Vaccine-Preventable Disease-Associated Hospitalisations Among Migrant and Non-migrant Children in New Zealand

Migration and infant immunization timeliness in New Zealand: Evidence from the Growing Up in New Zealand study

BACKGROUND

Migration has been recognized as an important determinant of child health outcomes including childhood vaccination status. This paper aims to examine the association between parental migration status and a less studied aspect of child immunization outcomes, namely timeliness, within the context of New Zealand (NZ), a country characterized by a substantial proportion of its resident population born overseas. Additionally, the study explored the impact of residential duration on children's immunization timeliness.

METHODS

The data was taken from a large, representative population-based cohort study in NZ (Growing Up in NZ study). A total of 6156 children and their parents, comprising 2241 foreign-born and 3915 NZ-born mothers and a sub-group of their partners were included in the analysis. The survey data was linked with the National Immunization Register dataset. Timely immunization was defined as receiving two vaccines at each scheduled vaccination point (at six-week, three-month, and five-month, totaling six doses of vaccines) within 30 days of their due date. We examined the associations between parental migration status, maternal residential duration, and child immunization timeliness while controlling for socio-economic variations. The results were presented as adjusted odds ratios (AORs) with 95 % confidence intervals (CIs).

RESULTS

The findings revealed that after adjustment for socioeconomic differences, children of foreign-born mothers exhibited higher odds of receiving all six studied vaccine doses on time compared to children of native-born mothers (AOR 1.51, 95 %CI:1.27-1.78). Similarly, having a foreign-born father was also significantly associated with timely completion of all six vaccine doses. Children of recent immigrants who had resided in the country for less than five years demonstrated higher odds of timely vaccination of all six vaccine doses compared to children of settled immigrants who had lived in the country for five or more years (AOR 1.65, 95 %CI: 1.25-2.19).

CONCLUSION

This study revealed a significant pattern in NZ where immigrants exhibited higher rates of timely immunization for their children compared to native-born parents. However, the findings also underscore the importance of providing support to settled immigrants, as their children experienced declines in timely vaccination rates compared to children of recent immigrants and even those born to NZ-born parents.

What is the impact of forced displacement on health? A scoping review

While there is a broad literature analysing the effects of migration on health, important knowledge gaps persist particularly on the causal effects of forced displacement on health outcomes. We undertake a scoping review of applied epidemiological, statistical and econometric studies examining causal health impacts of forced displacement, which initially identified 1454 studies from the health and social sciences disciplines published up to May 2021. Our study makes two key contributions. First, we offer a comprehensive overview of the evidence generated, methodologies adopted and analytical challenges faced by current research examining the causal relationship between forced displacement and health. Second, we present concrete examples of how key challenges around study design and estimation approaches influence the strength of the evidence-base on the topic, using as a case study the broad domain of reproductive health. We find that, beyond the increased mortality risk that can be attributed to forced displacement, most of the available empirical evidence for a wide range of health outcomes is prone to substantial bias, making it difficult to draw firm conclusions. Our synthesis of credible studies conducted in different settings indicates that current research practice in the field could be strengthened through selection of valid control groups and application of more appropriate causal inference methods. Our findings are useful to promote the generation of further evidence on the topic that can reliably inform the design of policies to protect the health of displaced populations.

Birth and Health Outcomes of Children Migrating With Parents: A Systematic Review and Meta-Analysis

Objective

To examine the birth and health outcomes of children migrating with parents internationally and domestically, and to identify whether the healthy migration effect exist in migrant children.

Methods

Five electronic databases were searched for cross-sectional, case-control, or cohort studies published from January 1, 2000 to January 30, 2021and written by English language, reporting the risk of health outcomes of migrant children (e.g., birth outcome, nutrition, physical health, mental health, death, and substance use) We excluded studies in which participants' age more than 18 years, or participants were forced migration due to armed conflict or disasters, or when the comparators were not native-born residents. Pooled odd ratio (OR) was calculated using random-effects models.

