Conflict and Health最新文献

{"title":"Epidemiological investigation of a cholera outbreak and its socioeconomic determinants in southwest state, Somalia, January - August, 2024.","authors":"Abdullahi Ahmed Tahlil, Nur Moallim Adan, Hassan Mohamed Abdi, Saido Gedi, Marian Muse Osman, Suad Moallin Aden, Chukwuma David Umeokonkwo, Mohamed Abdelrahman Mohamed, Kasim Mahdi Sultan","doi":"10.1186/s13031-025-00716-7","DOIUrl":"10.1186/s13031-025-00716-7","url":null,"abstract":"<p><strong>Introduction: </strong>Cholera remains a significant public health challenge in Somalia, particularly in the Southwest State, where recurrent outbreaks have been reported in January 2024. We investigated the epidemiological characteristics of a recent cholera outbreak in the southwest of Somalia and explored the socioeconomic determinants contributing to its persistence.</p><p><strong>Methodology: </strong>A descriptive cross-sectional study was conducted in Southwest State, Somalia, from January to August 2024, to characterize the outbreak using time, place, and person analyses, and to evaluate the frequency and distribution of cholera cases. Data were collected through structured interviews, a review of medical records, and a line list of suspected cases and epidemiologically linked patients at cholera treatment centers. Data were analyzed using SPSS. Logistic regression was used to examine the factors associated with cholera. A p-value of less than 0.05 was considered to be statistically significant.</p><p><strong>Results: </strong>A total of 5,639 cholera cases were recorded during the study period, with 2891 (51.3%) female. The case fatality rate was 0.5%. Among the cases, 663 (11.8%) tested positive for Vibrio cholerae 01 Inaba at the National Public Health Reference Laboratory. The outbreak predominantly affected children under five, accounting for 3203 (56.8%) of cases with a male-to-female ratio of 1.1:1 and an attack rate of 11.3 per 1,000. Watery Diarrhoea 4716 (83.6%), vomiting 4004 (71.0%), fever 5208 (92.4%), and abdominal cramps 3108 (55.1%) were the most common symptoms observed in the patients. Only 451 (11.8%) of cases reported having received the oral cholera vaccine. There were significant associations between high cholera incidence and low vaccination rate (AOR: 4.6, 95% CI: 2.63-8.49, p < 0.001) and limited access to safe drinking water (AOR: 2.4, 95% CI: 2.05-2.89, p < 0.001). Conversely, the availability of latrines (AOR: 0.5, 95% CI: 0.36-0.69, p < 0.001) and handwashing facilities with soap (AOR: 0.6, 95% CI: 0.48-0.79, p < 0.001) showed protective effects against cholera incidence.</p><p><strong>Conclusion: </strong>The cholera outbreak in Southwest State significantly impacted children under five. Low vaccination rate and limited access to safe drinking water were strong risk factors, whereas the presence of latrines and availability of handwashing facilities with soap were protective against the outbreak. Urgent interventions are essential to enhance vaccination efforts, improve sanitation infrastructure by increasing the number and accessibility of latrines, providing adequately spaced handwashing stations with soap, water, and drying facilities in public places, and ensuring access to safe drinking water to prevent future outbreaks.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"74"},"PeriodicalIF":3.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of armed conflict on vaccination coverage: a systematic review of empirical evidence from 1985 to 2025.","authors":"Tyler Y Headley, Christopher Wiley Shay, Yesim Tozan","doi":"10.1186/s13031-025-00708-7","DOIUrl":"10.1186/s13031-025-00708-7","url":null,"abstract":"<p><strong>Background: </strong>Armed conflict disrupts health systems and undermines routine immunization, contributing to excess morbidity and mortality. This systematic review examines empirical evidence on the impact of armed conflict on vaccination services and coverage, identifying patterns of disruption across geographic settings and conflict types.</p><p><strong>Methods: </strong>This study followed PRISMA guidelines and was registered in PROSPERO (CRD420251064804). We searched seven databases for peer-reviewed and grey literature (1985-2025) reporting quantitative comparisons of vaccination coverage before and after conflict onset, or between conflict-affected and unaffected populations. Screening and data extraction followed standardized systematic review protocols, with dual validation of a subset of studies. Due to methodological heterogeneity across studies, a meta-analysis was not conducted.