Matching health needs of refugee children with services: how big is the gap?

Raman, Shanti; Wood, Nicholas; Webber, Murray; Taylor, Kellie-Ann; Isaacs, David

doi:10.1111/j.1753-6405.2009.00431.x

Cited by 28 publications

(29 citation statements)

References 11 publications

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“…Age was inversely related to the presence of anemia and iron deficiency, supporting the notion that decreased iron intake during the critical period of human growth and development may have contributed to this finding. Immigrants and refugees originating from regions with limited access to iron- rich foods and higher rates of infectious diseases are at risk for iron deficiency [10] and resulting anemia [34]. Despite the fact that low ferritin levels are commonly used as an indicator of iron deficiency, this alone may underestimate the problem since occasional underlying infections falsely increase ferritin values to normal [9].…”

Section: Discussionmentioning

confidence: 99%

Clinical and laboratory evaluation of new immigrant and refugee children arriving in Greece

et al. 2017

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BackgroundMigrant children are a population at risk for various health problems. Despite the increased inflow of migrants in Greece, data regarding their health assessment are lacking. This study aims to describe the clinical and certain laboratory characteristics and identify possible associations in a group of new immigrant (I) and refugee (R) children, arriving in Athens, Greece.MethodsA prospective, cross- sectional study was performed in a migrant outpatient clinic of a tertiary Children’s hospital. All immigrant and refugee children, examined to obtain a health certificate, within 3 months of their arrival in the country, were enrolled. Clinical and laboratory information was collected in a pre- designed form. We applied multiple logistic regression models to investigate the association between the child’s status (immigrant vs refugee) and health indicators controlling for possible confounding effects, mainly of age and area of origin.ResultsFrom 2010 to 2013, a total of 300 children (I/R:138/162) with a mean age of 7.08 (range 1–14) years were included. Overall, 79.3% presented unknown vaccination status, 21.3% dental and 7.3% additional clinical problems. Latent tuberculosis was identified in 2.7%, while anemia, low serum ferritin and eosinophilia were found in 13.7%, 17.3%, and 22.7% of subjects, respectively. 57.7% had protective antibodies to hepatitis B surface antigen (anti-HBs ≥ 10 IU/L) and 30.6% elevated blood lead levels (EBLLs). Immigrants had less likely unknown immunization (OR = 0.25, p < 0.001), but had increased odds of low ferritin (OR = 1.97, p = 0.043), EBLLs (OR = 2.97, p = 0.001) and protective anti-HBs (OR = 1.79, p = 0.03). Age was inversely associated with anemia (OR = 0.0.89, p = 0.017), low ferritin (OR = 0.91, p = 0.027), EBLLs (OR = 0.86, p = 0.001) or positive anti-HBs (OR = 0.92, p = 0.025). Children from Europe or Africa presented decreased probability of EBLLs (OR = 0.31, p = 0.001, and OR = 0.15, p = 0.005, respectively) compared to those from Asia.ConclusionsNew immigrant and refugee children presented distinct clinical problems and certain laboratory abnormalities. Some of these health issues differed according to their migration status, age and geographic area of origin. These findings provide evidence that may assist the optimal approach of this vulnerable population.

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Section: Discussionmentioning

confidence: 99%

Clinical and laboratory evaluation of new immigrant and refugee children arriving in Greece

et al. 2017

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“…3, 14 -17 Developmental delays in refugee children may not be appreciated by families and, once identified, cultural barriers may interfere with intervention. 18,19 Delay or absence of services may negatively impact outcome. 20 Given the evidence for the positive effects of early intervention, it is important to identify the most appropriate approach to effectively screen refugee children.…”

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confidence: 99%

Developmental Screening of Refugees: A Qualitative Study

et al. 2016

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BACKGROUND AND OBJECTIVES: Refugee children are at high developmental risk due to dislocation and deprivation. Standardized developmental screening in this diverse population is challenging. We used the Health Belief Model to guide key-informant interviews and focus groups with medical interpreters, health care providers, community collaborators, and refugee parents to explore key elements needed for developmental screening. Cultural and community-specific values and practices related to child development and barriers and facilitators to screening were examined.

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“…Their health issues include incomplete immunisation, nutritional deficiencies, growth and development issues, poor dental health and communicable diseases, which can often be asymptomatic, such as tuberculosis . Comprehensive health screening after arrival is an opportunity to improve the individual health status of the children, their families and also public health outcomes for the community . Ensuring appropriate screening for the needs of a changing refugee cohort is challenging.…”

Section: Top 15 Countries Of Birth Of Humanitarian Refugees Settling mentioning

confidence: 99%

Tuberculosis infection in under‐2‐year‐old refugees: Should we be screening? A systematic review and meta‐regression analysis

Ghosh

Dronavalli

Raman

2019

J Paediatrics Child Health

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Aim: Refugees are at increased risk of tuberculosis infection due to time spent in crowded camps, decreased nutrition and originating from countries whose own tuberculosis control systems may have been disturbed. In Australia, tuberculosis is screened for in for all refugees aged 11-34 years old and in those aged 2-10 years arriving from high-incidence countries. Our aims were to determine if refugee children aged under 2 years of age should also be screened. Methods: A systematic literature review and meta-regression was carried out on studies in refugee children under 18 years old, involving screening for tuberculosis (active or latent tuberculosis infection (LTBI)). Studies were extracted from the last 10 years from a range of bibliographic databases using the search terms 'tuberculosis', 'children', 'screening' and 'refugee', which tested for tuberculosis using the tuberculin skin test (TST) or QuantiFERON-Gold (Interferon Gamma Release Assay (IGRA)). Results: Of the 15 included studies, prevalence of LTBI in < 2-year-olds was 5% using IGRA and 15% using TST (P < 0.05). Prevalence increased with age (odds ratio 1.12; 95% confidence interval: 1.06-1.17) cumulatively and decreased where IGRA was used for screening compared to TST (odds ratio 0.38; 95% confidence interval: 0.25-0.58). Prevalence of LTBI did not differ between general versus clinic refugee cohorts. Conclusions: Refugees are a particularly vulnerable group in their susceptibility to tuberculosis, and LTBI management is a critical part of tuberculosis disease control due to the lifetime risk of developing active tuberculosis. A prevalence of 5-15% for LTBI in the under 2 years age group would support them being included in screening programmes.

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Matching health needs of refugee children with services: how big is the gap?

Abstract: Implications: There is a strong moral and public health imperative to provide appropriately resourced, culturally competent and comprehensive health care to optimise refugee children's wellbeing.

Cited by 28 publications

References 11 publications

Clinical and laboratory evaluation of new immigrant and refugee children arriving in Greece

Clinical and laboratory evaluation of new immigrant and refugee children arriving in Greece

Developmental Screening of Refugees: A Qualitative Study

Tuberculosis infection in under‐2‐year‐old refugees: Should we be screening? A systematic review and meta‐regression analysis

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