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Lewtak K, Poznańska A, Kanecki K, Tyszko P, Goryński P, Jankowski K, Nitsch-Osuch A. Ukrainian migrants' and war refugees' admissions to hospital: evidence from the Polish Nationwide General Hospital Morbidity Study, 2014-2022. BMC Public Health 2023; 23:2336. [PMID: 38001432 PMCID: PMC10675912 DOI: 10.1186/s12889-023-17202-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Considering the rapid influx of Ukrainian migrants and war refugees into Poland, the knowledge of their health condition is becoming increasingly important for health system policy and planning. The aim of the study was to assess war-related changes in the frequency and structure of hospitalizations among Ukrainian migrants and refugees in Poland. METHODS The study is based on the analysis of hospital admission records of Ukrainian patients, which were collected in the Nationwide General Hospital Morbidity Study from 01.01.2014 to 31.12.2022. RESULTS In the study period, 13,024 Ukrainians were hospitalized in Poland, 51.7% of whom had been admitted to hospital after February 24, 2022. After the war broke out, the average daily hospital admissions augmented from 2.1 to 21.6 person/day. A noticeable increase in the share of women (from 50% to 62%) and children (from 14% to 51%) was also observed. The average age of patients fell from 33.6 ± 0.2 years to 24.6 ± 0.3 years. The most frequently reported hospital events among the migrants until 23.02.2022 were injuries (S00-T98) - 26.1%, pregnancy, childbirth and the puerperium (O00-O99) - 18.4%, and factors influencing health status and contact with health services (Z00-Z99) - 8.4%. After the war started, the incidence of health problems among migrants and war refugees changed, with pregnancy, childbirth and the puerperium (O00-O99) being the most common - 14.9%, followed by abnormal clinical and lab findings (R00-R99) - 11.9%, and infectious and parasitic diseases (A00-B99) - 11.0%. CONCLUSIONS Our findings may support health policy planning and delivering adequate healthcare in refugee-hosting countries.
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Affiliation(s)
- Katarzyna Lewtak
- Department of Health Promotion and Prevention of Chronic Diseases, National Institute of Public Health NIH - National Research Institute, 24 Chocimska Street, 00-791, Warsaw, Poland.
- Department of Social Medicine and Public Health, Medical University of Warsaw, Warsaw, Poland.
| | - Anna Poznańska
- Department of Population Health Monitoring and Analysis, National Institute of Public Health NIH - National Research Institute, Warsaw, Poland
| | - Krzysztof Kanecki
- Department of Social Medicine and Public Health, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Tyszko
- Department of Social Medicine and Public Health, Medical University of Warsaw, Warsaw, Poland
- Institute of Rural Health in Lublin, Lublin, Poland
| | - Paweł Goryński
- Department of Population Health Monitoring and Analysis, National Institute of Public Health NIH - National Research Institute, Warsaw, Poland
| | - Krzysztof Jankowski
- Department of Social Medicine and Public Health, Medical University of Warsaw, Warsaw, Poland
- National Geriatrics, Rheumatology and Rehabilitation Institute, Warsaw, Poland
| | - Aneta Nitsch-Osuch
- Department of Social Medicine and Public Health, Medical University of Warsaw, Warsaw, Poland
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Lardier DT, Hess J, Winter L, Goodkind JR. The impact of postresettlement stressors and access to health care on health outcomes in recently resettled refugees in the United States. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2023; 93:516-531. [PMID: 37650800 PMCID: PMC10840636 DOI: 10.1037/ort0000697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
This mixed-methods study examines mechanisms connecting the deployment of economic, social, and health care resources to emotional distress and physical health outcomes. Examining such mechanisms is critical for informing strategies, policies, and other interventions for reducing health disparities and improving refugee health in the United States and other resettlement contexts. Data for this study were collected as part of a randomized control trial in a mid-sized city in the Southwestern United States. Two-hundred ninety recently resettled (< 3 years) refugee adults from 143 households were enrolled in the study (36.2% Afghan, 32.8% Iraqi/Syrian, and 31.0% Great Lakes African; 52% women). Qualitative interview data were collected via semistructured interviews. A longitudinal structural equation path model of quantitative data from three time points over 12 months tested hypotheses that emerged from qualitative findings. In semistructured interviews, refugees in the United States (a) attributed the development of worse or new physical health problems to postresettlement stressors related to financial instability and limited social support that contributed to their emotional distress and (b) reported several barriers to accessing health care in the United States, including insufficient knowledge of health care resources, inadequate patient-provider communication, and navigating complex American health insurance systems, all of which exacerbated their physical health problems. Guided by these qualitative findings, longitudinal quantitative data revealed that: (a) postmigration stressors were associated with emotional distress and poor self-reported physical health, (b) emotional distress mediated the association between postmigration stressors and global health satisfaction, and (c) emotional distress was negatively associated with global health satisfaction. Findings document stressors refugees experience in the context of the unique environment created by the American health care system and how these stressors contribute to poor physical health through increased emotional distress. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- David T Lardier
- Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, University of New Mexico
| | - Julia Hess
- Department of Pediatrics, University of New Mexico School of Medicine, University of New Mexico
| | - Lucas Winter
- Department of Internal Medicine, University of New Mexico School of Medicine, University of NewMexico
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Huang L, Said R, Goh HC, Cao Y. The Residential Environment and Health and Well-Being of Chinese Migrant Populations: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2968. [PMID: 36833663 PMCID: PMC9957064 DOI: 10.3390/ijerph20042968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
China's internal migrants suffer from marginalised housing conditions, poor neighbourhood environments and residential segregation, which may have significant implications on health and well-being. Echoing recent calls for interdisciplinary research on migrant health and well-being, this study examines the associations and mechanisms of the impact of the residential environment on the health and well-being of Chinese migrants. We found that most of the relevant studies supported the "healthy migration effect", but the phenomenon was only applicable to migrants' self-reported physical health rather than mental health. The subjective well-being of migrants is lower than that of urban migrants. There is a debate between the effectiveness of residential environmental improvements and the ineffectiveness of residential environmental improvements in terms of the impact of the neighbourhood environment on migrants' health and well-being. Housing conditions and the neighbourhood's physical and social environment can enhance migrants' health and well-being by strengthening place attachment and social cohesion, building localised social capital and gaining neighbourhood social support. Residential segregation on the neighbourhood scale affects the health outcomes of migrant populations through the mechanism of relative deprivation. Our studies build a vivid and comprehensive picture of research to understand migration, urban life and health and well-being.
