Health and illness in migrants and refugees arriving in Europe: analysis of the electronic Personal Health Record system

Abstract

Background: The electronic Personal Health(ePHR) Record is a health information system that registers health data on newly arriving migrants and was implemented in eight European countries (Bulgaria, Croatia, Cyprus, Greece, Italy, Romania, Serbia, and Slovenia). This is a cross-sectional study aimed to describe the health problems and health status of all migrants attended at health clinics as part of the health assessment programme established in the reception centres(2016–2019). Methods: Data were collected on demographics, clinical and laboratory findings and diagnostics performed, including medical records. We classified all diseases using pre-specified algorithms according to information on prespecified variables from the ePHR questionnaire, ICD-10 codes, positive laboratory findings or review of medical records. Crude proportions were calculated and odds ratios estimated using logistic regression modelling. Results: The ePHR dataset contained a total of 19 564 clinical episodes in 14 436 individuals, recorded between January 2016 to October 2019. Most individuals (75%) were refugees or asylum seekers (22%) from 92 different nationalities. There were 2531/19564(12,9%) infectious diseases episodes reported during the study period, being 1283/2531(50.7%) of them pharyngo-tonsillitis, 529(20.9%) scabies, 158(6.2%) viral hepatitis, 156(6.1%) lower respiratory infections. There were 2462(17.1%) individuals with non-communicable diseases reported; including 821(5.7%) cardiovascular diseases, 1183(8.2%) neurological condition, 644(4.5%) Diabetes mellitus and 212(1.5%) kidney disease cases. Having Diabetes Mellitus (adjusted OR 3.3,[95%CI 2.7–4.1],p < 0.001), and neurological disorders (aOR 1.8,[95%CI 1.4–2.2], p < 0.001) were associated with cardiovascular disorders in the multivariable logistic regression model. Mental health problems were reported in 641/14436(4.4%) individuals and were associated with increasing age. Furthermore, 610 episodes of acute injuries were reported among 585/14436(4.1%) people, 517(88.4%) of them in men, (p < 0.001). Conclusions. The ePHR is a valuable tool to efficiently collect health-related data to better address migrant health issues. We described a mostly healthy population with many acute infectious disease episodes particularly in children, but also with significant number of chronic conditions and less frequent injuries or mental health problems.

Prevention and treatment of infectious diseases in migrants in Europe in the era of universal health coverage

“…25 However, few studies have focused on the most vulnerable migrant groups such as asylum seekers, refugees, and undocumented migrants. 28 In addition to an increased mortality risk for infectious diseases, 18 data suggest that migrants might present late [29][30][31][32] and have worse outcomes, 33 which could lead to increased transmission within migrant communities. 34 Before the COVID-19 pandemic, migrants to the EU or EEA comprised a third of all tuberculosis cases in the region in 2019.…”

The Increasing Population Movements in the 21st Century: A Call for the E-Register of Health-Related Data Integrating Health Care Systems in Europe

“…The main purpose of the central register deployed collectively by European countries to address the immigration crisis aims to enable secure, real-time access to crucial clinical information. It is expected that an inclusive e-register designed to integrate various health-related datasets, functioning as a clinical data sharing e-warehouse, intends to collect and store clinical information across different health care services [ 18 , 19 ] to be a core part of the safety e-network to improve the quality and continuity of care as well foster research projects. Preferably, an HDR should incorporate already existing internally-funded clinical/research registries in European countries and similar external databases outside the European Union (EU) governed by others, e.g., WHO.…”

The Economic Impact of Russia’s Ukraine Conflict on the EU Fuel Markets

“…The majority of refugees are women and children and are headed mainly to the neighboring countries of Poland, Romania, Moldova, Hungary, and Slovakia (Purvis, 2022). In this critical situation, the EU public health systems should be adapted to respond to the increased waves of refugees (Zenner et al, 2022;Jankowski and Gujski, 2022). Finally, there are many papers related to the situation in Ukraine that could be mentioned such as (Garner, 2022;Saunders, 2022).…”