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1.
Lancet Psychiatry ; 8(1): 36-47, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33156999

RESUMO

BACKGROUND: Understanding the time-varying association of pre-migration and post-migration stressors in refugees' mental health could help in designing tailored health promotion services at different resettlement stages and improving the efficiency of resource allocation. In this study, we explored these time-varying associations. METHODS: We used data from the first four waves (October, 2013, to February, 2017) of a national refugee-based longitudinal study, the Building a New Life in Australia (BNLA) project. Post-traumatic stress disorder (PTSD) and high risk of severe mental illness (HR-SMI) were used to assess mental health. The independent variables included the number of potentially traumatic events experienced during the pre-migration process, and a range of post-migration stressors. We used logistic regression models to analyse the relative importance of variables and time-varying associations between the pre-migration potentially traumatic events, post-migration resettlement stressors, and refugees' mental health. Analyses were stratified by gender, and sociodemographic covariates included age, marital status, education level, country of birth, and weekly income. RESULTS: 2399 participants were surveyed in Wave 1 of the BNLA project in 2013-14, of whom 2009 (83·7%) responded in Wave 2 in 2014-15, 1894 (78·9%) in Wave 3 in 2015-16, and 1929 (80·4%) in Wave 4 in 2016-17. The three most important factors associated with mental health in each wave differed for male and female refugees, but the socioeconomic stressors of loneliness and adjustment to life in Australia were consistently prominent. Positive associations between socioeconomic stressors and mental ill-health were found for both genders, with a peak at Wave 2 (adjusted odds ratio [AOR] among men, 1·60 [95% CI 1·26-2·03], p=0.0001 for PTSD; AOR 1·86 [1·35-2·55], p=0·0001 for HR-SMI; and among women, AOR 1·81 [1·27-2·57], p=0·0009 for PTSD; AOR 2·24 [1·49-3·38], p=0·0001 for HR-SMI). Associations between loneliness and mental health fluctuated, but were significant for both genders in Wave 4 (among men, AOR 1·90 [1·21-2·99], p=0·0051 for PTSD; AOR 3·70 [2·18-6·27], p<0·0001 for HR-SMI; and among women, AOR 3·65 [2·08-6·39], p<0·0001 for PTSD; AOR 3·68 [2·02-6·69], p<0·0001 for HR-SMI). The association between difficulties in adjustment to life in Australia and male refugees' mental ill-health increased continuously during the resettlement period. INTERPRETATION: Gender-specific and time-sensitive services should be considered to improve refugees' mental health. For both genders, improved economic conditions that complement social security benefits deserve attention and are relevant throughout the resettlement process. At the later stage of resettlement, services to reduce loneliness could be carried out, and reducing stressors related to adjustment to life in the host country is especially needed for male refugees. FUNDING: None.


Assuntos
Emigração e Imigração , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/complicações , Adulto , Austrália/epidemiologia , Feminino , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , Saúde Mental/estatística & dados numéricos , Saúde Mental/tendências , Pessoa de Meia-Idade , Refugiados/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estresse Psicológico/epidemiologia , Inquéritos e Questionários , Adulto Jovem
2.
Public Health Rep ; 136(1): 117-123, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33207130

RESUMO

OBJECTIVES: Immigrants are believed to be at high risk of infection with severe acute respiratory syndrome coronavirus 2, the virus that causes coronavirus disease 2019 (COVID-19). A leading suspected risk factor is their role in the essential workforce. We aimed to describe COVID-19-related risk factors among Bhutanese and Burmese refugees in the United States. METHODS: We administered an anonymous online survey in May 2020 among community leaders of Bhutanese and Burmese refugees. Using a snowball sampling strategy, we invited community leaders to complete the survey and share the link with others who met inclusion criteria (English proficient, aged ≥18, currently living in the United States). We compared respondents with and without recent COVID-19 and identified risk factors for infection. RESULTS: Of 218 refugees in 23 states who completed the survey from May 15 through June 1, 2020, fifteen (6.9%) reported infection with COVID-19. Being an essential worker during the pandemic (odds ratio [OR] = 5.25; 95% CI, 1.21-22.78), having an infected family member (OR = 26.92; 95% CI, 5.19-139.75), and being female (OR = 5.63; 95% CI, 1.14-27.82) were risk factors for infection. Among 33 infected family members, 23 (69.7%) were essential workers. CONCLUSION: Although we had a small snowball sample, we found that working in essential industries was associated with an increased risk of COVID-19 infection among Bhutanese and Burmese refugees. We call for larger studies that include Asian immigrant subgroups, as well as immediate attention to protecting immigrant essential workers during the COVID-19 pandemic.


