Bilukha, O.

Kaiser, R.

Salama, P.

Spiegel, P.B.

Woodruff, B.A.

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Abstracts - 14th World Congress on Disaster and Emergency Medicine s29These are some controversial issues in disaster medicineoutlined in some of the key questions about medical andpublic health preparedness, which are aimed at pinpointingand arriving at common definitions and understandingsstandard in the US disaster response. The purpose of thispaper is not only to introduce these questions, but also toencourage debate and provide final answers to these termsand issues. The goal is to get beyond vague and poorlydefined concepts, such as "preparedness" and "quarantine",and open a dialogue to effectively begin to define, analyzeand measure key parameters that define our ability torespond to and mitigate disaster.Keywords: disaster; emergencies; health; hospitals; preparedness;quarantine; response; United States (US)Prtbmp Disasl Mid 20O5;2O(2):s28-s29Using Design Effects from Previous Cluster Surveysto Guide Sample Size Calculation in EmergencySettingsR. Kaiser;1 B.A. Woodruff;1 0. Bilukha;1 P.B. Spiegel?P. SalamcP1. Centers for Disease Control and Prevention, Atlanta, GeorgiaUSA2. United Nations High Commissioner for Refugees (UNHCR),Switzerland3. United Nations Children's Fund (UNICEF), USAIntroduction: The standard survey design used in human-itarian emergencies (30 clusters with 30 individuals each) isbeing used increasingly to measure outcomes other thanacute malnutrition; however, research design effects forthese outcomes have not been evaluated thoroughly. Beingable to accurately estimate design effects is critical whencalculating the most efficient sample size for such surveys.Methods: Design effects and rates of homogeneity for sevennutrition and health outcomes were reviewed from nine popu-lation-based, cluster surveys conducted in emergency settings.Results: In children, the median design effects for mortali-ty, acute malnutrition, and anemia were 1.25, 1.4, and 1.5,respectively. Median design effects for the cumulativeprevalence of acute respiratory disease and diarrhea, and formeasles vaccination coverage were much higher: 3.6, 3.4,and 5.1, respectively. Four of the eight surveys that assessedcrude mortality showed design effects below two; the medi-an was 1.7. Re-analysis of mortality data from Kosovo andBadghis, Afghanistan, showed that given the same numberof clusters, changing sample size had a relatively small effecton the precision obtained for the estimate of mortality.Conclusions: In the majority of surveys, assuming a designeffect of 1.5 for acute malnutrition in children and 2 or lessfor crude mortality would produce a more efficient samplesize. In addition, increasing the sample size in cluster sur-veys without increasing the number of clusters may notresult in substantial improvements in precision.Keywords: cluster; design; effects; emergency; refugees; sample sizePnbosp Disast Mid 2005;20(2):s29Complex Emergencies: Epidemiological Models andModels of ResponseFrederick Burkle, JrJohns Hopkins University Medical Institutions, Baltimore, MarylandUSAComplex emergencies (CEs) are the most common,human-induced disasters and represent a major challengeto the humanitarian community. This presentation firstwill define the three major epidemiological country modelsof CEs: (1) developing; (2) chronic; and (3) developed, andhow they differ for planning purposes. Secondly, the exist-ing international response models: (1) multi-national; (2)unilateral; and (3) the Responsibility to Protect (R2P)models, in terms of their characteristics, objectives, andcontroversies will be discussed.Keywords: complex emergencies; disasters; model; responsePnhos? Dimit Mid 2005;20(2):s29Health Needs Among Sudanese Internally DisplacedPersons (Special Session on Humanitarian Crises of2003-2004)L. Amowitz;1 G. Kim,-2 E. Noji31. International Medical Corps, Santa Monica, California USA2. Harvard Medical School, Boston, Massachusetts USA3. Centers for Disease Control and Prevention, Atlanta, GeorgiaUSAIntroduction: Sudan has the largest displaced populationin the world with approximately 3-4 million internally dis-placed persons (IDPs), and an additional 400,000Sudanese refugees abroad. During the last 18 months,human rights violations have been on going and wide-spread in the Darfur region of Sudan.Objective: Using a combination of quantitative and quali-tative methods, the International Medical Corps (IMC)will perform an in-depth and credible real-time assessmentof health and basic needs among the >2 million IDPs in theSouth and West Darfur regions of Sudan. These assess-ments will help to identify better the basic needs and thegaps in humanitarian aid services, paying close attention tothe specific needs of women.Methods: All study participants for this population-basedassessment will be selected using systematic random sam-pling or a combination of systematic random sampling andcluster sampling as some IDP camps will not be accessibledue to safety issues or Government policy. Approximately1,200 households will be selected randomly and sampled inproportion to their distribution in IDP camps. The surveyaddresses demographics, the prevalence and extent of cer-tain abuses including sexual violence both by combatantsand non-combatants, the prevalence of suicidal ideation,suicide and depression rates, and women's roles in societyand primary health needs and gaps.Conclusion: A discussion of the findings of this survey tobe completed in January 2005 will include the wide-rangingimplications of establishing patterns of abuse and the healthneeds of survivors/victims, identifying specific policy rec-ommendations regarding the needs and/or vulnerabilities ofthe Sudanese IDPs, and identifying specific policy recom-mendations for gender-based and mental health needs.Keywords: humanitarian aid; internally displaced persons; publichealth; SudanPrebosp Disatl Mid 2005;20(2):s29March-April 2005 http://pdm.medicine.wisc.edu Prehospital and Disaster Medicinehttps:/www.cambridge.org/core/terms. https://doi.org/10.1017/S1049023X00012486Downloaded from https:/www.cambridge.org/core. University of Basel Library, on 11 Jul 2017 at 15:30:56, subject to the Cambridge Core terms of use, available at

Using Design Effects from Previous Cluster Surveys to Guide Sample Size Calculation in Emergency Settings

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