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Cost was also a major factor, as was the need to build local capacity to deal with the recurrent emergencies caused by cyclones.
A shortage of more than 25,000 classrooms leads to overcrowding, and in a large number of counties recurrent emergencies and insecurity delay the distribution of educational materials to schools, and compromise attendance during the school year.
In addition to volatile political and socio-economic situations in Central African Republic, Chad, Côte d'Ivoire, Democratic Republic of the Congo, Guinea and Guinea-Bissau, the region continues to confront malnutrition in the Sahel countries and recurrent emergencies, such as cholera, meningitis and floods.
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Hospital-based interventions to reduce the risk of future harm could benefit these adolescents by reducing episodes of injury, and may reduce recurrent emergency (ie, acute or unplanned) admissions for injury.
Of adolescents in the general population in England, we aimed to determine (1) the proportion that has an emergency admission to hospital for injury related to adversity (violence, self-harm or drug or alcohol misuse) and (2) the risk of recurrent emergency admissions for injury in adolescents admitted with adversity-related injury compared with those admitted with accident-related injury only.
Finally, we determined the risk of recurrent emergency admissions for injury in adolescents who had at least one admission between 10 and 19 years of age for adversity-related injury compared with adolescents only ever admitted for accidental injury during the same period.
Recurrent emergency admissions for injury were more common in adolescents with adversity-related injury (girls 17.3%, boys 16.5%) than in those with accident-related injury only (girls 4.7%, boys 7.4%), particularly for adolescents with adversity-related injury related to multiple types of adversity (girls 21.1%, boys 24.2%).
This helps improve the prediction and prevention of emergencies, particularly recurrent disasters, and prepare communities to cope with them should they occur.
The assumption that recurrent attenders to the emergency department do not necessarily have serious pathology must be challenged in this specific scenario.
A 12 year old boy presented with a 2 month history of recurrent epistaxis to the emergency department for his fourth episode.
Between July 2012 and December 2013, all consecutive patients referred by a third party or self-referred patients ≥18 years presenting with self-reported ACP (first or recurrent episode) at the emergency unit of the University Hospital Zurich were prospectively included in this study when a member of the study team was present.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com