</p><p><strong>Results: </strong>Of 8,043 citations screened, 33 met the inclusion criteria. Most focused on child immunization in settings across the Eastern Mediterranean (15, 45%) and African (12, 36%) regions. Data sources included household surveys (22, 67%) and health system records (8, 24%). Conflict exposure was most commonly measured using battle-related deaths (15, 45%). Analyses employing individual-level data were most common (10, 30%), followed by subnational administrative data (9, 27%). Nearly all studies (31, 94%) were observational or quasi-experimental. In 28 (85%) studies, conflict was associated with reduced vaccination coverage, sometimes exceeding 20% points for vaccines such as BCG, DTP, and polio. Declines were most pronounced in settings with civil war and moderate to high conflict intensity. Two studies reported localized increases in vaccination coverage, possibly due to targeted humanitarian interventions. Effect estimates were larger in studies using national or administrative-level data compared to those using household-level data, underscoring methodological variation as a key contributor to heterogeneity in reported impacts.</p><p><strong>Conclusions: </strong>Armed conflict is consistently associated with substantial declines in childhood vaccination coverage, most pronounced in civil war and military occupation settings and across conflicts with moderate-to-high annual BRDs. Regional disruptions were especially severe in the Eastern Mediterranean and sub-Saharan African regions. We found substantial variation in estimated effect sizes across analytic units (individual, household, region, country), suggesting that more aggregated data may better capture the broader impact of conflict on vaccination rates. Future research should incorporate standardized conflict and vaccination metrics to improve the generalizability of findings.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"71"},"PeriodicalIF":3.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-seeking behavior in conflict-affected settings: a cross-sectional study of internally displaced persons in Somalia.","authors":"Abdullahi Ahmed Tahlil, Osman Mohamed Mohamud, Suad Moallin Aden, Saido Gedi, Marian Muse Osman, Gallad Dahir, Liban Hassan Jimale, Abdiwali Ahmed Siyad, Mohamed Abdelrahman Mohamed","doi":"10.1186/s13031-025-00718-5","DOIUrl":"10.1186/s13031-025-00718-5","url":null,"abstract":"<p><strong>Introduction: </strong>Somalia has a large internally displaced persons (IDP) population due to prolonged conflict and recurrent natural disasters. IDPs face significant health challenges, including limited access to healthcare, poor living conditions, and high rates of preventable diseases. The study aims to investigate health-seeking behaviors among IDPs in Somalia, including factors associated with their decisions to seek healthcare, the types of healthcare services utilized, and barriers encountered in accessing care.</p><p><strong>Method: </strong>A cross-sectional study was conducted in eight densely populated IDP camps in Mogadishu and Baidoa, Somalia. A total of 1,063 participants aged 18 years and older, residing in the camps for a minimum of three months, were recruited using a multi-stage cluster sampling technique. Data were collected through face-to-face interviews using a structured questionnaire. Data analysis involved descriptive statistics, chi-square tests, and multivariate logistic regression to identify predictors of health-seeking behaviors. Adjusted odds ratios (AOR), 95% confidence intervals (CI), and p-values were reported to measure the strength and significance of associations.</p><p><strong>Results: </strong>The study revealed that 54.7% of IDPs sought healthcare within the past three months, primarily for acute illnesses. The most prevalent health problems were diarrheal diseases (36.9%), fever/chills (34.3%), and cough/cold (30.9%). Maternal and Child Health (MCH) facilities were the primary source of care (51.9%). Significant barriers to healthcare access included lack of transportation (38.3%), long wait times (26.1%), and medication unavailability (23.4%). Multivariate logistic regression analysis identified that being male (AOR: 2.05, 95% CI: 1.56-2.69, p < 0.001), aged 55 years and above (AOR: 0.14, 95% CI: 0.05-0.37, p = 0.001), single (AOR: 0.20, 95% CI: 0.11-0.37, p < 0.001), residing 6 months to 2 years in the camp (AOR: 1.68, 95% CI: 1.20-2.36, p < 0.001), living more than 2 km from a health facility (AOR: 3.34, 95% CI: 2.41-4.62, p < 0.001), and higher income (AOR: 0.27, 95% CI: 0.15-0.46, p < 0.001) were significantly associated with increased likelihood of seeking healthcare.</p><p><strong>Conclusion: </strong>A considerable proportion of IDPs sought healthcare, mainly for acute illnesses, but faced substantial barriers to access. These findings underscore the urgent need to improve healthcare infrastructure within IDP camps, enhance the accessibility and affordability of services-particularly for vulnerable groups-and implement health education programs to promote early health-seeking behaviors.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"76"},"PeriodicalIF":3.