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Dynamics of Socioeconomic Risk Factors for Neglected Tropical Diseases and Malaria in an Armed Conflict

Author

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  • Thomas Fürst
  • Giovanna Raso
  • Cinthia A Acka
  • Andres B Tschannen
  • Eliézer K N'Goran
  • Jürg Utzinger

Abstract

Background: Armed conflict and war are among the leading causes of disability and premature death, and there is a growing share of civilians killed or injured during armed conflicts. A major part of the civilian suffering stems from indirect effects or collateral impact such as changing risk profiles for infectious diseases. We focused on rural communities in the western part of Côte d'Ivoire, where fighting took place during the Ivorian civil war in 2002/2003, and assessed the dynamics of socioeconomic risk factors for neglected tropical diseases (NTDs) and malaria. Methodology: The same standardized and pre-tested questionnaires were administered to the heads of 182 randomly selected households in 25 villages in the region of Man, western Côte d'Ivoire, shortly before and after the 2002/2003 armed conflict. Principal Findings: There was no difference in crowding as measured by the number of individuals per sleeping room, but the inadequate sanitation infrastructure prior to the conflict further worsened, and the availability and use of protective measures against mosquito bites and accessibility to health care infrastructure deteriorated. Although the direct causal chain between these findings and the conflict are incomplete, partially explained by the very nature of working in conflict areas, the timing and procedures of the survey, other sources and anecdotal evidence point toward a relationship between an increased risk of suffering from NTDs and malaria and armed conflict. Conclusion: New research is needed to deepen our understanding of the often diffuse and neglected indirect effects of armed conflict and war, which may be worse than the more obvious, direct effects. Author Summary: Armed conflict and war and infectious diseases are globally among the leading causes of human suffering and premature death. Moreover, they are closely interlinked, as an adverse public health situation may spur violent conflict, and violent conflict may favor the spread of infectious diseases. The consequences of this vicious cycle are increasingly borne by civilians, often as a hidden and hence neglected burden. We analyzed household data that were collected before and after an armed conflict in a rural part of western Côte d'Ivoire, and investigated the dynamics of socioeconomic risk factors for neglected tropical diseases (NTDs) and malaria. We identified a worsening of the sanitation infrastructure, decreasing use of protective measures against mosquito bites, and increasing difficulties to reach public health care infrastructure. In contrast, household crowding, the availability of soap, and the accessibility of comparatively simple means of health care provision (e.g., traditional healers and community health workers) seemed to be more stable. Knowledge about such dynamics may help to increase crisis-proofness of critical infrastructure and public health systems, and hence mitigate human suffering due to armed conflict and war.

Suggested Citation

  • Thomas Fürst & Giovanna Raso & Cinthia A Acka & Andres B Tschannen & Eliézer K N'Goran & Jürg Utzinger, 2009. "Dynamics of Socioeconomic Risk Factors for Neglected Tropical Diseases and Malaria in an Armed Conflict," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 3(9), pages 1-10, September.
  • Handle: RePEc:plo:pntd00:0000513
    DOI: 10.1371/journal.pntd.0000513
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    References listed on IDEAS

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    1. Garfield, R.M. & Frieden, T. & Vermund, S.H., 1987. "Health-related outcomes of war in Nicaragua," American Journal of Public Health, American Public Health Association, vol. 77(5), pages 615-618.
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    Cited by:

    1. Peter J Hotez, 2016. "Neglected Tropical Diseases in the Anthropocene: The Cases of Zika, Ebola, and Other Infections," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 10(4), pages 1-6, April.
    2. Tapsoba, Augustin, 2023. "The cost of fear: Impact of violence risk on child health during conflict," Journal of Development Economics, Elsevier, vol. 160(C).
    3. Andrew L. Dabalen & Saumik Paul, 2012. "Effect of Conflict on Dietary Energy Supply: Evidence from Cote d'Ivoire," Discussion Papers 12/09, University of Nottingham, CREDIT.
    4. Dabalen, Andrew L. & Paul, Saumik, 2014. "Effect of Conflict on Dietary Diversity: Evidence from Côte d’Ivoire," World Development, Elsevier, vol. 58(C), pages 143-158.
    5. Minoiu, Camelia & Shemyakina, Olga N., 2014. "Armed conflict, household victimization, and child health in Côte d'Ivoire," Journal of Development Economics, Elsevier, vol. 108(C), pages 237-255.
    6. Thomas Fürst & Kigbafori D Silué & Mamadou Ouattara & Dje N N'Goran & Lukas G Adiossan & Yao N'Guessan & Fabian Zouzou & Siaka Koné & Eliézer K N'Goran & Jürg Utzinger, 2012. "Schistosomiasis, Soil-Transmitted Helminthiasis, and Sociodemographic Factors Influence Quality of Life of Adults in Côte d'Ivoire," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 6(10), pages 1-12, October.
    7. repec:nva:unnvaa:wp04-2012 is not listed on IDEAS
    8. Camelia Minoiu & Olga N. Shemyakina, 2012. "Armed Conflict, Household Victimization, and Child Health in C�te d'Ivoire," HiCN Working Papers 115, Households in Conflict Network.
    9. Saumik Paul & Andrew L. Dabalen, 2013. "Effect of Conflict on Dietary Energy Supply: Evidence from Cote d�Ivoire," HiCN Working Papers 156, Households in Conflict Network.

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