Tuberculosis in young refugees

Ritz, Nicole; Brinkmann, Folke; García, Begoña Santiago; Tebruegge, Marc; Kampmann, Beate

doi:10.1016/s0140-6736(15)01241-6

Cited by 22 publications

(15 citation statements)

References 7 publications

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“…There is no or no comprehensive screening for children among refugees [43]. National TB screening protocols (AsylG, IfSG) do not address the issue of TB screening for children younger than 15 years.…”

Section: Discussionmentioning

confidence: 99%

Yield of active screening for tuberculosis among asylum seekers in Germany: a systematic review and meta-analysis

et al. 2017

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All asylum seekers in Germany undergo upon-entry screening for tuberculosis TB, but comprehensive evidence on the yield is lacking. We compared the national estimates with the international literature in a systematic review and meta-analysis of studies reporting the yield of TB, defined as the fraction of active TB cases detected among asylum seekers screened in Germany upon entry. We searched 11 national and international databases for empirical studies and the internet for grey literature published in English or German without restrictions on publication time. Among 1,253 screened articles, we identified six articles reporting the yield of active TB based on German data, ranging from 0.72 (95% confidence interval (CI): 0.45–1.10) to 6.41 (95% CI: 4.19–9.37) per 1,000 asylum seekers. The pooled estimate across all studies was 3.47 (95% CI: 1.78–5.73; I2 = 94.9%; p < 0.0001) per 1,000 asylum seekers. This estimate was in line with international evidence (I2 = 0%; p for heterogeneity 0.55). The meta-analysis of available international estimates resulted in a pooled yield of 3.04 (95% CI: 2.24–3.96) per 1,000. This study provides an estimate across several German federal states for the yield of TB screening in asylum seekers. Further research is needed to develop more targeted screening programmes.

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Section: Discussionmentioning

confidence: 99%

Yield of active screening for tuberculosis among asylum seekers in Germany: a systematic review and meta-analysis

et al. 2017

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“…Many refugees have had limited access to healthcare for years and therefore arrive in host countries with neglected health conditions 6–8. The health of asylum-seeking children and adolescents is of key interest, as these represent an increasing refugee population in recent years and are a particularly vulnerable group 9–11…”

Section: Introductionmentioning

confidence: 99%

Perspective of asylum-seeking caregivers on the quality of care provided by a Swiss paediatric hospital: a qualitative study

et al. 2019

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ObjectivesThis study investigated the perspective of asylum-seeking caregivers on the quality of healthcare delivered to their children in a qualitative in-depth interview study. The health of asylum-seeking children is of key interest for healthcare providers, yet knowledge of the perspective of asylum-seeking caregivers when accessing healthcare is limited.SettingThe study took place in a paediatric tertiary care hospital in Basel, Switzerland.ParticipantsInterviews were done with 13 asylum-seeking caregivers who had presented with their children at the paediatric tertiary care hospital. Nine female and four male caregivers from Tibet, Eritrea, Afghanistan, Syria, Iraq, Albania and Macedonia were included. A diverse sample was chosen regarding cultural and social background, years of residence in Switzerland and reasons for seeking care. A previously developed and pilot-tested interview guide was used for semistructured in-depth interviews between 36 and 92 min in duration. Data analysis and reporting was done according to Consolidated Criteria for Reporting Qualitative Research. The number of interviews was determined by saturation of data.ResultsThe interviewees described a mismatch of personal competencies and external challenges. Communication barriers and unfamiliarity with new health concepts were reported as challenges. These were aggravated by isolation and concerns about their child’s health. The following factors were reported to strongly contribute to satisfaction of healthcare delivery: a respectful and trusting caregiver–provider relationship, the presence of interpreters and immediate availability of treatment.ConclusionsA mismatch of personal competencies and external challenges importantly influences the caregiver–provider relationship. To overcome this mismatch establishment of confidence was identified as a key factor. This can be achieved by availability of interpreter services, sufficient consultation time and transcultural trainings for healthcare workers. Coordination between the family, the government’s asylum system and the medical system is required to facilitate this process.

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“…Longer term implications include the progression of individuals from asymptomatic TB infection to TB disease, potentially years later in the final destination country where opportunities for contact tracing, preventive treatment, and the identification of further cases may have been lost [55]. Refugee and migrant children face particular barriers to realizing their right to health, with reduced access to, and utilization of, both preventive and general health care services [56].…”

Section: Introductionmentioning

confidence: 99%

Why the Convention on the Rights of the Child must become a guiding framework for the realization of the rights of children affected by tuberculosis

Roy

Brandt

Moodie³

et al. 2016

BMC Int Health Hum Rights

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BackgroundUntil recently, paediatric tuberculosis (TB) has been relatively neglected by the broader TB and the maternal and child health communities. Human rights-based approaches to children affected by TB could be powerful; however, awareness and application of such strategies is not widespread.DiscussionWe summarize the current challenges faced by children affected by TB, including: consideration of their family context; the limitations of preventive, diagnostic and treatment options; paucity of paediatric-specific research; failure in implementation of interventions; and stigma. We examine the articles of the Convention on the Rights of the Child (CRC) and relate them to childhood TB. Specifically, we focus on the five core principles of the CRC: children’s inherent right to life and States’ duties towards their survival and development; children’s right to enjoyment of the highest attainable standard of health; non-discrimination; best interests of the child; and respect for the views of the child. We highlight where children’s rights are violated and how a human rights-based approach should be used as a tool to help children affected by TB, particularly in light of the Sustainable Development Goals and their focus on universality and leaving no one behind.SummaryThe article aims to bridge the gap between those providing paediatric TB clinical care and conducting research, and those working in the fields of human rights policy and advocacy to promote a human rights-based approach for children affected by TB based upon the Convention on the Rights of the Child.

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Tuberculosis in young refugees

Cited by 22 publications

References 7 publications

Yield of active screening for tuberculosis among asylum seekers in Germany: a systematic review and meta-analysis

Yield of active screening for tuberculosis among asylum seekers in Germany: a systematic review and meta-analysis

Perspective of asylum-seeking caregivers on the quality of care provided by a Swiss paediatric hospital: a qualitative study

Why the Convention on the Rights of the Child must become a guiding framework for the realization of the rights of children affected by tuberculosis

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