Health problems and exposure to infectious risks in returning humanitarian aid workers.

BACKGROUND:Humanitarian aid workers are exposed to deployment-related health threats. Identifying subgroups at higher risk of infection in this diverse population could help optimize prevention. METHODS:We carried out a retrospective study based on anonymized data of humanitarian aid workers that visited our clinic for a post-deployment visit between January 1st, 2018, and December 31st, 2021. We conducted a descriptive analysis of basic demographic data, self-reported risk exposure and health problems encountered during deployment extracted from a standard questionnaire. RESULTS:The questionnaire was administered to 1238 aid workers during 1529 post-deployment medical consultations. The median age was 37.2 years (IQR 31.7-44.3) and 718/1529 (47.0%) were female aid workers. The median duration of deployment was 6 months (IQR 3-12 months). Most deployments (1321/1529 (86.4%)) were for a medical organization and in Sub-Saharan Africa (73.2%).The most common risk exposures were contact with freshwater in schistosomiasis endemic regions (187/1308 (14.3%)); unprotected sexual contact with a person other than a regular partner (138/1529 (9.0%)); suspected rabies exposure (56/1529 (3.7%)); and accidental exposure to blood (44/1529 (2.9%)).Gastrointestinal problems (487/1529 (31.9%)), malaria (237/1529 (15.5%)) and respiratory tract infections (94/1529 (6,2%)) were the most encountered health problems. Fifteen volunteers (1%) were hospitalized during deployment and 19 (1.2%) repatriated due to health problems. Adherence to malaria chemoprophylaxis was poor, only taken according to prescription in 355 out of 1225 (29.0%) of aid workers for whom prophylaxis was indicated. CONCLUSION:Humanitarian aid workers deployed abroad encounter significant rates of health problems and report a high level of risk exposure during their deployment, with the risks being greatest among younger people, those deployed to rural areas, and those working for non-medical organizations. These findings help guide future pre-deployment consultations, to increase awareness and reduce risk behaviour during deployment, as well as focus on adherence to medical advice such as malaria chemoprophylaxis.