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Affiliation(s)
- Liyan Huang
- Centre for Sustainable Urban Planning and Real Estate (SUPRE), Faculty of Built Environment, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- School of Management, University of Suzhou, Suzhou 234000, China
| | - Rosli Said
- Centre for Sustainable Urban Planning and Real Estate (SUPRE), Faculty of Built Environment, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Hong Ching Goh
- Centre for Sustainable Urban Planning and Real Estate (SUPRE), Faculty of Built Environment, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Yu Cao
- Faculty of Built Environment, Universiti Malaya, Kuala Lumpur 50603, Malaysia
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Iron deficiency, anemia and association with refugee camp exposure among recently resettled refugees: A Canadian retrospective cohort study. PLoS One 2022; 17:e0278838. [PMID: 36520858 PMCID: PMC9754286 DOI: 10.1371/journal.pone.0278838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 11/26/2022] [Indexed: 12/23/2022] Open
Abstract
Malnutrition and poor health are common among recently resettled refugees and may be differentially associated with pre-migration exposure to refugee camp versus non-camp dwelling. We aimed to investigate the associations of iron deficiency (ID), anemia, and ID anemia (IDA) with pre-migration refugee camp exposure among recently arrived refugees to Canada. To this end, we conducted a retrospective cohort study of 1032 adult refugees who received care between January 1, 2011, and December 31, 2015, within a specialized refugee health clinic in Calgary, Canada. We evaluated the prevalence, severity, and predictors of ID, anemia, and IDA, stratified by sex. Using multivariable logistic regression, we estimated the association of refugee camp exposure with these outcomes, adjusting for age, months in Canada prior to investigations, global region of origin, and parity. Among female refugees, the prevalence of ID, anemia, and IDA was 25% (134/534), 21% (110/534), and 14% (76/534), respectively; among males, 0.8% (4/494), 1.8% (9/494), and 0% (0/494), respectively. Anemia was mild, moderate, and severe in 55% (60/110), 44% (48/110) and 1.8% (2/110) of anemic females. Refugee camp exposure was not associated with ID, anemia, or IDA while age by year (ID OR = 0.96, 95% CI 0.93-0.98; anemia OR = 0.98, 95% CI 0.96-1.00; IDA OR = 0.96, 95% CI 0.94-0.99) and months in Canada prior to investigations (ID OR = 0.85, 95% CI 0.72-1.01; anemia OR = 0.81, 95% CI 0.67-0.97; IDA OR = 0.80, 95% CI 0.64-1.00) were inversely correlated with these outcomes. ID, anemia, and IDA are common among recently arrived refugee women irrespective of refugee camp exposure. Our findings suggest these outcomes likely improve after resettlement; however, given proportionally few refugees are resettled globally, likely millions of refugee women and girls are affected.
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Rosenthal T, Touyz RM, Oparil S. Migrating Populations and Health: Risk Factors for Cardiovascular Disease and Metabolic Syndrome. Curr Hypertens Rep 2022; 24:325-340. [PMID: 35704140 PMCID: PMC9198623 DOI: 10.1007/s11906-022-01194-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE OF REVIEW To summarize results of recent studies of migrants in Europe and North America and ongoing efforts to adapt strategies to provide them with inclusive sensitive health care. RECENT FINDINGS Major predisposing factors for developing hypertension, obesity, diabetes, and the metabolic syndrome in migrating populations and refugees were identified. Susceptibility to the metabolic syndrome is predominantly due to environmental factors and psychological stress. Acculturation also contributes to the emergence of cardiovascular (CV) risk factors in first-generation adult immigrants. Increased risk for later development of hypertension and dyslipidemia has also been detected in adolescent immigrants. Targets for public health efforts were based on data that show important differences in CV risk factors and prevalence of the metabolic syndrome among ethnic immigrant groups. Studies in young adults focused on lifestyle and dietary behaviors and perceptions about weight and body image, while the focus for older adults was end-of-life issues. Two important themes have emerged: barriers to health care, with a focus on cultural and language barriers, and violence and its impact on immigrants' mental health.
