Infectious Diseases among Refugee Children

Abstract

In recent years, there has been a substantial increase in refugee and asylum-seeking adults, adolescents and children to high-income countries. Infectious diseases remain the most frequently identified medical diagnosis among U.S.-bound refugee children. Medical screening and immunization are key strategies to reduce the risk of infectious diseases in refugee, internationally adopted, and immigrant children. Notable infectious diseases affecting refugee and other newly arriving migrants include latent or active tuberculosis, human immunodeficiency virus type 1 (HIV), hepatitis B, hepatitis C, vaccine-preventable diseases, malaria, and other parasitic infections. The U.S. Centers for Disease Control and Prevention and the American Academy of Pediatrics have published guidelines for health assessment of newly arriving immigrant, refugee, and internationally adopted children. Although, data on the health risks and needs of refugee exists in some high-income countries, there is an urgent need to develop robust evidence-informed guidance on screening for infectious diseases and vaccination strategies on a broader scale to inform national policies. Innovative approaches to reach migrant communities in the host nations, address health and other complex barriers to improve access to high-quality integrated health services, and strong advocacy to mobilize resources to improve health, safety, and wellbeing for refugee children and their families are urgent priorities.

Rubella epidemiology in the Central African Republic, 2015-2016 and molecular characterization of virus strains from 2008-2016

“…The outbreak in 2015 was probably linked to the socio-political crisis between 2013 and 2016, which led to the migration of people from rural zones to Bangui or close to the capital (UN High Commissioner for Refugees, 2015). Spontaneously and fortuitously constructed Internal Displacement Camps (IDPs) have become largely overcrowded long-term shelters and may have facilitated virus spread (Shetty, 2019). Although only 6 rubella cases are known to have occurred in refugees in the present study, studies in IDPs and refugees in other African countries have documented incidence increases or outbreaks of various infectious diseases and linked them to unhealthy living conditions, overcrowding and social marginalization (Hassanain et al, 2018, Ndombo et al, 2018, Roberts, 2017, Roggen et al, 2014, van Berlaer et al, 2016.…”

High Rates of Viral Suppression and Care Retention Among Youth Born Outside of the United States with Perinatally Acquired HIV

“…All patients perinatally acquired HIV. Ages ranged from 6 to 25 years, and the median age was 14 years [interquartile range (IQR), [12][13][14][15][16][17][18] (Table 1). The majority of patients were born in Africa (70%), whereas 11% were born in Europe, 8% in North America, 6% in Central/South America and 5% in Asia.…”

Meningococcal infections among refugees and immigrants: silent threats of past, present and future

“…These strategies are vaccination campaign during outbreak, maintain immunization systems for refugees according to host country's national immunization program and medical screening and/or immunization at arrival. 27,28 Based on more than 20 yof experience in the development and monitoring of a health assessment framework for the United States-bound immigrants and refugees, successful strategies are to improve health during planned migrations, including overseas screening, treatment and vaccination programs. These strategies have reduced tuberculosis rates; decreased transmission and importation of VPDs; prevented morbidity from parasitic diseases; and saved domestic health costs in the United States.…”

“…hepatitis A, hepatitis B, varicella) are most cost efficient than systematic immunization regardless of serostatus. 27,28,37 Fahrni et al 37 showed that for hepatitis A, serology-based immunization in specific age groups or countries with >25.7% of seropositivity and systematic vaccination for the others is the most costefficient immunization strategy. Vaccination without obtaining serologic tests for VPD may be a consideration in some settings since tests may be expensive, have a delayed turnaround time, and patients may be lost to follow-up due to re-location.…”