Results

Our research identified 10,404 records, of which 98 studies were retrained for analysis. The majority of the included studies (89, 91%) focused on international migration and 9 (9%) on migration within country. Compared with native children, migrant children had increased risks of malnutrition [OR 1.26 (95% CI 1.11-1.44)], poor physical health [OR 1.34 (95% CI 1.11-1.61)], mental disorder [OR 1.24 (95% CI 1.00-1.52)], and death [OR 1.11 (95% CI 1.01-1.21)], while had a lower risk of adverse birth outcome [OR 0.92 (95% CI 0.87-0.97)]. The difference of substance use risk was not found between the two groups.

Conclusion

Migrant children had increased risk of adverse health outcomes. No obvious evidence was observed regarding healthy migration effect among migrant children. Actions are required to address the health inequity among these populations.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/#myprospero, identifier: CRD42021214115.

Understanding barriers to immunisation against vaccine-preventable diseases in Pacific people in New Zealand, Aotearoa: an integrative review

Introduction Pacific people have an increased risk of hospitalisation if barriers to immunisation against vaccine-preventable diseases are not reduced. This research sought to determine what is known about the barriers to immunisations in Pacific people living in New Zealand and identify ways to reduce these barriers and inform health care. Aim To identify the barriers to immunisation for Pasifika and to identify ways to reduce these barriers and inform health care. Methods An integrative review was undertaken with databases searched for articles published between February 2021 and May 2021. The review follows the five-stage process of problem formulation; literature search; evaluation of data; data analysis and interpretation; and presentation of the results through discussion. Results Twelve studies were included. Three themes were identified: Deprivation, Health Literacy (which covered understanding the importance of immunisation programmes, attitudes and beliefs and communication), and access to health care (including communication accessibility to health professionals and physical access). Discussion This review has identified that barriers such as level of deprivation strongly influences immunisation uptake in Pacific people. The significance of government-led initiatives was shown to improve the rates of immunisation of Pacific children. Pacific people's awareness of immunisation programmes and government campaigns are encouraged to incorporate ethnic-specific strategies in addressing barriers, such as bringing vaccinations to where Pacific people frequent, including churches, community hubs, and venues that parents can easily access.

The Influencing Legal and Factors of Migrant Children's Educational Integration Based on Convolutional Neural Network

This research aims to analyze the influencing factors of migrant children's education integration based on the convolutional neural network (CNN) algorithm. The attention mechanism, LSTM, and GRU are introduced based on the CNN algorithm, to establish an ALGCNN model for text classification. Film and television review data set (MR), Stanford sentiment data set (SST), and news opinion data set (MPQA) are used to analyze the classification accuracy, loss value, Hamming loss (HL), precision (Pre), recall (Re), and micro-F1 (F1) of the ALGCNN model. Then, on the big data platform, data in the Comprehensive Management System of Floating Population and Rental Housing, Student Status Information Management System, and Student Information Management System of Beijing city are taken as samples. The ALGCNN model is used to classify and compare related data. It is found that in the MR, STT, and MPQA data sets, the classification accuracy and loss value of the ALGCNN model are better than other algorithms. HL is the lowest (15.2 ± 1.38%), the Pre is second only to the BERT algorithm, and the Re and F1 are both higher than other algorithms. From 2015 to 2019, the number of migrant children in different grades of elementary school shows a gradual increase. Among migrant children, the number of migrant children from other counties in this province is evidently higher than the number of migrant children from other provinces. Among children of migrant workers, the number of immigrants from other counties in this province is also notably higher than the number of immigrants from other provinces. With the gradual increase in the years, the proportion of township-level expenses shows a gradual decrease, whereas the proportion of district and county-level expenses shows a gradual increase. Moreover, the accuracy of the ALGCNN model in migrant children and local children data classification is 98.6 and 98.9%, respectively. The proportion of migrant children in the first and second grades of a primary school in Beijing city is obviously higher than that of local children (p < 0.05). The average final score of local children was greatly higher than that of migrant children (p < 0.05), whereas the scores of migrant children's listening methods, learning skills, and learning environment adaptability are lower, which shows that an effective text classification model (ALGCNN) is established based on the CNN algorithm. In short, the children's education costs, listening methods, learning skills, and learning environment adaptability are the main factors affecting migrant children's educational integration, and this work provides a reference for the analysis of migrant children's educational integration.

Infectious Diseases among Refugee Children

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.