Assuntos
/etnologia , Refugiados/estatística & dados numéricos , Adulto , Butão/etnologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Mianmar/etnologia , Exposição Ocupacional/estatística & dados numéricos , Pandemias , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Estados Unidos/epidemiologia
3.
PLoS One ; 15(12): e0243005, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33259555

RESUMO

AIM: To determine the prevalence and causes of blindness, vision impairment and cataract surgery coverage among Rohingya refugees aged ≥ 50 years residing in camps in Cox's Bazar, Bangladesh. METHODS: We used the Rapid Assessment of Avoidable Blindness (RAAB) methodology to select 76 clusters of 50 participants aged ≥ 50 years with probability proportionate to size. Demographic and cataract surgery data were collected using questionnaires, visual acuity was assessed per World Health Organization criteria and examinations were conducted by torch, and with direct ophthalmoscopy in eyes with pinhole-corrected vision <6/12. RAAB software was used for data entry and analysis. RESULTS: We examined 3,629 of 3800 selected persons (95.5%). Age and sex adjusted prevalence of blindness (<3/60), severe visual impairment (SVI; >3/60 to ≤6/60), moderate visual impairment (MVI; >6/60 to ≤6/18), and early visual impairment (EVI; >6/18 to ≤6/12) were 2.14%, 2.35%, 9.68% and 14.7% respectively. Cataract was responsible for 75.0% of blindness and 75.8% of SVI, while refractive error caused 47.9% and 90.9% of MVI and EVI respectively. Most vision loss (95.9%) was avoidable. Cataract surgical coverage among the blind was 81.2%. Refractive error was detected in 17.1% (n = 622) of participants and 95.2% (n = 592) of these did not have spectacles. In the full Rohingya cohort of 76,692, approximately 10,000 surgeries are needed to correct all eyes impaired (<6/18) by cataract, 12,000 need distance glasses and 73,000 require presbyopic correction. CONCLUSION: The prevalence of blindness was lower than expected for a displaced population, in part due to few Rohingya being ≥60 years and the camp's good access to cataract surgery. We suggest the United Nations High Commissioner for Refugees include eye care among recommended health services for all refugees with long-term displacement.


Assuntos
Cegueira/prevenção & controle , Cegueira/cirurgia , Extração de Catarata/estatística & dados numéricos , Refugiados/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Bangladesh , Cegueira/epidemiologia , Cegueira/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mianmar/epidemiologia , Mianmar/etnologia , Presbiopia/epidemiologia , Prevalência , Erros de Refração/epidemiologia , Resultado do Tratamento
4.
Adv Chronic Kidney Dis ; 27(5): 427-433, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-33308509

RESUMO

Racial, ethnic, socioeconomic, age, and sex-related health disparities in kidney disease are prominent in the United States. The Coronavirus Disease 2019 (COVID-19) pandemic has disproportionately affected marginalized populations. Older adults, people experiencing unstable housing, racial and ethnic minorities, and immigrants are potentially at increased risk for infection and severe complications from COVID-19. The direct and societal effects of the pandemic may increase risk of incident kidney disease and lead to worse outcomes for those with kidney disease. The rapid transition to telemedicine potentially limits access to care for older adults, immigrants, and people experiencing unstable housing. The economic impact of the pandemic has had a disproportionate effect on women, minorities, and immigrants, which may limit their ability to manage kidney disease and lead to complications or kidney disease progression. We describe the impact of COVID-19 on marginalized populations and highlight how the pandemic may exacerbate existing disparities in kidney disease.


