Practical needs and considerations for refugees and other forcibly displaced persons with neurological disorders: Recommendations using a modified Delphi approach

Gates Open Research

article

Shawheen Rezaei¹  Foksouna Sakadi²  Fu-Liong Hiew³  Ildefonso Rodriguez-Leyva⁴  Jera Kruja⁶  Mohammad Wasay⁸  Osheik AbuAsha Seidi⁹  Saad Abdel-Aziz^1,11  Shahriar Nafissi^1,12  Farrah Mateen¹ 

[1] Neurology, Massachusetts General Hospital;General Hospital of National Reference;Neurology, Kuala Lumpur Hospital;Universidad Autonoma de San Luis Potosi;Neurology, Hospital Central Dr. Ignacio Morones Prieto;Neurology, University of Medicine;Neurology, University Hospital Center Mother Teresa;Neurology, Aga Khan University Hospital;University of Khartoum;Neurology, Soba University Hospital;Médecins Sans Frontières;Neurology, Tehran University of Medical Sciences;Neurology, Shariati Hospital;Harvard Medical School

关键词: Neurology;    Refugee;    Asylum;    Armed Conflict;    Epilepsy: Diagnosis;    Practice;    Stroke;    Headache;   

DOI  :  10.12688/gatesopenres.13447.2

学科分类：电子与电气工程

来源: American Journal Of Pharmtech Research

【 摘 要 】

Background: 70 million forcibly displaced people worldwide, including refugees, internally displaced persons, and asylum seekers. While the health needs of forcibly displaced people have been characterized in the literature, more still needs to be done globally to translate this knowledge into effective policies and actions, particularly in neurology. Methods: In 2020, a global network of published experts on neurological disease and refugees was convened. Nine physician experts from nine countries (2 low, 1 lower-middle income, 5 upper-middle, 1 high income) with experience treating displaced people originating from 18 countries participated in three survey and two discussion rounds in accordance with the Delphi method. Results: A consensus list of priority interventions for treating neurological conditions in displaced people was created, agnostic to cost considerations, with the ten highest ranking tests or treatments ranked as: computerized tomography scans, magnetic resonance imaging scans, levetiracetam, acetylsalicylic acid, carbamazepine, paracetamol, sodium valproate, basic blood tests, steroids and anti-tuberculous medication. The most important contextual considerations (100% consensus) were all economic and political, including the economic status of the displaced person’s country of origin, the host country, and the stage in the asylum seeking process. The annual cost to purchase the ten priority neurological interventions for the entire displaced population was estimated to be 220 million USD for medications and 4.2 billion USD for imaging and tests. Conclusions: A need for neuroimaging and anti-seizure medications for forcibly displaced people was emphasized. These recommendations could guide future research and investment in neurological care for forcibly displaced people.

【 授权许可】

CC BY