Display options
Cite
Jablonka A, Dopfer C, Happle C, et al. Acute respiratory infections in an adult refugee population: an observational study. NPJ Prim Care Respir Med. 2021;31(1):50doi: 10.1038/s41533-021-00261-9.
Jablonka, A., Dopfer, C., Happle, C., Shalabi, A., Wetzke, M., Hummers, E., Friede, T., Heinemann, S., Hillermann, N., Simmenroth, A., & Müller, F. (2021). Acute respiratory infections in an adult refugee population: an observational study. NPJ primary care respiratory medicine, 31(1), 50. https://doi.org/10.1038/s41533-021-00261-9
Jablonka, Alexandra, et al. "Acute respiratory infections in an adult refugee population: an observational study." NPJ primary care respiratory medicine vol. 31,1 (2021): 50. doi: https://doi.org/10.1038/s41533-021-00261-9
Jablonka A, Dopfer C, Happle C, Shalabi A, Wetzke M, Hummers E, Friede T, Heinemann S, Hillermann N, Simmenroth A, Müller F. Acute respiratory infections in an adult refugee population: an observational study. NPJ Prim Care Respir Med. 2021 Dec 21;31(1):50. doi: 10.1038/s41533-021-00261-9. PMID: 34934070.
Copy Download .nbib Format: NLM
Share it on

NPJ Prim Care Respir Med. 2021 Dec 21;31(1):50. doi: 10.1038/s41533-021-00261-9.

Acute respiratory infections in an adult refugee population: an observational study.

NPJ primary care respiratory medicine

Alexandra Jablonka, Christian Dopfer, Christine Happle, Andree Shalabi, Martin Wetzke, Eva Hummers, Tim Friede, Stephanie Heinemann, Nele Hillermann, Anne Simmenroth, Frank Müller

Affiliations

  1. German Center for Infection Research (DZIF), Partner site Hannover-Braunschweig, Hannover, Germany.
  2. Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany.
  3. Department of Pediatrics, Neonatology and Allergology, Hannover Medical School, Hannover, Germany.
  4. Department of General Practice, University Medical Center Goettingen, Goettingen, Germany.
  5. Department of Medical Statistics, University Medical Center Goettingen, Goettingen, Germany.
  6. Department of General Practice, University Hospital Wuerzburg, Wuerzburg, Germany.
  7. Department of General Practice, University Medical Center Goettingen, Goettingen, Germany. [email protected].

PMID: 34934070 DOI: 10.1038/s41533-021-00261-9

Abstract

The presence of acute infectious respiratory diseases (ARD) is one of the main reasons why recently arrived refugees seek medical help. This paper investigates the incidence rates of acute respiratory diseases in an adult refugee population as well as associated sociodemographic factors and drug treatments. We conducted a retrospective observational study of deidentified medical records. The data were collected between 2015 and 2019 in the health care centers of two large German initial reception centers for refugees. Multivariable analyses controlling for sociodemographics were carried out using generalized estimating equations. Out of 10,431 eligible residents, 6965 medical encounters of 2840 adult patients were recorded over 30 months. Of all the adult patients, 34.4% sought medical help for a respiratory symptom or diagnosis at least once. Older patients and patients from Sub-Saharan Africa sought help less often. The occurrence of ARD showed a typical distribution over the course of the year. Facility occupancy was not associated with ARD occurrence. Acute respiratory symptoms are a leading cause for adult refugee patients to seek medical care. The doctor contact rates due to ARD were consistently two to three times higher among refugees than among German residents.

© 2021. The Author(s).