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Affiliation(s)
- Talma Rosenthal
- Department of Physiology and Pharmacology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rhian M Touyz
- Research Institute of McGill University Health Centre, Montreal, QC, Canada
| | - Suzanne Oparil
- Vascular Biology & Hypertension Program, Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294-0007, USA.
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Anthropological Research Study of Migrants at the First Aid and Reception Center (CPSA) of Lampedusa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095337. [PMID: 35564734 PMCID: PMC9105405 DOI: 10.3390/ijerph19095337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/23/2022] [Accepted: 04/15/2022] [Indexed: 02/06/2023]
Abstract
A medical anthropology research study was conducted in 2015 at the First Aid and Reception Center (CPSA) on the island of Lampedusa (Italy) as part of a larger health project carried out by the National Institute for Health, Migration and Poverty (INMP) in Rome. The study investigated the health conditions of migrants at the moment of their departure and on arrival, their migration journey, and their life plans and expectations for the future. The ethnographic method adopted for the study was based on participant observation and on data collection by means of a semi-structured interview (51 items simultaneously translated by cultural mediators into Tigrinya, Arabic, English, and French). Interviewed were 112 adults (82 men and 30 women) from the Gulf of Guinea and the Horn of Africa. The cooccurrence of forced migration and economic concerns was confirmed; violence and torture were constants throughout the migration journey in 81% of cases. Ethnographic data detailed the timing, countries, settings, perpetrators, and types of violence endured. A combination of qualitative and quantitative findings can both facilitate the identification of fragile health conditions and support clinicians in the diagnostic, therapeutic, and rehabilitation pathways. These data illustrate the importance and feasibility of multidisciplinary collaboration even in emergency contexts.
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Kuo SF, Yeh YC, Chang CC, Lin YF, Wang SY. Psychometrics and measurement invariance: Health Literacy Scale for Vietnamese and Indonesian married immigrants. J Adv Nurs 2022; 78:1836-1847. [PMID: 35384029 DOI: 10.1111/jan.15241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/13/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022]
Abstract
AIMS To examine the psychometrics and measurement invariance of the Short-Form Health Literacy 12-item questionnaire (HL-SF12) among Vietnamese and Indonesian married immigrants. DESIGN A cross-sectional survey design. METHODS In total, 1171 Vietnamese and Indonesian married immigrants were enrolled between September 2019 and December 2019. An exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to verify the structural validity of the suggested factor structure. The multiple-group CFA (MGCFA) used a series of hierarchical nested-in models as a measurement invariance test which confirmed the adequacy of the model fit at each stage. RESULTS/FINDINGS The Kaiser-Meyer-Olkin coefficient was 0.898, and the Bartlett test of sphericity was statistically significant (χ2 [66] = 1965.97, p < 0.01). According to a scree plot and Kaiser's criterion for eigenvalues of >1, the EFA explained 61.6% of the total variance and confirmed three theoretically supported factors of health care, disease prevention and health promotion. The 12 items showed factor loadings of >0.4 and four items were in each subscale. The CFA showed adequate structural validity, including a relative chi-squared/degrees of freedom (X2 /df) of 2.01, a comparative fit index (CFI) of 0.98 and a root mean square error of approximation (RMSEA) of 0.04 (95% confidence interval [0.03, 0.05]) in married immigrants. For the measurement invariance, a change in the goodness-of-fit measures did not exceed 0.02 for the RMSEA or 0.01 for the CFI. The results indicated Cronbach's α values of 0.87 for the HL-SF12 scale in Vietnamese and Indonesian combined samples (n = 1171). A t-test showed that the HL-SF12 and its three subscales were unable to significantly differentiate between Vietnamese and Indonesian groups (all p > 0.05). CONCLUSIONS The HL-SF12 scale showed acceptable theoretically supported structural validity, equivalent measurement invariance and reliable internal consistency among Vietnamese and Indonesian married immigrants. Measurements of immigrants' HL using the HL-SF12 could be integrated into future immigrant health policies. IMPACT As the first study of the measurement invariance of the HL-SF12 instrument among immigrants. Related factors of immigrants' HL can be further explored to increase immigrants' health and empowerment.
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Affiliation(s)
- Shu-Fen Kuo
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yueh-Chen Yeh
- Department of Nursing, National Taichung University of Science and Technology, Taichung, Taiwan
| | - Chia-Chi Chang
- School of Gerontology Health Management, College of Nursing, and Dean of College of Interdisciplinary Studies, Taipei Medical University, Taipei, Taiwan
| | - Yu-Fang Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Shu-Yi Wang
- Loretto Heights School of Nursing, Rueckert-Hartman College for Health Professions, Regis University, Denver, Colorado, USA
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Strategies of communicating health-related risks to vulnerable groups of immigrants during a pandemic: a scoping review of qualitative and quantitative evidence. INTERNATIONAL JOURNAL OF HEALTH GOVERNANCE 2021. [DOI: 10.1108/ijhg-06-2021-0070] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this rapid scoping review was to map existing literature on risk communication strategies implemented by authorities and aimed at vulnerable immigrants in the context of pandemics.
Design/methodology/approach
Existing literature on the topic was charted in terms of its nature and volume by summarizing evidence regarding the communication strategies. Literature searches were conducted in Academic Search Premier and CINAHL, databases were searched from 2011 to present on March 31, 2021.
