Morbidity profile and sociodemographic characteristics of unaccompanied refugee minors seen by paediatric practices between October 2014 and February 2016 in Bavaria, Germany

Abstract

BackgroundThis study aimed to investigate the morbidity profile and the sociodemographic characteristics of unaccompanied refugee minors (URM) arriving in the region of Bavaria, Germany, between October 2014 and February 2016.MethodsThe retrospective cross sectional study included 154 unaccompanied refugee minors between 10 and 18 years of age. The data was derived from medical data records of their routine first medical examination in two paediatric practices and one collective housing for refugees in the region of Bavaria, Germany.ResultsOnly 12.3% of all participants had no clinical finding at arrival. Main health findings were skin diseases (31.8%) and mental disorders (25%). In this cohort the hepatitis A immunity was 92.8%, but only 34.5% showed a constellation of immunity against hepatitis B. Suspect cases for tuberculosis were found in 5.8% of the URM. There were no HIV positive individuals in the cohort. Notably, 2 females were found to have undergone genital mutilations.ConclusionsThe majority of arriving URM appear to have immediate health care needs, whereas the pathologies involved are mostly common entities that are generally known to the primary health care system in Germany. Outbreaks due to hepatitis A virus are unlikely since herd immunity can be assumed, while this population would benefit from hepatitis B vaccination due to low immunity and high risk of infection in crowded housing conditions. One key finding is the absence of common algorithms and guidelines in health care provision to URM.

Migrant children in transit: health profile and social needs of unaccompanied and accompanied children visiting the MSF clinic in Belgrade, Serbia

“…Staying in substandard conditions of often overcrowded settlements with changeable access to water and hygienic conditions was one of the main reasons behind high prevalence of skin conditions such as scabies and body lice. Based on our findings, the frequency of these conditions was slightly higher than in similar studies and reports from the EU, which could be attributed to MSF mainly treating individuals who found themselves outside of the official system, in more precarious living environment [ 18 – 20 ].…”

Mental Health Outcomes of Unaccompanied Refugee Minors: a Rapid Review of Recent Research

“…Five years after arrival, many still experienced clinical levels of mental health problems Level of daily hassles was an important predictor of mental health outcomes High Laukamp (2019) Germany [ 31 ] Cross-sectional 246 URMs from Syria 78% male Clinical Interview Diagnosis based ICD Mental and behavioural problems were detected in 11% Mental and behavioural problems did not differ significantly between the regions/countries of origin Gender did not predict mental or behavioural rate Mostly PTSD and Depression Moderate Müller (2019) Germany [ 32 ] Cross-sectional 68 URMs (total 98 refugees in study) Mainly from Afghanistan, Syria and Eritrea PTSS measured by Child and Adolescent Trauma Screen CATS Internalizing symptoms of depression and anxiety and externalizing behaviours measure by Hopkins Symptom Checklist-37 for Adolescents (HSCL-37A) URMs higher rates of anxiety compared to accompanied (38.2% vs 23.3%) Number of traumatic experiences main predictor of PTSS, Depression and anxiety Lower levels of individual resources, lower levels of social support in the host country and poorer German language proficiency were associated with higher levels of psychological distress for URMs High Sierau (2019) Germany. [ 33 ] Cross-sectional 105 URMs from Syria and Afghanistan PTSD symptoms were measured using the Posttraumatic Stress Disorder Checklist (PCL-5 Symptoms of depression were measured with the Patient Health Questionnaire , 9-item module (PHQ-9 Anxiety symptoms were assessed with the Generalized Anxiety Disorder Scale (GAD-7 Somatic symptoms were measured using the Somatic Symptoms Scale (SSS-8) Close to 60% reported mental health problems 40% depression and 32% PTSD URMs without any family contact had less social support Lower social support predicted PTSD, depression and anxiety URMs without family contact very ta risk for poor mental health outcomes Moderate Kloning, (2018) Germany [ 34 ] Retrospective cohort 154 URMs Mainly from Somalia (27.8%) PTSD Using clinical judgement and questionnaire 25% had PTSD Low Ehntholt (2018) UK [ 35 ] Prospective cohort 35 URMs in UK detention centres due to age dispute Structured Clinical Interview for DSM-IV (SCID-IV), Reactions of Adolescents to Traumatic Stress (RATS), Stressful Life Events (SLE) and Detention Experiences Checklist–UK version (DEC-UK) were administered ...…”

“…Müller (2019) Germany [32] x x x Sierau (2019) Germany. [33] x x x x Kloning, (2018) Germany [34] x x Ehntholt (2018) UK [35] x…”

Hepatitis B Vaccination Coverage in Germany: Systematic Review

“…Two studies measured a not speci ed VC of 4.4% resp. 14.9% in unaccompanied refugee minors (UAM) (31,35) and three a not speci ed VC between 9.1% and 18.6% in adult refugees (23,27,32). For patients with a direct or indirect migration background of a general medicine practice the not speci ed VC was 17.4% (25).…”