References

  1. Bradby, H., Humphris, R., Newall, D. & Phillimore, J. Public Health Aspects of Migrant Health: A Review of the Evidence on Health Status for Refugees and Asylum Seekers in the European Region 44th edn (WHO Regional Office for Europe, 2015). - PubMed
  2. Hargreaves, S., Kumar, B. N., McKee, M., Jones, L. & Veizis, A. Europe’s migrant containment policies threaten the response to covid-19. BMJ 368, m1213 (2020). - PubMed
  3. Isenring, E., Fehr, J., Gültekin, N. & Schlagenhauf, P. Infectious disease profiles of Syrian and Eritrean migrants presenting in Europe: a systematic review. Travel Med Infect. Dis. 25, 65–76 (2018). - PubMed
  4. Georgakopoulou, T. et al. Ongoing measles outbreak in Greece related to the recent European-wide epidemic. Epidemiol. Infect. 146, 1692–1698 (2018). - PubMed
  5. Jones, G. et al. Measles outbreak in a refugee settlement in Calais, France: January to February 2016. Eur. Surveill. 21, 30167 (2016). - PubMed
  6. Hsan, K., Naher, S., Gozal, D., Griffiths, M. D. & Furkan Siddique, M. R. Varicella outbreak among the Rohingya refugees in Bangladesh: lessons learned and potential prevention strategies. Travel Med. Infect. Dis. 31, 101465 (2019). - PubMed
  7. Vairo, F. et al. An outbreak of chickenpox in an asylum seeker centre in Italy: outbreak investigation and validity of reported chickenpox history, December 2015-May 2016. Eur. Surveill. https://doi.org/10.2807/1560-7917.ES.2017.22.46.17-00020 (2017). - PubMed
  8. Lesens, O., Baud, O., Henquell, C., Lhermet Nurse, A. & Beytout, J. Varicella outbreak in Sudanese refugees from Calais. J. Travel Med. https://doi.org/10.1093/jtm/taw042 (2016). - PubMed
  9. Redditt, V. J., Janakiram, P., Graziano, D. & Rashid, M. Health status of newly arrived refugees in Toronto, Ont: Part 1: infectious diseases. Can. Fam. Physician 61, e303–e309 (2015). - PubMed
  10. Oltrogge, J. H. et al. Episodes of care in a primary care walk-in clinic at a refugee camp in Germany - a retrospective data analysis. BMC Fam. Pract. 21, 193 (2020). - PubMed
  11. Chung, R. Y.-N., Dong, D. & Li, M. M. Socioeconomic gradient in health and the covid-19 outbreak. BMJ 369, m1329 (2020). - PubMed
  12. Wang, Z. & Tang, K. Combating COVID-19: health equity matters. Nat. Med. 26, 458 (2020). - PubMed
  13. Greenaway, C. et al. COVID-19: exposing and addressing health disparities among ethnic minorities and migrants. J. Travel Med. https://doi.org/10.1093/jtm/taaa113 (2020). - PubMed
  14. Bundesamt für Migration und Flüchtlinge. Das Bundesamt in Zahlen 2019 (2020). - PubMed
  15. United Nations High Commissioner for Refugees. UNHCR population statistics. http://popstats.unhcr.org/en/overview (2020). - PubMed
  16. Kleinert, E. et al. Does refugee status matter? Medical needs of newly arrived asylum seekers and resettlement refugees - a retrospective observational study of diagnoses in a primary care setting. Confl. Health 13, 39 (2019). - PubMed
  17. Hermans, M. P. J. et al. Healthcare and disease burden among refugees in long-stay refugee camps at Lesbos, Greece. Eur. J. Epidemiol. 32, 851–854 (2017). - PubMed
  18. Goodman, L. F., Jensen, G. W., Galante, J. M., Farmer, D. L. & Taché, S. A cross-sectional investigation of the health needs of asylum seekers in a refugee clinic in Germany. BMC Fam. Pract. 19, 64 (2018). - PubMed
  19. Wetzke, M. et al. Healthcare utilization in a large cohort of asylum seekers entering Western Europe in 2015. Int. J. Environ. Res. Public Health. https://doi.org/10.3390/ijerph15102163 (2018). - PubMed
  20. Müller, F. et al. Factors influencing the frequency of airway infections in underage refugees: a retrospective, cross sectional study. Int. J. Environ. Res Public Health 17, 6823 (2020). - PubMed
  21. Müller, F. et al. Disease burden in a large cohort of asylum seekers and refugees in Germany. J. Glob. Health 11, 4002 (2021). - PubMed
  22. Robert Koch-Institut. GrippeWeb als Wichtiges Instrument in der Vorbereitung und Bewältigung einer Zukünftigen Pandemie: RKI-Bib1 (Robert Koch-Institut, 2017). - PubMed
  23. World Bank Group. Atlas of Sustainable Development Goals 2018: From World Development Indicators (World Bank Group, 2018). - PubMed
  24. Agency for Healthcare Research and Quality. Chronic Condition Indicator (CCI) for ICD-10-CM (beta version). https://www.hcup-us.ahrq.gov/toolssoftware/chronic_icd10/chronic_icd10.jsp (2020). - PubMed
  25. Thomas, M. & Bomar, P. A. StatPearls: Upper Respiratory Tract Infection (StatPearls Publishing, 2020). - PubMed