Assuntos
/epidemiologia , Status Econômico/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/estatística & dados numéricos , Pessoas em Situação de Rua/estatística & dados numéricos , Nefropatias/epidemiologia , Fatores Etários , Equidade em Saúde , Disparidades em Assistência à Saúde/etnologia , Humanos , Nefropatias/etnologia , Refugiados/estatística & dados numéricos , Fatores Sexuais , Classe Social , Imigrantes Indocumentados/estatística & dados numéricos , Estados Unidos/epidemiologia
5.
Global Health ; 16(1): 118, 2020 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-33334370

RESUMO

BACKGROUND: Since 2016 Venezuela has seen a collapse in its economy and public health infrastructure resulting in a humanitarian crisis and massive outward migration. With the emergence of the novel coronavirus SARS-CoV-2 at the end of 2019, the public health emergency within its borders and in neighboring countries has become more severe and as increasing numbers of Venezuelans migrants return home or get stuck along migratory routes, new risks are emerging in the region. RESULTS: Despite clear state obligations to respect, protect and fulfil the rights to health and related economic, social, civil and political rights of its population, in Venezuela, co-occurring malaria and COVID-19 epidemics are propelled by a lack of public investment in health, weak governance, and violations of human rights, especially for certain underserved populations like indigenous groups. COVID-19 has put increased pressure on Venezuelan and regional actors and healthcare systems, as well as international public health agencies, to deal with a domestic and regional public health emergency. CONCLUSIONS: International aid and cooperation for Venezuela to deal with the re-emergence of malaria and the COVID-19 spread, including lifting US-enforced economic sanctions that limit Venezuela's capacity to deal with this crisis, is critical to protecting rights and health in the country and region.


Assuntos
/prevenção & controle , Emigração e Imigração/estatística & dados numéricos , Direitos Humanos/normas , Malária/transmissão , /epidemiologia , Recessão Econômica/estatística & dados numéricos , Direitos Humanos/tendências , Humanos , Malária/epidemiologia , Refugiados/estatística & dados numéricos , Venezuela/epidemiologia
6.
CMAJ Open ; 8(4): E819-E824, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33293331

RESUMO

BACKGROUND: There is high risk of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in congregate settings, including shelters. This study describes a coronavirus disease 2019 (COVID-19) outbreak and corresponding reported symptomatology at a shelter in Toronto. METHODS: This clinical and epidemiologic analysis focuses on a COVID-19 outbreak at a dedicated refugee shelter in downtown Toronto. All adult residents on site at the shelter were offered SARS-CoV-2 testing on Apr. 20, 2020. At the time of testing, residents were screened for 3 typical COVID-19 symptoms (fever, cough and shortness of breath). Among those who tested positive, a more comprehensive clinical assessment was conducted 1 day after testing and a standardized 15-item symptom screen was administered by telephone 14 days after testing. We report rates of positive test results and clinical symptoms with each assessment interval. RESULTS: Of the 63 adult residents on site at the shelter, 60 agreed to be tested. Among those tested, 41.7% (n = 25) were positive for SARS-CoV-2 infection. Of those who tested positive (n = 25), 20.0% (n = 5) reported fever, cough or shortness of breath at the time of testing. On more detailed assessment 1 day later, 70.8% (17/24) reported a broader range of symptoms. During the 14 days after testing, 87.5% (21/24) reported symptoms of infection. INTERPRETATION: We found a high rate of SARS-CoV-2 infection in this shelter population. Our study underscores the high risk of SARS-CoV-2 transmission in congregate living settings and the importance of mobilizing timely testing and management of symptomatic, paucisymptomatic and asymptomatic residents in shelters.