Findings
Five articles met the criteria and were included in this review, pointing at limited research in this area. The findings indicated that a close interaction between communication authorities and immigrants is important. Community education, building trust in communication sources, clear risk communication and inclusive decision-making among all were found to be important when communicating health risks to immigrants.
Research limitations/implications
The primary limitation of this rapid scoping review is that the literature searches were conducted in only two databases, namely, Academic Search Premier and CINAHL. A wider search across several other databases could have given more profound results. Furthermore, some studies where immigrants were conceptualized as, for instance, “disadvantaged groups” might be overseen due to a choice of the search strategy used in this study. There are also certain limitations related to the studies included in this review.
Practical implications
Identifying efficient ways of conveying recommendations may further assist authorities and scientists in developing more effective health-related risk communication.
Originality/value
This study covered health-related risk communication in the context of pandemics, addressing the need to investigate different groups of immigrants and the challenges related to communicating risks to these groups.
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Patel H, Szkinc-Olsson G, Lennartsson Al Liddawi M. A qualitative study of nurses' experiences of self-care counseling in migrant patients with heart failure. Int J Nurs Sci 2021; 8:279-288. [PMID: 34307776 PMCID: PMC8283704 DOI: 10.1016/j.ijnss.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/14/2021] [Accepted: 05/19/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives This study aims to enhance researchers’ and nurses’ understanding of how to best support migrant patients with heart failure in self-care management. Previous research on self-care in heart failure patients has highlighted its importance, particularly among migrant populations. Nurses play an important role in informing and engaging patients with chronic conditions like heart failure to support their active participation in self-care. However, nurses’ experiences of providing self-care counseling to migrant populations with heart failure have not been studied. Methods A qualitative study was conducted. Nurses working with migrant patients with HF (n = 13) from different types of facility in Western Sweden were interviewed between October and December 2020. Data were collected using semi-structured interviews and analyzed using inductive thematic analysis. Results The main theme that emerged from the interviews was the difficulty for nurses “to find balance” in self-care counseling. The nurses during self-care counseling had: “to accept challenges,” “to use creative strategies,” faced “problems related to health literacy,” and “to work according to their (the nurses’) obligations.” It was evident that nurses faced several challenges in counseling migrants in self-care, including language and cultural barriers, time resource constraints, low levels of health literacy, and experienced disharmony between the law and their professional norms. They perceived building caring relationships with their patients to be crucial to fostering health-promoting self-care processes. Conclusions To increase self-care adherence, nurses must become more sensitive to cultural differences and adapt self-care counseling to patients’ health literacy. The findings of this research support and challenge nurses in providing the best counsel to migrant patients with heart failure living in Sweden’s multi-ethnic society. Policymakers in the health care organization should act to facilitate mutual cultural understanding between all involved partners for patient-safe self-care counseling.
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Affiliation(s)
- Harshida Patel
- Institute of Health Care and Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Grazyna Szkinc-Olsson
- Institute of Health Care & Sciences, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Sweden
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Ziegler S, Wahedi K, Stiller M, Jahn R, Straßner C, Schwill S, Bozorgmehr K. Health and medical care for refugees: design and evaluation of a multidisciplinary clinical elective for medical students. GMS JOURNAL FOR MEDICAL EDUCATION 2021; 38:Doc39. [PMID: 33763524 PMCID: PMC7958918 DOI: 10.3205/zma001435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 09/30/2020] [Accepted: 11/20/2020] [Indexed: 06/12/2023]
Abstract
Objective: Caring for refugee patients places special demands on health professionals. To date, medical students in Germany have rarely been systematically prepared for these challenges. This article reports on the development, conceptualisation, implementation, evaluation, and relevance of a multidisciplinary elective for medical students in the clinical study phase. Methodology: The course content was developed based on a needs-assessment among medical students and in cooperation with medical colleagues working in the field of refugee care. The course consisted of a seminar with medical, legal, administrative and socio-cultural learning content as well as a field placement in the medical outpatient clinic of the local reception centre for asylum seekers, which was accompanied by a systematic reflection process. The evaluation concept contained qualitative and quantitative elements. Results: 123 students completed the elective over six semesters (summer 2016 through to winter 2018). It was continuously evaluated and further developed. The students reported learning progress mainly in the following areas: Legal foundations of the asylum procedure and health care entitlements for asylum seekers; multi-perspectivity through multidisciplinarity as well as professional, ethical, interpersonal, and political insights gained through the practical experience. Summary: To prepare students for the complex challenges to be faced in medical care for refugees, a structured, multidisciplinary teaching programme, which combines theory, practice and reflection helps to foster insights into the many facets of this field of activity. The questions students brought to the seminar, the course contents and evaluation results are intended to inspire the design and implementation of similar courses at other universities.
