Summary Key Points:
Mortality
In the second quarter of 2016, 40 mortalities were reported from Zaatri camp with a Crude Mortality Rate (CMR) of (0.2/1,000 population/month; 2.0/1,000 population/year) which is comparable to the reported CMR in the first quarter of 2016 , as well as the reported CMR in 2015 and 2014 but is lower than both the reported CMR in Syria prior to the conflict in 2010 (0.33/1,000 population/month; 4.0/1,000 population/year) and the reported CMR in Jordan in 2014 according to the Department of Statistics (0.51/1,000 population/month; 6.1/1,000 population/year).
Among the 40 deaths, 15% were neonatal with a neonatal mortality rate of 8.7/1,000 livebirths which is lower than the reported neonatal mortality rate in Zaatri camp for 2015 (14.5/1,000 livebirths) as well as Jordan’s neonatal mortality rate of 14.9/1,000 livebirths; 23% were children under 5, and 50% of total mortalities were elderly above 60 years of age.
Ischemic heart disease, cardiovascular disorder and cerebrovascular disease accounted for approximately 48% of all reported mortality cases, while cancer accounted for 20% of all reported mortality cases.
CMR is influenced by the size of the population. Thus, despite the fact that CMR was calculated based on the median population in Zaatri in the second quarter of 2016 which was 79,382, it should be kept in mind that there may have been some fluctuations through the year due to people moving in and out of the camp as well as refugees leaving the camp. Furthermore, the cases of deaths reported in Zaatri are the cases that took place inside the camp as well as cases referred to health facilities outside the camp. Nevertheless, this system does not capture death cases that take place outside the camp who have not followed the usual referral procedures; i.e. cases that by themselves directly approached health facilities outside the camp and have not been reported by their family members back in the camp.
Taking the two above mentioned factors into consideration, the calculated CMR for Zaatri in the second quarter of 2016 might be underestimated or overestimated.
Morbidity
There were 61.7 full time clinicians in Zaatri camp during the second quarter of 2016 covering the outpatient department (OPD) with 27 consultations/clinician/day on average which is comparable with 2015 and is within the acceptable standard (<50 consultations/clinician/day).
Nineteen alerts were investigated during the second quarter of 2016 for diseases of outbreak potential; watery diarrhea, bloody diarrhea, acute jaundice syndrome, acute flaccid paralysis, and suspected meningitis.
For acute health conditions upper respiratory tract infections (URTI), dental conditions and skin infections were the main reasons to seek medical care in the second quarter of 2016.
For chronic health conditions, hypertension, diabetes and asthma were the main reasons to seek medical care in the second quarter of 2016 same as first quarter of 2016, as well as 2015 and 2014.
There is a marked decrease in the total consultations for Diabetes and Hypertension. This could be owed to the fact that MdM clinic stopped providing health services in Zaatri camp during the first quarter of 2016 and all chronic disease patients were shifted to JHAS clinic. JHAS clinic has a system in place for chronic disease patients to follow up with the internist once every three months if in stable state and to come collect the prescribed medications once every month directly from the pharmacy. This has resulted in decreased consultations for both Diabetes and Hypertension.
Mental health consultations accounted for 1.4% of total consultations. Severe emotional disorders (including moderate- severe depression) and epilepsy/seizures were the two main reasons to seek mental health care during the second quarter of 2016 same as first quarter of 2016, as well as 2015 and 2014.
There is a marked increase in the number of reported injuries “bites (all causes)” as compared to the first quarter of 2016. The increased trend was noticed during the month of June noting that this increased tend was also observed during the second quarter of 2015.