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the youth perceptions of factors contributing to victims' silence during the armed conflict in Ethiopia.","authors":"Besfat Berihun Erega, Wassie Yazie Ferede, Assefa Kebie Mitku, Tegegne Wale Belachew, Dagne Addisu, Begizew Yimenu Mekuriaw, Yitayal Ayalew Goshu, Habtam Desse Alemayehu, Eyob Shitie Lake, Rahel Birhanu Arage","doi":"10.1186/s13031-025-00715-8","DOIUrl":"10.1186/s13031-025-00715-8","url":null,"abstract":"<p><strong>Background: </strong>Globally, one of the most devastating and worst consequence of armed war and conflict is the increased prevalence of violence against women and children. Violence against women and children includes all forms of sexual violence, domestic attack, and other forms of physical and mental harm on women and children. In contexts with war and instability, the reporting of violence against women and children becomes beyond a legal context rather considered as a huge socio-cultural and psychological challenge. This study aims to unpack the complex web of factors that youth perceive to contribute to the silence due to armed conflict in the face of violence against women and children in the Amhara Regional State. METHODS : A multi- district community based cross sectional study was conducted among selected districts of South Gondar zone, Ethiopia. All youth residents in the selected districts of South Gondar Zone and who were ready questions during the data collection period were included in the study. The study participants were chosen at the household level using a straightforward random selection technique. For the analysis, SPSS version 23 was utilized. The perception of youth about victim's silence was measured in-terms of perceived psychological, social, cultural, institutional and knowledge gap factors of victims. To know the crude association between the factors and youth perceptions of being silent victim, odds ratio (OR) was calculated with a 95% confidence interval (CI). Then, variables with a P-value of ≤ 0.2 were considered for multivariate analysis. Finally, P-value of ≤ 0.05 together with the confidence interval were used to be considered as having significant association.</p><p><strong>Result: </strong>A total of 592 respondents were included in this study with 92.2% response rate. Fear of the victim for attack being targeted by the perpetrator, fear of retaliation, economic dependence of the victim, fear of social stigma, the silence of bystanders were the youth perceived determinants of non-reporting violent acts by the victims of violence. CONCLUSIONS_: It was found that factors related to social, economical, perpetrator and bystander attitude were the determinants of being silent victims.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"75"},"PeriodicalIF":3.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding relationships among climate change, conflict, migration/displacement and health in humanitarian settings: a scoping review.","authors":"Molly E Lasater, Gabrielle Prager, Yuni A Choi, Tim Groteclaes, Divya Rao, Shona P Kamps, Chiara Altare, Paul B Spiegel","doi":"10.1186/s13031-025-00707-8","DOIUrl":"10.1186/s13031-025-00707-8","url":null,"abstract":"<p><strong>Background: </strong>Climate change is increasing the frequency and intensity of various extreme weather events across regions, globally. Climate change has also been associated with conflict, migration and displacement, and health in complex and multi-causal relationships, particularly in humanitarian settings. This study aimed to better understand linkages and relationships at the nexus of climate change, conflict, migration/displacement, and health in humanitarian settings.</p><p><strong>Methods: </strong>We searched the academic literature in four databases (PubMed, Embase, Scopus, GreenFILE) and the grey literature in 18 organizational websites. Titles and abstracts, and full texts from the academic literature were independently screened by two reviewers following PRISMA scoping review guidelines. For the grey literature, a single reviewer screened titles and abstracts and full texts, and extracted data. All extracted data were synthesized by domain.</p><p><strong>Results: </strong>We included 178 articles in this scoping review, describing four domains: climate change and migration/displacement and health; climate change and conflict and migration/displacement; climate change and conflict and migration/displacement and health; and climate change and conflict and health. Articles most frequently focused on climate change, migration/displacement and health. We identified complex, non-linear, multicausal and interrelated relationships at the nexus of these domains in diverse contexts that informed the development of a conceptual framework of direct and indirect relationships. We found that climate change, conflict, migration/displacement, and health intersect with pre-existing vulnerabilities to further exacerbate risks and vulnerabilities or cause new risks and vulnerabilities at this nexus.