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Affiliation(s)
- Sandra Ziegler
- Heidelberg University Hospital, Section Health Equity Studies & Migration, Department of General Medicine and Health Services Research, Heidelberg, Germany
| | - Katharina Wahedi
- Heidelberg University Hospital, Section Health Equity Studies & Migration, Department of General Medicine and Health Services Research, Heidelberg, Germany
| | - Mariella Stiller
- Heidelberg University Hospital, Section Health Equity Studies & Migration, Department of General Medicine and Health Services Research, Heidelberg, Germany
| | - Rosa Jahn
- Heidelberg University Hospital, Section Health Equity Studies & Migration, Department of General Medicine and Health Services Research, Heidelberg, Germany
| | - Cornelia Straßner
- Heidelberg University Hospital, Section Health Equity Studies & Migration, Department of General Medicine and Health Services Research, Heidelberg, Germany
| | - Simon Schwill
- Heidelberg University Hospital, Section Health Equity Studies & Migration, Department of General Medicine and Health Services Research, Heidelberg, Germany
| | - Kayvan Bozorgmehr
- Heidelberg University Hospital, Section Health Equity Studies & Migration, Department of General Medicine and Health Services Research, Heidelberg, Germany
- Bielefeld University, School of Public Health, Department of Population Medicine and Health Services Research, Bielefeld, Germany
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Ayele A, Abera D, Hailu M, Birhanu M, Desta K. Prevalence and associated risk factors for Hepatitis B and C viruses among refugees in Gambella, Ethiopia. BMC Public Health 2020; 20:721. [PMID: 32429964 PMCID: PMC7236441 DOI: 10.1186/s12889-020-08893-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/11/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Currently, there is an increased flow of refugees into Ethiopia from neighboring countries. However, there are no post-arrival screening mechanisms for hepatitis B and C viruses which could be an additional burden for the local population. Hence, this study aimed to determine the prevalence and associated risk factors for hepatitis B and C viruses among refugees in Gambella, Ethiopia. It also aimed to determine the knowledge, attitude, and practice concerning hepatitis B and C viruses among participants. METHODS A cross-sectional study was conducted among 453 refugees in Gambella, Ethiopia from January until May 2018. A questionnaire was used to collect data on refugees' socio-demographic, risk factors, and KAP of hepatitis B and C infections. Five milliliters of blood sample were collected from each participant and the serum was used for HBsAg and anti-HCV antibody screening rapid tests. Positive samples were further tested by ELISA method. Data were performed using SPSS version 20, and a p-value less than 0.05 was considered statistically significant. RESULTS The overall prevalence of HBsAg and anti-HCV among refugees was 7.3% (33/453) and 2.0% (9/453) respectively. Of these, 6.8% (25/370) and 1.4% (5/370) of females were positive for HBsAg and anti-HCV, whereas 9.6% (8/83) and 4.8% (4/83) of males were positive for HBsAg and anti-HCV. The age group of 18-29 and 30-41 years old were related to HCV infection (P = 0.003 and P = 0.020). However, proposed risk factors were not related to HBV and HCV infections. Knowledge assessment showed that 86.5% (392/453) did not know how HBV and HCV infections are transmitted, and 86.8% (393/453) had no information about the availability of HBV vaccine. CONCLUSION This study showed intermediate prevalence of hepatitis B and hepatitis C virus in a large refugee camp in Ethiopia. The prevalence of hepatitis C virus was found to increase with age, but no other risk factor for either virus identified as significant. Refugees' understanding of hepatitis B and C was very limited. This indicates the need for screening policy to be implemented and integrated with other health services and awareness creation about the infection in all refugee camps of Gambella.
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Affiliation(s)
- Abiyu Ayele
- Department of Medical Laboratory Sciences, Ethiopian Airport, Addis Ababa, Ethiopia
| | - Dessie Abera
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Melese Hailu
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Muluken Birhanu
- Department of Medical Laboratory Sciences, College of Health Sciences, Assosa University, Assosa, Ethiopia
| | - Kassu Desta
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Crowe CS, Massenburg BB, Morrison SD, Chang J, Friedrich JB, Abady GG, Alahdab F, Alipour V, Arabloo J, Asaad M, Banach M, Bijani A, Borzì AM, Briko NI, Castle CD, Cho DY, Chung MT, Daryani A, Demoz GT, Dingels ZV, Do HT, Fischer F, Fox JT, Fukumoto T, Gebre AK, Gebremichael B, Haagsma JA, Haj-Mirzaian A, Handiso DW, Hay SI, Hoang CL, Irvani SSN, Jozwiak JJ, Kalhor R, Kasaeian A, Khader YS, Khalilov R, Khan EA, Khundkar R, Kisa S, Kisa A, Liu Z, Majdan M, Manafi N, Manafi A, Manda AL, Meretoja TJ, Miller TR, Mohammadian-Hafshejani A, Mohammadpourhodki R, Mohseni Bandpei MA, Mokdad AH, Naimzada MD, Ndwandwe DE, Nguyen CT, Nguyen HLT, Olagunju AT, Olagunju TO, Pham HQ, Pribadi DRA, Rabiee N, Ramezanzadeh K, Ranganathan K, Roberts NLS, Roever L, Safari S, Samy AM, Sanchez Riera L, Shahabi S, Smarandache CG, Sylte DO, Tesfay BE, Tran BX, Ullah I, Vahedi P, Vahedian-Azimi A, Vos T, Woldeyes DH, Wondmieneh AB, Zhang ZJ, James SL. Global trends of hand and wrist trauma: a systematic analysis of fracture and digit amputation using the Global Burden of Disease 2017 Study. Inj Prev 2020; 26:i115-i124. [PMID: 32169973 PMCID: PMC7571361 DOI: 10.1136/injuryprev-2019-043495] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 12/26/2019] [Accepted: 12/28/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND As global rates of mortality decrease, rates of non-fatal injury have increased, particularly in low Socio-demographic Index (SDI) nations. We hypothesised this global pattern of non-fatal injury would be demonstrated in regard to bony hand and wrist trauma over the 27-year study period. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 was used to estimate prevalence, age-standardised incidence and years lived with disability for hand trauma in 195 countries from 1990 to 2017. Individual injuries included hand and wrist fractures, thumb amputations and non-thumb digit amputations. RESULTS The global incidence of hand trauma has only modestly decreased since 1990. In 2017, the age-standardised incidence of hand and wrist fractures was 179 per 100 000 (95% uncertainty interval (UI) 146 to 217), whereas the less common injuries of thumb and non-thumb digit amputation were 24 (95% UI 17 to 34) and 56 (95% UI 43 to 74) per 100 000, respectively. Rates of injury vary greatly by region, and improvements have not been equally distributed. The highest burden of hand trauma is currently reported in high SDI countries. However, low-middle and middle SDI countries have increasing rates of hand trauma by as much at 25%. CONCLUSIONS Certain regions are noted to have high rates of hand trauma over the study period. Low-middle and middle SDI countries, however, have demonstrated increasing rates of fracture and amputation over the last 27 years. This trend is concerning as access to quality and subspecialised surgical hand care is often limiting in these resource-limited regions.