Assuntos
/epidemiologia , Surtos de Doenças/prevenção & controle , Refugiados/estatística & dados numéricos , /genética , Adulto , /virologia , Canadá/epidemiologia , Tosse/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Dispneia/epidemiologia , Feminino , Febre/epidemiologia , Habitação , Humanos , Incidência , Masculino , Pessoa de Meia-Idade
7.
Epidemiol Psychiatr Sci ; 29: e192, 2020 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-33298230

RESUMO

AIMS: Research demonstrates elevated levels of common mental disorders among Syrian refugees, but the majority of studies have, to date, focused on adult populations. This study aims to estimate the prevalence of depression, anxiety and post-traumatic stress disorder (PTSD) among Syrian children and adolescents living in Sultanbeyli district of Istanbul, Turkey. METHODS: A population-based survey among Syrian children and adolescents aged 8-17 years living in Sultanbeyli district was conducted in 2019, as part of an all-age survey of disability. 80 clusters of 50 participants (all-ages) were selected from the local municipality's refugee registration database using probability proportionate to size sampling. Children aged 8-17 years were assessed for symptoms of common mental disorders using the Child Revised Impact of Event Scale (CRIES-8) and abbreviated versions of the Center for Epidemiologic Studies Depression Scale for Children (CES-DC) and the Screen for Child Anxiety Related Disorders (SCARED). RESULTS: Of the 852 participants, 23.7% (95% CI 19.9-27.2) screened positive for symptomatic depression, PTSD and anxiety. The prevalence estimates for depression, PTSD and anxiety were 12.5% (95% CI 9.8-15.6), 11.5% (95% CI 9.1-14.4) and 9.2% (95% CI 6.8-12.1), respectively. Depression and PTSD were significantly more common in older adolescents, whilst anxiety and PTSD were significantly more common in girls. Depression was more common in children from poorer households and those who had received no education. Children coming from larger households were less likely to show symptoms of PTSD. CONCLUSIONS: Syrian refugee children and adolescents are vulnerable to common mental disorders, and culturally appropriate prevention and intervention support are needed for this population.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adolescente , Ansiedade/etnologia , Criança , Estudos Transversais , Depressão/etnologia , Feminino , Humanos , Masculino , Vigilância da População , Prevalência , Refugiados/estatística & dados numéricos , Resiliência Psicológica , Fatores Socioeconômicos , Transtornos de Estresse Pós-Traumáticos/etnologia , Síria/etnologia , Turquia/epidemiologia
8.
Afr Health Sci ; 20(2): 682-689, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33163032

RESUMO

Background: Women's fertility characteristics are affected by many different factors. Aim: To gain an awareness of fertility characteristics of Syrian refugee women and the influential factors. Methods: This study was planned as a cross-sectional study to determine the efficiency and related factors of Syrian refugees living in Istanbul. The survey of 300 refugee women applying Arabs who migrated to Turkey, Kurds, Turkmen and Yezidi origin they receive. Result: Average age of the women studied was 34.26 ± 10.15, 34.6% of the participants had not received any education, 37% had less than two-year inter-pregnancy interval, 58.6% have not received "Safe Motherhood" service, 43.6% have conceived their last child unwillingly. Women in the study group had in average 3±2,4 children and the number of children they wanted was 3±1,59. These values were substantially affected negatively by the women's education level and positively by the income level. Yezidis had significantly more children than other ethnic groups and did not have a "religious ban" on voluntary abortion. Conclusion: It has been noted that fertility characteristics of refugee women who migrated to Turkey changed according to their ethnic backgrounds and were sustained in the country they migrated to. Along with harsh living conditions and insufficient access to health services the situation has been observed to pose serious risks on reproductive health.


Assuntos
Fertilidade , Serviços de Saúde/provisão & distribução , Refugiados/psicologia , Serviços de Saúde Reprodutiva/estatística & dados numéricos , Saúde Reprodutiva/etnologia , Adulto , Feminino , Acesso aos Serviços de Saúde , Humanos , Gravidez , Campos de Refugiados , Refugiados/estatística & dados numéricos , Síria/etnologia , Turquia/epidemiologia
9.
Afr Health Sci ; 20(2): 709-714, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33163035