</p><p><strong>Conclusion: </strong>While associations among climate change, conflict, migration/displacement and health are of significant concern, there has been limited examination at this nexus. Findings of this review indicate that research and practice should critically consider and embrace the complex and interrelated ways in which climate change has interrelated and cascading impacts on conflict, migration/displacement and health. Future research can build upon the findings of this review to identify the strength of associations at this nexus and holistic and effective responses. There is a need to adopt integrated and multi-disciplinary approaches to research, programming and policy in humanitarian settings while strengthening climate-resilient health systems.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"73"},"PeriodicalIF":3.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public knowledge, attitudes, practices, and key influencing factors regarding cancer screening in Yemen.","authors":"Sayida Al-Jamei, Arwa Al-Shargabi, Elham D Al-Qafaf, Ayat Al-Jaki, Mohammed A Al-Dhubhani, Aisha A H Al-Jamaei","doi":"10.1186/s13031-025-00709-6","DOIUrl":"10.1186/s13031-025-00709-6","url":null,"abstract":"<p><strong>Background: </strong>Public awareness plays a pivotal role in the effectiveness of cancer screening programs and reducing mortality rates. In Yemen, where cancer incidence is steadily increasing, limited research addresses cancer screening practices comprehensively. Most regional studies focus on specific cancers, such as breast or colorectal cancer, lacking an inclusive perspective. Thus, this study evaluates the Yemeni public's knowledge, attitudes, and practices regarding cancer screening.</p><p><strong>Methods: </strong>A cross-sectional study was conducted by distributing a validated survey questionnaire to potential participants using convenience sampling. Descriptive statistics were used to summarize sociodemographic data, knowledge of cancer screening, practice and attitudes toward cancer screening. Logistic regression analysis was employed to identify associations between independent variables and the overall knowledge.</p><p><strong>Results: </strong>A total of 996 eligible individuals successfully completed the survey. While over half of the participants (52.1%) reported awareness of cancer screening, substantial gaps in understanding were evident, with only 21.4% rated their knowledge as good. Breast cancer screening emerged as the most recognized, while awareness of screenings for lung, colorectal, cervical, and prostate cancers remained minimal. The study also found that 42.9% of participants acknowledged the key benefits of cancer screening, yet fewer than one-third recognized all major cancer prevention strategies. Cancer screening participation was alarmingly low, with 8.5% of participants undergoing any form of screening. Key barriers included financial constraints, lack of awareness, and perceptions of unnecessary screening. Educational attainment, profession, and marital status significantly influenced participants' knowledge levels. Postgraduate participants, healthcare workers, and single individuals demonstrated higher knowledge levels compared to others.</p><p><strong>Conclusion: </strong>The study reveals a clear gap between awareness and participation in cancer screening, influenced by sociodemographic disparities. Targeted awareness efforts and improved access to screening are urgently needed to address cultural, financial, and systemic barriers.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"72"},"PeriodicalIF":3.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review of interventions addressing gender-based violence in West Africa: examining typologies, delivery mechanisms, outcomes, and stakeholder involvement.","authors":"Ifunanya Clara Agu, Mahua Das, Rebecca King, Prince Agwu, Chinyere Ojiugo Mbachu","doi":"10.1186/s13031-025-00712-x","DOIUrl":"10.1186/s13031-025-00712-x","url":null,"abstract":"<p><strong>Background: </strong>Gender-based violence (GBV) remains a significant public health and human rights concern globally, with interventions in West Africa designed to address prevention, response, and survivor support. This scoping review aims to synthesize existing evidence on interventions addressing GBV in West Africa, describing their typologies, delivery mechanisms, and outcomes.</p><p><strong>Methods: </strong>We used two search strings to identify GBV interventions implemented in West Africa and published between January 2010 and March 2025 across five databases, including PubMed, Zendy, Google Scholar, Medline, and ResearchGate. Two independent reviewers screened the titles, abstracts, and full texts of all identified publications for eligibility and inclusion into the study. A total of 25 studies met the inclusion criteria and were included in the study. Data were analysed thematically and presented based on typologies and mechanisms, outcomes using the WHO RESPECT framework, and stakeholders' involvement in GBV interventions.</p><p><strong>Results: </strong>The majority of the studies (10) were conducted in Ghana, with six in Nigeria and only a few in other countries, including Niger (2), Senegal (1), Guinea (1), Sierra Leone (1), Côte d'Ivoire (2), and Liberia (1). 