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Affiliation(s)
- Christopher Stephen Crowe
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, Washington, USA
| | - Benjamin Ballard Massenburg
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, Washington, USA
| | - Shane Douglas Morrison
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, Washington, USA
| | - James Chang
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University, Palo Alto, California, USA
| | - Jeffrey Barton Friedrich
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, Washington, USA
| | - Gdiom Gebreheat Abady
- College of Medicine and Health Sciences, Department of Nursing, Adigrat University, Adigrat, Ethiopia
| | - Fares Alahdab
- Evidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, Minnesota, USA
| | - Vahid Alipour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.,Health Economics Department, Iran University of Medical Sciences, Tehran, Iran
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Malke Asaad
- Plastic Surgery Department, University of Texas, Houston, Texas, USA
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland.,Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
| | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Antonio Maria Borzì
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Nikolay Ivanovich Briko
- Epidemiology and Evidence Based Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Chris D Castle
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Daniel Youngwhan Cho
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, Washington, USA
| | - Michael T Chung
- Department of Otolaryngology - Head & Neck Surgery, Wayne State University, Detroit, Michigan, USA
| | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Gebre Teklemariam Demoz
- School of Pharmacy, Aksum University, Aksum, Ethiopia.,Addis Ababa University, Addis Ababa, Ethiopia
| | - Zachary V Dingels
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Hoa Thi Do
- Center of Excellence in Public Health Nutrition, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Florian Fischer
- Department of Population Medicine and Health Services Research, Bielefeld University, Bielefeld, Germany
| | - Jack T Fox
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Takeshi Fukumoto
- Department of Dermatology, Kobe University, Kobe, Japan.,Gene Expression & Regulation Program, The Wistar Institute, Philadelphia, Pennsylvania, USA
| | | | | | - Juanita A Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Arvin Haj-Mirzaian
- Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran.,Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.,Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Chi Linh Hoang
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Seyed Sina Naghibi Irvani
- Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jacek Jerzy Jozwiak
- Department of Family Medicine and Public Health, University of Opole, Opole, Poland
| | - Rohollah Kalhor
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Amir Kasaeian
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Pars Advanced and Minimally Invasive Medical Manners Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Yousef Saleh Khader
- Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
| | - Rovshan Khalilov
- Department of Physiology, Baku State University, Baku, Azerbaijan
| | - Ejaz Ahmad Khan
- Epidemiology and Biostatistics Department, Health Services Academy, Islamabad, Pakistan
| | - Roba Khundkar
- Nuffield Department of Surgical Sciences, Oxford University Global Surgery Group, University of Oxford, Oxford, UK
| | - Sezer Kisa
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Zichen Liu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Marek Majdan
- Department of Public Health, Trnava University, Trnava, Slovakia
| | - Navid Manafi
- Ophthalmology Department, Iran University of Medical Sciences, Tehran, Iran.,Ophthalmology Department, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ali Manafi
- Plastic Surgery Department, Iran University of Medical Sciences, Tehran, Iran
| | - Ana-Laura Manda
- Surgery Department, Emergency University Hospital Bucharest, Bucharest, Romania
| | - Tuomo J Meretoja
- Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland.,University of Helsinki, Helsinki, Finland
| | - Ted R Miller
- Pacific Institute for Research & Evaluation, Calverton, Maryland, USA.,School of Public Health, Curtin University, Perth, Western Australia, Australia
| | | | | | - Mohammad A Mohseni Bandpei
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.,Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Mukhammad David Naimzada
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia.,Experimental Surgery and Oncology Laboratory, Kursk State Medical University of the Ministry of Health of the Russian Federation, Kursk, Russia
| | | | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | | | - Andrew T Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | - Tinuke O Olagunju
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Hai Quang Pham
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | | | - Navid Rabiee
- Department of Chemistry, Sharif University of Technology, Tehran, Iran
| | - Kiana Ramezanzadeh
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Nicholas L S Roberts
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Leonardo Roever
- Department of Clinical Research, Federal University of Uberlândia, Uberlândia, Brazil
| | - Saeed Safari
- Emergency Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abdallah M Samy
- Department of Entomology, Ain Shams University, Cairo, Egypt
| | - Lidia Sanchez Riera
- Rheumatology Department, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.,Institute of Bone and Joint Research, University of Sydney, Syndey, New South Wales, Australia
| | - Saeed Shahabi
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Catalin-Gabriel Smarandache
- Surgery 2nd Department - SUUB, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Surgery 2nd Department, Bucharest Emergency Hospital, Bucharest, Romania
| | - Dillon O Sylte
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | | | - Bach Xuan Tran
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
| | - Irfan Ullah