RESUMO

Background: Low birth weight (LBW) is an important indicator of reproductive health and general health status of population. Objectives: The present study was aimed to estimate the prevalence of low birth weight (LBW), and to investigate the associations between some risk factors and LBW in Syrian refugee and Turkish population in Kilis, Turkey. Methods: The population of this study constituted of a total of 4379 infants born in Kilis State Hospital in 2016 using a retrospective cross-sectional study design. The data were collected from birth records. The data were analyzed using SPSS version 16.0. Binary logistic regression analysis was performed to identify predictors of low birth weight. Factors with a p-value < 0.05 were deemed to be statistically significant. Results: The prevalence of LBW was 6.7% in all groups. Significant relationships were found between young maternal age, Syrian refugee mother, female infants, cesarean delivery and LBW. Conclusion: The prevalence of low birth weight in the study area was comparatively lower than that of countrywide figure. Maternal related variables like, maternal age, mother's nationality, and mode of birth (vaginal, cesarean) take after up as well as new-born related variables like gender of the neonate were significantly related with low birth weight.


Assuntos
Parto Obstétrico/estatística & dados numéricos , Hospitais Públicos/estatística & dados numéricos , Recém-Nascido de Baixo Peso , Complicações na Gravidez/epidemiologia , Resultado da Gravidez/etnologia , Gestantes/etnologia , Refugiados/estatística & dados numéricos , Adulto , Peso ao Nascer , Cesárea , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Masculino , Idade Materna , Mães , Gravidez , Cuidado Pré-Natal , Prevalência , Estudos Retrospectivos , Fatores de Risco , Síria/etnologia , Turquia/epidemiologia , Adulto Jovem
10.
Z Kinder Jugendpsychiatr Psychother ; 48(6): 453-457, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-33172360

RESUMO

Mental Disorders among Refugees Abstract. Children and adolescents with migration and refugee backgrounds are subject to various health-related, psychosocial, sociocultural, and economic burdens that may influence the prevalence, manifestation, course, and treatment as well as prognosis of mental disorders. In addition, they are particularly disadvantaged by numerous barriers to accessing the mental healthcare and treatment granted natives. The so-called transition gap only exacerbates the situation. As a solution, we provide recommendations for improving the mental healthcare of children and adolescents with a migration and refugee background analogous to the situation for adults. For inpatient settings, where mental healthcare is inadequate, we recommend the establishment of so-called adolescent wards under child and adolescent and adult psychiatric-psychotherapeutic management, with appropriate nursing and therapeutic staffing as well as a special "transition management" including the training of intercultural competence.


Assuntos
Transtornos Mentais/epidemiologia , Refugiados/psicologia , Refugiados/estatística & dados numéricos , Adolescente , Criança , Humanos , Transtornos Mentais/diagnóstico , Transtornos Mentais/terapia , Prevalência
11.
JAMA Netw Open ; 3(10): e2021678, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33052405

