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Burden of Cardiovascular Morbidity and Mortality Following Humanitarian Emergencies: A Systematic Literature Review

Published online by Cambridge University Press:  15 December 2014

Kaitlin G. Hayman ,
Davina Sharma ,
Robert D. Wardlow II  and
Sonal Singh
Kaitlin G. Hayman*
Affiliation:
Johns Hopkins Bloomberg School of Public Health, Baltimore, MarylandUSA Division of Emergency Medicine, Western University, London, Ontario, Canada
Davina Sharma
Affiliation:
Johns Hopkins Bloomberg School of Public Health, Baltimore, MarylandUSA
Robert D. Wardlow II
Affiliation:
Johns Hopkins University School of Medicine, Baltimore, MarylandUSA
Sonal Singh
Affiliation:
Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MarylandUSA
*
Correspondence: Kaitlin Hayman, MD, MPH Division of Emergency Medicine London Health Sciences Centre 800 Commissioners Road E London, Ontario, Canada, N6A 5W9 E-mail khayman2010@gmail.com
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Abstract

Background

The global burden of cardiovascular mortality is increasing, as is the number of large-scale humanitarian emergencies. The interaction between these phenomena is not well understood. This review aims to clarify the relationship between humanitarian emergencies and cardiovascular morbidity and mortality.

Methods

With assistance from a research librarian, electronic databases (PubMed, Scopus, CINAHL, and Global Health) were searched in January 2014. Findings were supplemented by reviewing citations of included trials. Observational studies reporting the effect of natural disasters and conflict events on cardiovascular morbidity and mortality in adults since 1997 were included. Studies without a comparison group were not included. Double-data extraction was utilized to abstract information on acute coronary syndrome (ACS), acute decompensated heart failure (ADHF), and sudden cardiac death (SCD). Review Manager 5.0 (Version 5.2, The Nordic Cochrane Centre; Copenhagen Denmark,) was used to create figures for qualitative synthesis.

Results

The search retrieved 1,697 unique records; 24 studies were included (17 studies of natural disasters and seven studies of conflict). These studies involved 14,583 cardiac events. All studies utilized retrospective designs: four were population-based, 15 were single-center, and five were multicenter studies. Twenty-three studies utilized historical controls in the primary analysis, and one utilized primarily geographical controls.

Discussion

Conflicts are associated with an increase in long-term morbidity from ACS; the short-term effects of conflict vary by study. Natural disasters exhibit heterogeneous effects, including increased occurrence of ACS, ADHF, and SCD.

Conclusions

In certain settings, humanitarian emergencies are associated with increased cardiac morbidity and mortality that may persist for years following the event. Humanitarian aid organizations should consider morbidity from noncommunicable disease when planning relief and recuperation projects.

HaymanKG, SharmaD, WardlowRDII, SinghS. Burden of Cardiovascular Morbidity and Mortality Following Humanitarian Emergencies: A Systematic Literature Review. Prehosp Disaster Med. 2015;30(1):1-9.

Keywords

disaster medicinedisastersheart diseases
Type
Comprehensive Review
Information
Prehospital and Disaster Medicine , Volume 30 , Issue 1 , February 2015 , pp. 80 - 88
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2014 

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Footnotes

Conflicts of interest: none

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