  26. Arroll, B. Common cold. BMJ Clin. Evid. 2011, 1510 (2011). - PubMed
  27. Kane, S. P. Sample size calculator. https://clincalc.com/stats/samplesize.aspx (2019). - PubMed
  28. Furaijat, G., Kleinert, E., Simmenroth, A. & Müller, F. Implementing a digital communication assistance tool to collect the medical history of refugee patients: DICTUM Friedland - an action-oriented mixed methods study protocol. BMC Health Serv. Res. 19, 103 (2019). - PubMed
  29. Robert Koch-Institut. Bericht zur Epidemiologie der Influenza in Deutschland Saison 2017/18: RKI-Bib1 (Robert Koch-Institut, 2018). - PubMed
  30. Dune, T., Ayika, D., Thepsourinthone, J., Mapedzahama, V. & Mengesha, Z. The role of culture and religion on sexual and reproductive health indicators and help-seeking attitudes amongst 1.5 generation migrants in Australia: a quantitative pilot study. Int. J. Environ. Res. Public Health 18, 1341 (2021). - PubMed
  31. Place, V. et al. Interventions to increase migrants’ care-seeking behaviour for stigmatised conditions: a scoping review. Soc. Psychiatry Psychiatr. Epidemiol. 56, 913–930 (2021). - PubMed
  32. Tejpal, A. et al. Sex-based differences in COVID-19 outcomes. J. Womens Health 30, 492–501 (2021). - PubMed
  33. Chen, L., Han, X.-D., Li, Y.-L., Zhang, C.-X. & Xing, X.-Q. Severity and outcomes of influenza-related pneumonia in type A and B strains in China, 2013–2019. Infect. Dis. Poverty 9, 42 (2020). - PubMed
  34. Happle, C. et al. Pediatric healthcare utilization in a large cohort of refugee children entering Western Europe during the migrant crisis. Int. J. Environ. Res. Public Health. https://doi.org/10.3390/ijerph16224415 (2019). - PubMed
  35. UNHCR. Resettlement Handbook (UNHCR, 2011). - PubMed
  36. Townsend, L., Flisher, A. J., Gilreath, T. & King, G. A systematic literature review of tobacco use among adults 15 years and older in sub-Saharan Africa. Drug Alcohol Depend. https://doi.org/10.1016/j.drugalcdep.2005.12.008 (2006). - PubMed
  37. Brathwaite, R., Addo, J., Smeeth, L. & Lock, K. A systematic review of tobacco smoking prevalence and description of tobacco control strategies in Sub-Saharan African countries; 2007 to 2014. PLoS ONE 10, e0132401 (2015). - PubMed
  38. Kenealy, T. & Arroll, B. Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database Syst. Rev. 2013, CD000247 (2013). - PubMed
  39. Sloth, L. B. et al. Antibiotic resistance patterns of Escherichia coli in migrants vs non-migrants: a study of 14 561 urine samples. J. Travel Med. https://doi.org/10.1093/jtm/taz080 (2019). - PubMed
  40. Kleinert, E. et al. Prescription of antibiotics in the medical care of newly arrived refugees and migrants. Pharmacoepidemiol. Drug Saf. https://doi.org/10.1002/pds.5254 (2021). - PubMed
  41. O'Sullivan, J. W., Harvey, R. T., Glasziou, P. P. & McCullough, A. Written information for patients (or parents of child patients) toreduce the use of antibiotics for acute upper respiratory tract infections in primary care. Cochrane Database Syst. Rev. 11, CD011360 (2016). - PubMed
  42. Ghorpade, D. D. et al. COPD awareness in the urban slums and rural areas around Pune city in India. NPJ Prim. Care Respir. Med. 31, 6 (2021). - PubMed
  43. Soriano, J. B. et al. The general public’s knowledge of chronic obstructive pulmonary disease and its determinants: current situation and recent changes. Arch. Bronconeumol. 48, 308–315 (2012). - PubMed
  44. Fouad, F. M., McCall, S. J., Ayoub, H., Abu-Raddad, L. J. & Mumtaz, G. R. Vulnerability of Syrian refugees in Lebanon to COVID-19: quantitative insights. Confl. Health 15, 13 (2021). - PubMed
  45. Thomas, C. M., Osterholm, M. T. & Stauffer, W. M. Critical considerations for COVID-19 vaccination of refugees, immigrants, and migrants. Am. J. Trop. Med. Hyg. 104, 433–435 (2021). - PubMed
  46. Waya, J. L. L. et al. The first sixty days of COVID-19 in a humanitarian response setting: a descriptive epidemiological analysis of the outbreak in South Sudan. Pan Afr. Med. J. 37, 384 (2020). - PubMed
  47. Ssematimba, A., Nakakawa, J. N., Ssebuliba, J. & Mugisha, J. Y. T. Mathematical model for COVID-19 management in crowded settlements and high-activity areas. Int. J. Dyn. Control. https://doi.org/10.1007/s40435-021-00781-9 (2021). - PubMed
  48. Bartovic, J., Datta, S. S., Severoni, S. & D’Anna, V. Ensuring equitable access to vaccines for refugees and migrants during the COVID-19 pandemic. Bull. World Health Organ. 99, 3–3A (2021). - PubMed

Publication Types