RESUMO

Importance: The management of noncommunicable diseases in humanitarian crises has been slow to progress from episodic care. Understanding disease burden and access to care among crisis-affected populations can inform more comprehensive management. Objective: To estimate the prevalence of hypertension and diabetes with biological measures and to evaluate access to care among Syrian refugees in northern Jordan. Design, Setting, and Participants: This cross-sectional study was undertaken from March 25 to April 26, 2019, in the districts of Ramtha and Mafraq, Jordan. Seventy clusters of 15 households were randomly sampled, and chain referral was used to sample Syrian households, representative of 59 617 Syrian refugees. Adults were screened and interviewed about their access to care. Data analysis was performed from May to September 2019. Exposures: Primary care delivered through a humanitarian organization since 2012. Main Outcomes and Measures: The main outcomes were self-reported prevalence of hypertension and diabetes among adults aged 18 years or older and biologically based prevalence among adults aged 30 years or older. The secondary outcome was access to care during the past month among adults aged 18 years or older with a diagnosis of hypertension or diabetes. Results: In 1022 randomly sampled households, 2798 adults aged 18 years or older, including 275 with self-reported diagnoses (mean [SD] age, 56.5 [13.2] years; 174 women [63.3%]), and 915 adults aged 30 years or older (608 women [66.5%]; mean [SD] age, 46.0 [12.8] years) were screened for diabetes and hypertension. Among adults aged 18 years or older, the self-reported prevalence was 17.2% (95% CI, 15.9%-18.6%) for hypertension, 9.8% (95% CI, 8.6%-11.1%) for diabetes, and 7.3% (95% CI, 6.3%-8.5%) for both conditions. Among adults aged 30 years or older, the biologically based prevalence was 39.5% (95% CI, 36.4%-42.6%) for hypertension, 19.3% (95% CI, 16.7%-22.1%) for diabetes, and 13.5% (95% CI, 11.4%-15.9%) for both conditions. Adjusted for age and sex, prevalence for all conditions increased with age, and women had a higher prevalence of diabetes than men (adjusted prevalence ratio, 1.3%; 95% CI, 1.0%-1.7%), although the difference was not significant. Complications (57.4%; 95% CI, 51.5%-63.1%) and obese or overweight status (82.8%; 95% CI, 79.7%-85.5%) were highly prevalent. Among adults aged 30 years or older with known diagnoses, 94.1% (95% CI, 90.9%-96.2%) currently took medication. Among adults aged 18 years or older with known diagnoses, 26.8% (95% CI, 21.3%-33.1%) missed a medication dose in the past week, and 49.1% (95% CI, 43.3%-54.9%) sought care in the last month. Conclusions and Relevance: During this protracted crisis, obtaining care for noncommunicable diseases was feasible, as demonstrated by biologically based prevalence that was only moderately higher than self-reported prevalence. The high prevalence of complications and obese or overweight status, however, suggest inadequate management. Programs should focus on reinforcing adherence and secondary prevention to minimize severe morbidity.


Assuntos
Diabetes Mellitus/terapia , Acesso aos Serviços de Saúde/normas , Hipertensão/terapia , Adulto , Idoso , Estudos Transversais , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/etnologia , Feminino , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Hipertensão/epidemiologia , Hipertensão/etnologia , Jordânia , Masculino , Pessoa de Meia-Idade , Prevalência , Refugiados/estatística & dados numéricos , Autorrelato , Síria/epidemiologia , Síria/etnologia
12.
Psychiatr Danub ; 32(Suppl 3): 386-395, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33030459

RESUMO

The use of violence and aggression on civilians during the war has become one of the most prominent military events of the 20th and 21st centuries, resulting in an increasing number of refugees and displaced persons in the midst of regional and tribal conflicts. We are witnessing a daily increase in the number of migrants when people are fleeing from their homes because of human rights violations, persecution, poverty, and conflict. When found in "host" countries, they often encounter bad conditions, with uncertainty and instability. Many come to Europe in search of economic and personal opportunities for progress, where they face different types of process of acculturation. 'Place loss', acute and chronic trauma, family disorders, and family reunification issues became more and more important issues. Refugees, asylum seekers and irregular migrants have a higher risk for certain mental health disorders, including posttraumatic stress, depression and psychosis. In addition to being exposed to various risk factors for mental disorders, migrants often face barriers to access to adequate health care to address these issues. Some of the biggest challenges for migrant populations within "host" countries include: lack of knowledge of health care rights and health systems; poor knowledge of the language; different belief systems and cultural expectations of health care; and the general lack of trust in experts and in government. The rates of depressive and anxiety disorders usually increase over time, and poor mental health is associated with poor socioeconomic conditions - particularly with social isolation and unemployment. Acculturative stress often implies a high discrepancy in the acculturation between parents and their children. This dislocation of families in new conditions has been caused by the different degrees of acceptance of "new culture" by children and parents, which causes serious difficulties, especially in bilingual terms.