- Gomal Center of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan.,TB Culture Laboratory, Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan, Pakistan
| | - Parviz Vahedi
- Department of Anatomical Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Amir Vahedian-Azimi
- Trauma Research Center, Nursing Facility, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.,Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Dawit Habte Woldeyes
- Department of Human Anatomy, Histology, and Embryology, Bahir Dar University, Bahir Dar, Ethiopia
| | - Adam Belay Wondmieneh
- Department of Nursing, Wollo University, Dessie, Ethiopia.,Department of Nursing and Midwifery, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zhi-Jiang Zhang
- Department of Preventive Medicine, Wuhan University, Wuhan, China
| | - Spencer L James
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
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13
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Mantica G, Van der Merwe A, Terrone C, Gallo F, Zarrabi AD, Vlok AL, Ackermann HM, Territo A, Esperto F, Olapade-Olapa EO, Riccardi N, Bongers M, Bonkat G. Awareness of European practitioners toward uncommon tropical diseases: are we prepared to deal with mass migration? Results of an international survey. World J Urol 2019; 38:1773-1786. [PMID: 31538244 DOI: 10.1007/s00345-019-02957-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 09/13/2019] [Indexed: 01/09/2023] Open
Abstract
PURPOSE The recent rise in migration from Africa through the Mediterranean basin into Europe has resulted in an increased incidence of uncommon diseases such as schistosomiasis and genito-urinary tuberculosis, which were previously largely unknown in this region. This study aimed to evaluate the insight of European urologists into diagnosing and managing these disease conditions and to determine whether they were adequately prepared to deal with the changing disease spectrum in their countries. METHODS A survey including specific questions about the diagnosis and management of 'tropical' urological diseases was distributed among urologists working in Europe and Africa. Multivariate logistic regression models were performed to detect the continent (African or European) effect on knowledge of and insight into tropical urological diseases. RESULTS A total of 312 surveys were administered. African and European respondents accounted for 109 (36.09%) and 193 (63.91%) respondents, respectively. The multivariate logistic regression analysis demonstrated a significant deficiency in the knowledge of tropical urological diseases in the European cohort compared with the African cohort (p < 0.05). Moreover, in the European cohort, markedly superior knowledge of tropical urological diseases was observed for respondents who had previously worked in a developing country. CONCLUSIONS Though European urologists are not required to have the same insight as African urologists, they showed a very unsatisfactory knowledge of tropical urological diseases. The experience of working in a developing country could improve the knowledge of European urologists regarding tropical urological diseases.
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Affiliation(s)
- Guglielmo Mantica
- Department of Urology, Stellenbosch University and Tygerberg Hospital, Francie Van Zijl Drive, Tygerberg, Cape Town, 7505, South Africa. .,Department of Urology, Policlinico San Martino Hospital, University of Genoa, Genoa, Italy.
| | - André Van der Merwe
- Department of Urology, Stellenbosch University and Tygerberg Hospital, Francie Van Zijl Drive, Tygerberg, Cape Town, 7505, South Africa
| | - Carlo Terrone
- Department of Urology, Policlinico San Martino Hospital, University of Genoa, Genoa, Italy
| | - Fabio Gallo
- UO Biostatistics, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Amir D Zarrabi
- Department of Urology, Stellenbosch University and Tygerberg Hospital, Francie Van Zijl Drive, Tygerberg, Cape Town, 7505, South Africa
| | - Adriaan L Vlok
- Department of Urology, Stellenbosch University and Tygerberg Hospital, Francie Van Zijl Drive, Tygerberg, Cape Town, 7505, South Africa
| | - Hilgard M Ackermann
- Department of Urology, Stellenbosch University and Tygerberg Hospital, Francie Van Zijl Drive, Tygerberg, Cape Town, 7505, South Africa
| | - Angelo Territo
- Department of Urology, Fundaciò Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | | | - Emiola O Olapade-Olapa
- Department of Surgery, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Niccolò Riccardi
- Infectious Disease Clinic, San Raffaele Scientific Institute, Milan, Italy
| | - Marius Bongers
- Department of Urology, The Urology Hospital, Pretoria, South Africa
| | - Gernot Bonkat
- Alta Uro AG, Merian Iselin Klinik, Centre of Biomechanics and Calorimetry, University of Basel, Basel, Switzerland
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14
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Fozouni L, Weber C, Lindner AK, Rutherford GW. Immunization coverage among refugee children in Berlin. J Glob Health 2019; 9:010432. [PMID: 31217960 PMCID: PMC6571106 DOI: 10.7189/jogh.09.010432] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Background The Tempelhof refugee camp offers in-camp immunizations. Other camps, like Neukölln, rely on a centralized immunization system. We aimed to determine the impact of conflict on immunization rates of Syrian children and to measure the efficacy of in-camp immunization services. Methods Families with children aged 1-5 in Tempelhof and Neukölln camps were surveyed. Surveys included siblings under the age of 18. Differences were compared using χ2 test. Results Data on 179 children at Tempelhof and 40 children at Neukölln were collected. At Tempelhof, amongst Syrian children, 27.8% under the age of 5 were “fully immunized-memory,” in contrast to 73.7% over the age of 5 (P = 0.005). This difference in immunization rates by memory between the age groups was not observed in Afghani children (P = 0.34) or in Iraqi children (P = 0.10). Furthermore, compared to the 27.8% of Syrian children, 75% of Afghani children under the age of 5 were “fully vaccinated-memory” (P = 0.0009). Compared to Tempelhof, more children at Neukölln were partially immunized (93%) or had no immunizations (5%) (P < 0.001).