42% (11) of the articles focused on various forms of GBV that were not limited to intimate partner violence (IPV), while 39% (10 articles) specifically targeted IPV interventions. Only 19% (5) of these articles discussed interventions for physical violence, notably domestic violence and female genital mutilation/cutting (FGM/C). The intervention strategies included community-based, facility-based, school-based, and media-technology approaches, aimed at diverse groups such as adolescents, households, pregnant women, men, couples, GBV victims, and healthcare providers. Community-based initiatives, like gender dialogue groups and awareness campaigns, were effective in promoting gender-equitable attitudes; however, maintaining long-term behavioural change proved difficult for the males. Facility-based initiatives, involving sexual assault referral centres (SARCs) and therapeutic counselling, enhanced access to medical and psychological care, although challenges remained in survivor follow-ups and the tertiary level of care.</p><p><strong>Conclusion: </strong>Our review findings highlight the importance of integrating multi-pronged approaches, combining community-based initiatives, institutional capacity-building, technological innovations, economic empowerment, and long-term sustainability efforts to comprehensively tackle GBV. Future interventions should prioritize addressing emotional and psychological violence, focus on schools and male engagement, and explore scalable models for institutional integration.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"70"},"PeriodicalIF":3.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research and conflict: mapping research trends and gaps in Ukrainian Emergency Medical Services- a scoping review.","authors":"Rafael Castro-Delgado, Manisha Panta Bhandari, Radha Subedi Acharya","doi":"10.1186/s13031-025-00711-y","DOIUrl":"10.1186/s13031-025-00711-y","url":null,"abstract":"<p><strong>Introduction: </strong>Conflict´s impact on research has seldom been analyzed, while research activities may improve population health and health service provision in conflicts. Efficient functioning of Emergency Medical Services (EMS) is essential for providing regular emergency care and addressing the healthcare needs arising from the ongoing conflict in Ukraine. However, research on the development, challenges, and opportunities of EMS system are limited. The objective of this review was to document the research trends, identify how conflict has shaped research production, and knowledge gaps related to EMS in Ukraine from 2002 to 2024.</p><p><strong>Methods: </strong>A systematic literature search was conducted on January 26, 2025, on PubMed, Scopus, and Web of Science, following the PRISMA-ScR guidelines. The review included peer-reviewed studies, commentaries, case studies, reports, and policy documents focusing on EMS in Ukraine. Data extraction and analysis were performed using Microsoft Excel (Version 2501) and Jupyter Notebook(running on Jupyter Server 2.15.0) with visualization using Sankey plots and heatmaps.</p><p><strong>Results: </strong>Of the 1,010 initially identified articles, 62 met the inclusion criteria. Research topics have evolved significantly, with Disease-Specific Care in conflict emerging as an extensively studied area (n = 8) post-2022. Quality of Care (n = 12) and Hospital Care (n = 7) were prominent focus areas. Profound impact on EMS research activity was noted in the 2022 invasion in comparison to the 2014 conflict, causing widespread service disruptions (n = 15) and a positive impact on the evolution of EMS training (n = 11). Key research gaps included lack of data, standardized protocols, and resource limitations within the emergency management system.</p><p><strong>Conclusions: </strong>This review highlights the evolving field of EMS research in Ukraine, emphasizing the growing focus on specialized care in conflict environments. The findings underscore both the resilience of Ukraine's EMS system and the need to establish standardized data collection systems, develop cost-effective resource management strategies, improve coordination among key stakeholders, and explore innovative technologies to enhance EMS operations in crisis situations.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"69"},"PeriodicalIF":3.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional status and associated factors of children aged 6 to 59 months in gedeb, SNNPR, Ethiopia, following the Guji-Gedeo conflict.","authors":"Alemayehu Legesse, Belayneh Genoro, Arega Haile, Adane Tesfaye","doi":"10.1186/s13031-025-00696-8","DOIUrl":"10.1186/s13031-025-00696-8","url":null,"abstract":"<p><strong>Background: </strong>The Guji-Gedeo conflict displaced over 300,000 individuals in Gedeb District, worsening malnutrition in the region. This study aimed to assess the nutritional status and identify the factors associated with malnutrition among children aged 6 to 59 months who returned to Gedeb District, SNNPR, Ethiopia, after the conflict.