Assuntos
Aculturação , Saúde Mental/estatística & dados numéricos , Refugiados , Migrantes , Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/epidemiologia , Europa (Continente) , Humanos , Refugiados/psicologia , Refugiados/estatística & dados numéricos , Migrantes/psicologia , Migrantes/estatística & dados numéricos
13.
Neurology ; 95(19): e2605-e2609, 2020 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-33004606

RESUMO

OBJECTIVE: Asylum seekers experience a high burden of physical and psychological trauma, yet there is a scarcity of literature regarding the epidemiology and sequelae of head injury (HI) in asylum seekers. We examined HI prevalence and association with neuropsychiatric comorbidities in asylum seekers. METHODS: A retrospective cross-sectional study was performed through review of 139 medical affidavits from an affidavit database. Affidavits written from 2010 to 2018 were included. Demographic and case-related data were collected and classified based on the presence of HI. For neuropsychiatric sequelae, the primary study outcome was headache and the secondary outcomes were depression, posttraumatic stress disorder, and anxiety. Multivariable logistic regression was performed to examine the association between HI and neuropsychiatric sequelae, adjusted for demographic and clinical characteristics. RESULTS: A total of 139 medical affidavits of asylum seekers were included. The mean age was 27.4 ± 12.1 years, 56.8% were female, and 38.8% were <19 years. Almost half (42.5%) explicitly self-reported history of HI. Compared to clients who did not report HI, clients with HI were older and more likely to report a history of headache, physical abuse, physical trauma, concussion, and loss of consciousness. After adjustment for demographic and clinical characteristics, clients with HI had greater odds for neuropsychological sequelae such as headache (odds ratio [OR] 4.2, 95% confidence interval [CI] 2.0-8.7) and depression (OR 2.5, 95% CI 1.1-5.7). CONCLUSIONS: We observed a high prevalence of HI in asylum seekers. Comprehensive screening for HI and neuropsychiatric comorbidities is encouraged when evaluating asylum seekers.


Assuntos
Ansiedade/epidemiologia , Traumatismos Craniocerebrais/epidemiologia , Depressão/epidemiologia , Cefaleia/epidemiologia , Refugiados/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Violência/estatística & dados numéricos , Adolescente , Adulto , Ansiedade/psicologia , Concussão Encefálica/epidemiologia , Concussão Encefálica/psicologia , Traumatismos Craniocerebrais/psicologia , Estudos Transversais , Depressão/psicologia , El Salvador/etnologia , Feminino , Guatemala/etnologia , Haiti/etnologia , Cefaleia/psicologia , Honduras/etnologia , Humanos , Masculino , Transtornos da Memória/epidemiologia , Transtornos da Memória/psicologia , México/etnologia , Nicarágua/etnologia , Razão de Chances , Questionário de Saúde do Paciente , Prevalência , Trauma Psicológico/epidemiologia , Trauma Psicológico/psicologia , Refugiados/psicologia , Estudos Retrospectivos , Distribuição por Sexo , Delitos Sexuais/psicologia , Delitos Sexuais/estatística & dados numéricos , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Inconsciência/epidemiologia , Inconsciência/psicologia , Estados Unidos/epidemiologia , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/psicologia , Adulto Jovem
14.
Global Health ; 16(1): 103, 2020 10 22.
Artigo em Inglês | MEDLINE | ID: mdl-33092609

RESUMO

The deteriorating political and economic situation in Venezuela has ramifications far beyond the Latin American country's borders as almost five million Venezuelans fled and migrated into countries in the region due to the crisis at home. The scarcity of health services, the lack of information sharing, and the absence of reliable data in Venezuela create challenges for confronting developing health emergencies and disease outbreaks. The need for accurate data is especially dire given the current COVID-19 pandemic and evolving movement of refugees. While countries and international organizations came together to form a coordinated response to Venezuela's political and humanitarian crisis, this geopolitical progress is threatened by the rapid spread of COVID-19, and the instinct for countries to focus inwards on domestic response priorities, rather than engage in regional cooperation. It is critical that the international community set aside geopolitical differences and cooperate to seek an accurate picture of the conditions on the ground to improve the welfare of Venezuelan migrants and to provide a more robust response to the current pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Confiabilidade dos Dados , Cooperação Internacional , Pandemias , Pneumonia Viral/epidemiologia , Refugiados/estatística & dados numéricos , Humanos , Política , Socorro em Desastres , Venezuela/etnologia
15.
Ann Glob Health ; 86(1): 129, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33102149

