found to be positive for SARS-COV-2 IgG antibody, giving a positivity rate of SARS-COV-2 IgG at 0.10%, and 29 were positive for SARS-CoV-2 IgM antibody, with a positivity rate of SARS-CoV-2 IgM at 0.28%. There was no statistical difference in the positive rate of antibody among different genders, ages, and ABO blood types, but it was related to the number of confirmed coronavirus disease 2019 (COVID-19) cases in each city.

The SARS-CoV-2 seroprevalence rate in Chongqing was low and correlated with the number of confirmed COVID-19 cases.

Improve disaster response by planning for and logistically supporting acute exacerbations of chronic diseases.

Am J Dis Med

Provide a more effective medical response by emphasizing the management of acute exacerbations of chronic diseases in disasters. Disaster victims n...

Disaster healthcare disparities solutions: Part 1-Preparation.

Am J Dis Med

The purpose of this study was to explore the potential solutions for disaster healthcare disparities. This paper is the first of a three-part serie...

Disaster healthcare disparities solutions: Part 2-Response.

Am J Dis Med

The purpose of this study was to explore the potential solutions for disaster healthcare disparities. This paper is the second of a three-part seri...

Disaster healthcare disparities solutions: Part 3-Recovery and mitigation.

Am J Dis Med

The purpose of this study was to explore the potential solutions for disaster healthcare disparities. This paper is the third of a three-part serie...

Surgical capacity is disaster preparedness: A scoping review of how surgery and anesthesiology departments responded to COVID-19.

Am J Dis Med

This study evaluated how surgical and anesthesiology departments adapted their resources in response to the coronavirus disease 2019 (COVID-19) pandemic.

This scoping review used the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews protocol, with Covidence as a screening tool. An initial search of PubMed, Embase, Web of Science, Global Index Medicus, and Cochrane Systematic Reviews returned 6,131 results in October 2021. After exclusion of duplicates and abstract screening, 415 articles were included. After full-text screening, 108 articles remained.

Most commonly, studies were retrospective in nature (47.22 percent), with data from a single institution (60.19 percent). Nearly all studies occurred in high-income countries (HICs), 78.70 percent, with no articles from low-income countries. The reported responses to the COVID-19 pandemic involving surgical departments were grouped into seven categories, with multiple responses reported in some articles for a total of 192 responses. The most frequently reported responses were changes to surgical department staffing (29.17 percent) and task-shifting or task-sharing of personnel (25.52 percent).

Our review reflects the mechanisms by which hospital surgical systems responded to the initial stress of the COVID-19 pandemic and reinforced the many changes to hospital policy that occurred in the pandemic. Healthcare systems with robust surgical systems were better able to cope with the initial stress of the COVID-19 pandemic. The well-resourced health systems of HICs reported rapid and dynamic changes by providers to assist in and ultimately improve the care of patients during the pandemic. Surgical system strengthening will allow health systems to be more resilient and prepared for the next disaster.

Stop the Bleed® in medical schools: Early advocacy and promising results.

Am J Dis Med

We hypothesized that medical students would be empowered by hemorrhage-control training and would support efforts to include Stop the Bleed® (STB) in medical education.

Student empowerment was measured by Likert-scale scoring, 1 (Strongly Disagree) to 5 (Strongly Agree). The usage of hemorrhage-control skills was also measured.

A total of 419 students (95.9 percent) affirmed that the course taught the basics of bleeding control, and 169 (79.3 percent) responded positively at follow-up, with a significant decrease in Likert response (4.65, 3.87, p < 0.001). Four hundred and twenty-three students (97.0 percent) affirmed that they would apply bleeding control skills to a patient, and 192 (90.1 percent) responded positively at follow-up (4.61, 4.19, p < 0.001). Three hundred and sixty-one students (82.8 percent) believed that they were able to save a life, and 109 (51.2 percent) responded positively at follow-up (4.14, 3.56, p < 0.001). Four hundred and twenty-five students (97.0 percent) would recommend the course to another medical student, and 196 (92.0 percent) responded positively at follow-up (4.68, 4.31, p < 0.001). Six students (2.8 percent) used skills on live patients, with success in five of the six instances.

Medical students were empowered by STB and have used hemorrhage-control skills on live victims. Medical students support efforts to include STB in medical education.

Terrorist attacks against healthcare facilities involving hostages.

Am J Dis Med

The incidence of terrorist attacks against healthcare facilities has been increasing over recent years. In addition to direct attacks on physical structures, many attacks have involved taking hostages. Hospital and healthcare facilities remain historically underprepared for terrorist attacks, representing vulnerable locations. Yet, studies examining the frequency and reach of hostage-taking incidents within healthcare facilities are limited.

A search of the Global Terrorism Database was performed. A total of 191,465 terrorist attacks were identified. The database search was narrowed down to healthcare-related terrorist attacks (2,322) and then manually analyzed to only include those incidents which involved hospitals and hostage-taking (64).

Sixty-four attacks against hospitals involving hostage-taking were identified. A total of 91 victims were injured in these attacks, and 47 were killed. The attacks affected a total of 23 countries worldwide, conducted largely by unidentified terrorist organizations, with approximately half involving firearms.

This study shows that terrorist attacks against healthcare facilities that involve -hostage-taking have increased in frequency over the past 10 years and have global reach. Systems may still be underprepared for this potentially increasing phenomenon and require preparedness plans with education and simulated practice in place. Healthcare facilities should consider mitigation strategies such as preparedness drills and additional education.