The long-term burden of war injuries in LMICs: Case of the Lebanese War of 2006

Abstract Background Armed conflict is a major cause of disability and mortality, particularly in LMICs. July 12, 2006 marks the start of a 33-day war in Lebanon which resulted in at least 1191 deaths and 4409 injured, the vast majority of whom were civilians. Little is known about the consequences of war-injuries inflicted on civilians. The AUB arm of the NIHR PrOTeCT Group aims to identify 1) war-injury characteristics associated with high burden of care 2) the long-term socioeconomic burden and 3) the quality of life of the injured civilians and their access to healthcare and medicine under conditions of war. Methods This study employs a mixed-method research design by reviewing medical records of patients admitted to hospitals in Lebanon between July 12th and August 15th, 2006, conducting interviews with patients, and administering the EQ5D5L questionnaire to understand the burden of injuries and the quality of life of patients 13 years after injury. Qualitative and quantitative data analysis methods will be used. Preliminary Results 25 interviews have been conducted so far. Injured civilians were mostly males, average age 27. The most common mechanism of injury was blast injury. Most patients underwent multiple surgeries as well as revision surgeries. The emerging themes include description of the 1-scene and type of injury; 2-referral process from the injury site to the hospital; 3-the types of services received; and 4-the financial and non-financial long-term impact. They described the long-term burden including chronic pain, poor mobility, anxiety or depression, and limited activities of daily living. Conclusions These preliminary results show that civilians injured during the July 2006 war are experiencing physical and psychological sequelae; thus, more services need to be offered to civilians injured during war. Key messages Physical impairments related to war injuries influenced the quality of life of study participants. Affordable or free rehabilitation services need to be offered to civilians injured during war.

Download Full-text

Long-term Impact of Adenotonsillectomy on the Quality of Life of Children with Sleep-disordered breathing

International Archives of Otorhinolaryngology ◽

10.1055/s-0040-1709195 ◽

2020 ◽

Author(s):

Juliana Alves Sousa Caixeta ◽

Jessica Caixeta Silva Sampaio ◽

Vanessa Vaz Costa ◽

Isadora Milhomem Bruno da Silveira ◽

Carolina Ribeiro Fernandes de Oliveira ◽

...

Keyword(s):

Quality Of Life ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Sleep Disordered Breathing ◽

Long Term Effects ◽

Obstructive Sleep ◽

Long Term Impact ◽

Disordered Breathing

Abstract Introduction Adenotonsillectomy is the first-line treatment for obstructive sleep apnea secondary to adenotonsillar hypertrophy in children. The physical benefits of this surgery are well known as well as its impact on the quality of life (QoL), mainly according to short-term evaluations. However, the long-term effects of this surgery are still unclear. Objective To evaluate the long-term impact of adenotonsillectomy on the QoL of children with sleep-disordered breathing (SDB). Method This was a prospective non-controlled study. Children between 3 and 13 years of age with symptoms of SDB for whom adenotonsillectomy had been indicated were included. Children with comorbities were excluded. Quality of life was evaluated using the obstructive sleep apnea questionnaire (OSA-18), which was completed prior to, 10 days, 6 months, 12 months and, at least, 18 months after the procedure. For statistical analysis, p-values lower than 0.05 were defined as statistically significant. Results A total of 31 patients were enrolled in the study. The average age was 5.2 years, and 16 patients were male. The OSA-18 scores improved after the procedure in all domains, and this result was maintained until the last evaluation, done 22 ± 3 months after the procedure. Improvement in each domain was not superior to achieved in other domains. No correlation was found between tonsil or adenoid size and OSA-18 scores. Conclusion This is the largest prospective study that evaluated the long-term effects of the surgery on the QoL of children with SDB using the OSA-18. Our results show adenotonsillectomy has a positive impact in children's QoL.

Download Full-text