187478 Chronic Disease in a War-Torn State

Tuesday, October 28, 2008: 3:30 PM

Ramin G. Asgary, MD, MPH, MSc , Depts of Medicine and Social and Community Medicine, Montefiore Med Ctr.; and MPH Program in Global Health, Mount Sinai Med Ctr., Albert Einstein College of Medicine and The Mount Sinai School of Medicine, Bronx, NY
Background: Abkhazia, a small former Soviet Union state under international embargo with previously very well-functioning health and social system and infrastructure, suffers from health system collapse due to a civil war in a post-Soviet era. Medications and medical supplies are provided by international organizations. Chronic diseases such as coronary artery diseases, hypertension, and osteoarthritis were common before the soviet collapse and civil war.

Methods: During an ongoing and systematic evaluation to identify common pathologies in office visits, all 75 generalists and pediatricians in all countries' 24 clinics and hospitals documented diagnoses and treatments over a six-month period. Regular visits to offices ensured proper data collection.

Result: 86% of all diagnosis was: infectious diseases (40.5%) mostly upper and lower respiratory infections. Chronic cardiovascular diseases (18%) including hypertension and ischemic heart diseases as well as musculoskeletal diseases (5.6%) including osteoarthritis were documented. Other diagnoses included gastro-intestinal (4.7%) including gastritis and peptic ulcers, neuro-psychiatric (4.6%) including migraine, sleep disorders and epilepsy, skin disorders (4.6%), and chronic respiratory diseases (3.6%). Helminthes was 2.8%. Tuberculosis was epidemic. The provision of medications and supplies were adjusted accordingly to ensure proper management of common illnesses. Data was communicated to local authorities and other international organizations.

Conclusion: This data provides insight into the unique health challenges faced by a society with a previously well functioning system as compared to other common post-conflict states. The relatively high rate of chronic disease demonstrates that the epidemiology of disease after a conflict mirrors the original social and health characteristics of the society.

Learning Objectives:
a) to recognize the health system challenges in a war-torn state b) to discuss the epidemiology of chronic disease after a conflict in a previously well functioning health system

Keywords: War, Chronic Diseases

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I performed the study and developed the abstract
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.