Aktuelle Seroprävalenz, Impfstatus und prädiktiver Wert der Leberenzyme für Hepatitis B bei Flüchtlingen in Deutschland

Hampel, A.; Solbach, Philipp; Cornberg, Markus; Schmidt, Reinhold; Behrens, Georg; Jablonka, Alexandra

doi:10.1007/s00103-016-2333-8

Cited by 30 publications

(9 citation statements)

References 17 publications

(24 reference statements)

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“…Another pregnant refugee suffered from syphilis and was treated immediately to prevent vertical transmission. Even though, in the first case, test results suggested no immediate threat to the offspring, and treatment was successful in the second case, both observations illustrate the importance infectious disease screening in migrants, especially in pregnant refugees, as the prevalence of severe, vertically transmittable diseases is higher in migrants than in the general population [ 14 , 32 ]. Also, we observed an alarmingly low rate of anti-rubella seropositivity in the small specimen of serologically tested pregnant refugees: only 44% of the expecting mothers had protective anti-rubella IgG-levels.…”

Section: Discussionmentioning

confidence: 99%

“…Optimized maternal healthcare significantly improves pregnancy outcomes; hence, a targeted outreach to pregnant refugees may be needed to improve healthcare utilization in this patient group [ 3 , 13 ]. For example, refugees may carry an increased risk for intrauterinely transmitted diseases such as hepatitis, syphilis, and HIV [ 14 , 15 ]. Furthermore, they are at risk for insufficient vaccination against diseases such as rubella and varicella which can lead to profound and fatal outcome in their offspring [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Pregnancy Related Health Care Needs in Refugees—A Current Three Center Experience in Europe

Dopfer

Vakilzadeh

Happle

et al. 2018

IJERPH

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Background: Immigration into Europe has reached an all-time high. Provision of coordinated healthcare, especially to refugee women that are at increased risk for adverse pregnancy outcomes, is a challenge for receiving health care systems. Methods: We assessed pregnancy rates and associated primary healthcare needs in three refugee cohorts in Northern Germany during the current crisis. Results: Out of n = 2911 refugees, 18.0% were women of reproductive age, and 9.1% of these were pregnant. Pregnancy was associated with a significant, 3.7-fold increase in primary health care utilization. Language barrier and cultural customs impeded healthcare to some refugee pregnant women. The most common complaints were demand for pregnancy checkup without specific symptoms (48.6%), followed by abdominal pain or urinary tract infections (in 11.4% of cases each). In 4.2% of pregnancies, severe complications such as syphilis or suicide attempts occurred. Discussion: We present data on pregnancy rates and pregnancy associated medical need in three current refugee cohorts upon arrival in Germany. Healthcare providers should be particularly aware of the requirements of pregnant migrants and should adapt primary caretaking strategies accordingly.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pregnancy Related Health Care Needs in Refugees—A Current Three Center Experience in Europe

Dopfer

Vakilzadeh

Happle

et al. 2018

IJERPH

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“…The HBV prevalence among populations with migration background was higher than in the GP among refugees who were screened in an emergency department (country of origin not specified) (24), and among patients with migration background primarily from the Eastern Mediterranean Area and Eastern Europe (40). The study among refugees arriving from Syria, where none were tested positive for HBV (23) was among unaccompanied minors who may have a different prevalence than the adult population.…”

Section: Prevalence In At-risk Populationsmentioning

confidence: 90%

“…One study was among refugees screened in an emergency department and found a prevalence of HBsAg and anti-HBc of 2.3 and 14.0%, respectively. The country of birth was not specified (24). Another study screened patients with migration background (patient or parents of patient) and found an HBsAg prevalence of 3.6% and anti-HBc of 32.5%.…”

Section: Hepatitis Bmentioning

confidence: 99%

Prevalence of Hepatitis B, C, and D in Germany: Results From a Scoping Review

Sperle

Steffen

Leendertz

et al. 2020

Front. Public Health

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Background: One of the five strategic directions in the World Health Organization global health sector strategy on viral hepatitis 2016-2021 is to generate strong strategic information for focused action to understand the viral hepatitis epidemic and focus the response. Knowledge of national prevalence is a cornerstone of strategic information. Germany is considered to be a low prevalence country for viral hepatitis B, C, and D, however the prevalence is likely to be higher among at-risk groups. Methods: The aim of this work was to give a detailed overview of the prevalence of viral hepatitis B (HBsAg, anti-HBc), C (anti-HCV, HCV RNA), and D (anti-HDV, HDV RNA) in different population groups in Germany. Therefore, we analyzed the results of a comprehensive literature search on various aspects of the epidemiological situation of hepatitis B, C, and D in Germany. Eligible publications including information on hepatitis B, C, and D prevalence were extracted from the overall spreadsheet table and summarized and analyzed based on virus and different population groups. A quality appraisal was performed using a checklist developed by Hoy et al. to assess risk of bias in prevalence studies. Results: Overall, 51 publications were identified through the literature search. The overall prevalence of HBsAg in the general (and proxy) population ranged from 0.3 to 1.6%. Among at-risk groups, including clinical populations and health care workers, the HBsAg prevalence ranged from 0.2% (among rheumatic patients) to 4.5% among HIV positive patients. The overall prevalence of anti-HCV in the general (and proxy) population ranged from 0.2 to 1.9%. Among at-risk groups, including clinical populations and health care workers, the anti-HCV prevalence ranged from 0.04% (among health care workers) to 68.0% among people who inject drugs. Conclusions: The hepatitis B and C prevalence in the general population in Germany is low. Prevalence is high to very high among at-risk populations, however for some Sperle et al. Hepatitis B, C, and D Prevalence groups evidence was incomplete or missing completely. To reach the elimination goals in Germany and implement a targeted response, more research among at-risk groups is needed.

