Description of a migrant pediatric population visiting the Toulouse Children's Hospital emergency department.

BACKGROUND: Today, one in eight migrants and one in two refugees are children. Since this population has been less studied than the adult population, there is little data available on the state of health of this pediatric migrant population and the reasons they seek care. OBJECTIVE: The objective of this study was to describe the sociodemographic and medical characteristics of a pediatric migrant population visiting an emergency department in order to better understand their specific needs. MATERIALS AND METHODS: This was a retrospective observational study using data from medical records and social surveys of migrant children who had visited the Toulouse pediatric emergency department between 1 January 2018 and 31 December 2018. RESULTS: A total of 203 migrant children, i.e., 344 emergency visits, were analyzed. The average age of the children was 3.3 years old. More than half (58.1%) of the children were from Eastern Europe; 71% visited due to infectious pathologies. The severity of the reasons for visiting (90% of the reasons for visiting had a CCMU (Clinical Classification of Emergency Patients) of 1 or 2) and the hospitalization rate (9%) were not higher in the pediatric migrant population than in the general pediatric population. We discovered associated diagnoses (e.g., scabies, anemia, oral and dental disorders) in connection with migration and/or the resulting vulnerability. There was a language barrier in 78% of the visits analyzed with underuse of professional interpreting (7%). CONCLUSION: Because of the journey they make, migrant children are likely to have specific health needs and require dedicated care.

FOXE3 mutations: genotype-phenotype correlations.

Microphthalmia and anophthalmia (MA) are severe developmental eye anomalies, many of which are likely to have an underlying genetic cause. More than 30 genes have been described, each of which is responsible for a small percentage of these anomalies. Among these, is the FOXE3 gene, which was initially described in individuals with dominantly inherited anterior segment dysgenesis and, subsequently, associated with recessively inherited primary aphakia, sclerocornea and microphthalmia. In this work, we describe 8 individuals presenting with an MA phenotype. Among them, 7 are carrying biallelic recessive FOXE3 mutations and 2 of these have novel mutations: p.(Ala78Thr) and p.(Arg104Cys). The last of our patients is carrying in the heterozygous state the recessive p.(Arg90Leu) mutation in the FOXE3 gene. To further understand FOXE3 involvement in this wide spectrum of ocular anomalies with 2 different patterns of inheritance, we reviewed all individuals with ocular abnormalities described in the literature for which a FOXE3 mutation was identified. This review demonstrates that correlations exist between the mutation type, mode of inheritance and the phenotype severity. Furthermore, understanding the genetic basis of these conditions will contribute to overall understanding of eye development, improve the quality of care, genetic counseling and, in future, gene-based therapies.