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Affiliation(s)
- Laila Fozouni
- School of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Christoph Weber
- Department of Infectious Diseases, Vivantes Auguste - Viktoria Klinikum, Berlin and Airport Tempelhof Refugee Camp, Berlin, Germany
| | - Andreas K Lindner
- Department of Infectious Diseases, Vivantes Auguste - Viktoria Klinikum, Berlin and Airport Tempelhof Refugee Camp, Berlin, Germany
| | - George W Rutherford
- School of Medicine, University of California, San Francisco, San Francisco, California, USA
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15
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Abstract
The increasing number of refugees, migrants and international travelers influences the surgical spectrum of abdominal diseases. The aim of this review is to familiarize surgeons with specific diseases which are endemic in the patients' countries of origin and are likely to be diagnosed with increasing incidence in Germany. Low levels of hygiene in the countries of origin or refugee camps is associated with a high incidence of numerous infections, such as helminth infections, typhoid fever or amoebiasis, which if untreated can cause surgical emergencies. Historically, some of them were common in Germany but have been more or less eradicated because of the high socioeconomic standard. Echinococcosis and Chagas disease are frequently treated surgically while schistosomiasis can mimic intestinal cancer. Abdominal tuberculosis presents in a variety of abdominal pathologies and frequently causes diagnostic uncertainty. Sigmoid volvulus has a very low incidence among Europeans, but is one of the most common abdominal surgical conditions of adults in endemic countries. The number of patients who eventually undergo surgery for these conditions might be relatively low; however, surgeons must be aware of them and consider them as differential diagnoses in refugees and migrants with acute or chronic abdominal symptoms.
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Affiliation(s)
- T J Wilhelm
- Chirurgische Klinik, Universitätsklinikum Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.
| | - S Post
- Chirurgische Klinik, Universitätsklinikum Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
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16
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Population-based assessment of health, healthcare utilisation, and specific needs of Syrian migrants in Germany: what is the best sampling method? BMC Med Res Methodol 2019; 19:5. [PMID: 30616507 PMCID: PMC6323854 DOI: 10.1186/s12874-018-0652-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 12/26/2018] [Indexed: 02/06/2023] Open
Abstract
Background Studies elucidating health-related information and special needs of Syrian migrants living in Germany are urgently required. However, data is scarce and finding appropriate sampling strategies to obtain representative results is challenging. In order to increase survey response in hard-to-reach populations, new methods were developed. One of them is respondent-driven sampling (RDS), a network sampling technique. We aimed to assess if respondent-driven sampling is a better approach to recruit Syrian migrants for health research than classical random sampling via the population registry. Methods A cross-sectional study was conducted in Munich between April and June 2017 inviting adults (18+ years) born in Syria to answer an online questionnaire asking for sociodemographic and health-related information. Recruitment of participants was done using a) random sampling via the population registry (PR) and b) RDS. The two study populations recruited via respondent-driven sampling and the population registry were compared to a sample drawn from the population registry with respect to gender and citizenship. In addition, the two study populations were compared to each other regarding self-reported health status, healthcare utilisation, lifestyle factors, social network size, and acculturation. Results Of 374 persons randomly drawn from the population registry, 49 individuals answered the questionnaire completely (response: 13.1%) while via RDS 195 participants were recruited by 16 seeds. More persons possessed German citizenship in the total sample (20.5, 95% CI: 16.6 to 24.8%) and in the PR study population (28.6, 95% CI: 16.6 to 43.3%) than in the study population (0.5, 95% CI: 0.1 to 1.5%). Participants recruited via the population registry were older, smoked less, reported more often to hold a university degree, and indicated a higher prevalence of chronic diseases, more frequent healthcare utilisation, higher scores of acculturation as well as a larger social network compared to the study population obtained via RDS. Conclusions Response was very low in the PR sample. The number of participants recruited via RDS was larger and led to a study population with substantially different characteristics. Our study thus indicates that RDS is a useful way to gain access to specific subgroups that are hard to reach via traditional random sampling. Electronic supplementary material The online version of this article (10.1186/s12874-018-0652-1) contains supplementary material, which is available to authorized users.
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