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“…Seit 2015 hat sich die wissenschaftliche Datenlage zur Gesundheit und medizinischen Versorgung von Asylsuchenden in Deutschland kontinuierlich verbessert: Während noch 2014 ein systematisches Review zur Gesundheit von Asylsuchenden in Europa keine Studie aus Deutschland fand [23], und noch 2016 ein systematisches Review zum Stand der Wissenschaft bezüglich der Gesundheit von Geflüchteten in Deutschland große Lücken feststellte [24], gab es in den Folgejahren eine Vielzahl an Publikationen z. B. zum Krankheitsspektrum im Rahmen von Erstaufnahmeuntersuchungen und anderen Screenings [25][26][27][28][29], zur Prävalenz psychischer Erkrankungen [15,[30][31][32][33], zum Impfstatus [15,27], zu rechtlichen und medizinethischen Fragen [34,35], und zur Versorgungslogistik und Fragen der Versorgungsforschung [36][37][38][39][40][41].…”

Section: Diskussionunclassified

„Da muss sich jemand anders kümmern“ – Die medizinische Versorgung von Asylsuchenden als Herausforderung für eine bio-psycho-soziale Medizin

Führer

2019

Gesundheitswesen

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ZUSAMMENFASSUNG Ziel der Studie Die Medizin wird verschiedentlich dafür kritisiert, die biologischen Facetten von Gesundheit und Krankheit gegenüber gesellschaftlichen Einflüssen zu privilegieren. Gegen diesen Vorwurf hat sich in den letzten Jahrzehnten ein medizintheoretischer Ansatz etabliert, der ein bio-psycho-soziales Krankheitskonzept vertritt. Dieser Artikel nutzt ethnografische Perspektiven auf die medizinische Versorgung von Asylsuchenden, um zu untersuchen, inwiefern die Prinzipien der bio-psycho-sozialen Medizin in Bezug auf die wissenschaftlich fundierte Berücksichtigung gesellschaftlicher Einflüsse auf die Gesundheit und Krankheit dieser Patientengruppe verwirklicht werden. Methoden Dabei findet ein ethnografisches Methodenrepertoire mit narrativen Interviews, Leitfadeninterviews und teilnehmender Beobachtung Anwendung. Ergebnisse Anhand des Umgangs mit den rechtlichen Rahmenbedingungen der medizinischen Versorgung von Asylsuchenden und mit Sprachinkongruenz wird gezeigt, dass es Ärzt/-innen regelmäßig nicht gelingt, die gesundheitsbezogene Lebenswelt dieser Patientengruppe adäquat und wissenschaftlichen Standards entsprechend in Diagnostik und Therapie zu berücksichtigen. Stattdessen rekurrieren sie im klinischen Alltag häufig auf improvisierte Lösungsansätze oder verschieben die Verantwortung auf andere, oft unbenannte Akteure. Schlussfolgerung Sozialwissenschaftliche Ansätze, v. a. aus der Medizinanthropologie, könnten diese zu Versorgungsdefiziten führenden Schwierigkeiten beheben und sollten daher vermehrt in die ärztliche Aus- und Weiterbildung integriert werden. Dadurch könnten zudem theoretische und methodische Lücken geschlossen werden, die möglicherweise auch in der Versorgung anderer Patientengruppen bedeutsam sind.

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Aktuelle Seroprävalenz, Impfstatus und prädiktiver Wert der Leberenzyme für Hepatitis B bei Flüchtlingen in Deutschland

Abstract: This study showed a high prevalence of HBsAg in a German refugee sample in comparison to the general German population. Liver enzymes are not an appropriate tool for screening for hepatitis B virus infection.

Cited by 30 publications

References 17 publications

Pregnancy Related Health Care Needs in Refugees—A Current Three Center Experience in Europe

Pregnancy Related Health Care Needs in Refugees—A Current Three Center Experience in Europe

Prevalence of Hepatitis B, C, and D in Germany: Results From a Scoping Review

„Da muss sich jemand anders kümmern“ – Die medizinische Versorgung von Asylsuchenden als Herausforderung für eine bio-psycho-soziale Medizin

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