</p><p><strong>Methods: </strong>A community-based cross-sectional study was conducted from December 2019 to February 2020, involving 418 children selected through multistage sampling. Data were analyzed using Bayesian binary logistic regression, with SPSS for data management and WinBUGS for parameter estimation. Anthropometric measures were calculated using WHO Anthro software, and the Markov Chain Monte Carlo (MCMC) method was applied to estimate parametric distributions.</p><p><strong>Results: </strong>The study found a malnutrition prevalence of 45.9% among children, with significant contributing factors identified. Key predictors include female gender (β = 0.306, 95% CI: 0.584-3.158, AOR = 1.358), children's age, maternal BMI (β = -2.500, 95% CI: 0.332-1.810, AOR = 0.777), urban residence (β = -0.919, 95% CI: 0.098-1.631, AOR = 0.399), birth intervals, family size (4-5) (β = -1.350, 95% CI: 0.057-1.188, AOR = 0.259), maternal education, recent diarrhea episode (β = 0.180, 95% CI: 0.218-2.354, AOR = 1.200), occupation, and improved sanitation facilities (β = -0.174, 95% CI: 0.265-2.660, AOR = 0.840).</p><p><strong>Conclusion: </strong>This study reveals high malnutrition rates in Gedeb, with protective factors such as lower birth orders, maternal education, urban residence, improved sanitation, normal maternal BMI, and government employment. While these findings suggest areas for intervention, the cross-sectional design limits generalizability. Further longitudinal research is needed to confirm these results and guide effective interventions.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"68"},"PeriodicalIF":3.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of childhood maltreatment on treatment outcomes for posttraumatic stress symptoms and aggression in male former combatants using narrative exposure therapy [NET] - results from a RCT in Eastern democratic Republic of Congo.","authors":"Tobias Rieder, Katy Robjant, Amani Chibashimba, Sabine Schmitt, Stephan Goerigk, Thomas Elbert, Anke Koebach, Andrea Jobst","doi":"10.1186/s13031-025-00710-z","DOIUrl":"10.1186/s13031-025-00710-z","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the impact of childhood maltreatment on treatment outcomes among male ex-combatants in a randomized controlled trial (RCT) of Narrative Exposure Therapy for Forensic Offender Rehabilitation (FORNET), a specialized psychotherapy used to treat trauma sequelae including symptoms of posttraumatic stress disorder (PTSD), compared with treatment as usual (TAU). Specifically, we aim to compare former child and adult male soldiers who experienced childhood sexual abuse (CSA) with those who did not.</p><p><strong>Methods: </strong>We conducted a sub-analysis of data from Koebach et al. [J Consult Clin Psychol. 2021], focusing on a sample of male former soldiers in the eastern Democratic Republic of Congo (DRC). Participants were categorized into two groups based on their history of CSA. Outcome measures included the prevalence of lifetime sexual assaults, perpetration of sexual violence against others, appetitive aggression, current violent behavior, symptoms of PTSD and depression and responses to two treatment modalities: TAU and FORNET.</p><p><strong>Results: </strong>The group with a history of CSA had significantly higher rates of re-experiencing sexually assaults, especially by superiors, and of perpetrating sexual assaults against others. In addition, this group presented elevated baseline scores in all outcomes (appetitive aggression, current violent behavior, symptoms of PTSD and depression). Regarding effectiveness of treatment arms, the FORNET group demonstrated significantly greater reductions in appetitive aggression levels, PTSD symptoms and depressive symptoms compared to the TAU group, with no difference in treatment effectiveness between participants with and without a history of CSA. However, individuals with CSA showed statistically superior improvements in current violent behavior, with similar score levels to those without CSA after 6-9 months.</p><p><strong>Conclusion: </strong>CSA among former soldiers was significantly associated with a higher prevalence of PTSD and increased risk of both sexual revictimization and the perpetration of sexual and other violent acts. FORNET demonstrates effectiveness in reducing appetitive aggression, PTSD symptoms, and violent behavior even in the subgroup highly affected by CSA - showing an even greater impact on current violent behavior. The ability of NET to address trauma and perpetration in a chronological sequence and adapt to the specific challenges of CSA likely account for its effectiveness in treating this complexly traumatized population, ultimately contributing to a reduction of violence in post-conflict communities. Special attention should be paid to revictimization during the rehabilitation process of ex-combatants.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"67"},"PeriodicalIF":3.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}