RESUMO

In August 2017, Bangladesh saw a massive influx of Rohingya refugees following their violent persecution by the Myanmar authorities. Since then, the district of Cox's Bazar has been home to nearly 900,000 Rohingya refugees living in the densely populated and unhygienic camps. The refugees have been living in makeshift settlements which are cramped into one another, making it extremely difficult to maintain "social distance". The overcrowded conditions coupled with the low literacy level, lack of basic sanitation facilities, face masks and gloves and limited communication make these camps an ideal place for the virus to spread rapidly. As nations struggle to contain the SARS-CoV-2 virus, refugees are one such population who are extremely vulnerable to the effects of this outbreak. If issues are not addressed at an early stage, its effects can be catastrophic.


Assuntos
Infecções por Coronavirus , Aglomeração , Transmissão de Doença Infecciosa/prevenção & controle , Controle de Infecções , Pandemias , Pneumonia Viral , Campos de Refugiados , Refugiados/estatística & dados numéricos , Bangladesh/epidemiologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Acesso aos Serviços de Saúde/normas , Necessidades e Demandas de Serviços de Saúde , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Controle de Infecções/normas , Mianmar/epidemiologia , Pandemias/prevenção & controle , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Campos de Refugiados/normas , Campos de Refugiados/provisão & distribução , Saneamento/normas
17.
Ann Glob Health ; 86(1): 135, 2020 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-33117656

RESUMO

The intersection of digital health platforms and refugee health in the context of the novel 2019 coronavirus disease (COVID-19) has not yet been explored. We discuss the ability of a novel mobile health (mhealth) platform to be effectively adapted to improve health access for vulnerable displaced populations. In a preliminary analysis of 200 Syrian refugee women, we found positive user feedback and uptake of an mhealth application to increase access to preventive maternal and child health services for Syrian refugees under temporary protection in Turkey. Rapid adaptation of this application was successfully implemented during a global pandemic state to perform symptomatic assessment, disseminate health education, and bolster national prevention efforts. We propose that mhealth interventions can provide an innovative, cost-effective, and user-friendly approach to access the dynamic needs of refugees and other displaced populations, particularly during an emerging infectious disease outbreak.


Assuntos
Infecções por Coronavirus/epidemiologia , Necessidades e Demandas de Serviços de Saúde , Disparidades em Assistência à Saúde/estatística & dados numéricos , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Refugiados/estatística & dados numéricos , Telemedicina/organização & administração , Adulto , Criança , Pré-Escolar , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/prevenção & controle , Infecções por Coronavirus/prevenção & controle , Feminino , Acesso aos Serviços de Saúde/organização & administração , Humanos , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Turquia , Populações Vulneráveis/estatística & dados numéricos
18.
Ulus Travma Acil Cerrahi Derg ; 26(5): 713-718, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32946091

RESUMO

BACKGROUND: Although Turkey hosts the largest number of Syrian immigrants, the interpretation of their health problems seems to be inadequate and understudied. In this study, we aimed to investigate whether being a refugee is a prognostic factor or not for peptic ulcer perforation (PUP). METHODS: A retrospective study was designed in Turkish Citizen patients and the refugees to compare the prognosis who underwent surgery for PUP. After ethical committee approval, the data of 143 patients, constituting 130 males and 13 females, operated for PUP, were collected. Patients' files, surgery notes and outpatient policlinic data were evaluated. RESULTS: In this study, 105 patients were Turkish Citizen, while the remaining 38 patients were refugees. Eight (7.6%) Turkish and one (2.6%) refugee patient died. There was no statistical significance between the two groups concerning mortality (p=0.445). Age, perforation diameter and localization, need of reoperation, nasogastric tube detention time, CRP, hematocrit, albumin, creatinine, BUN levels were found statistically significant for mortality. CONCLUSION: Although being a refugee has been identified as a risk in the etiopathogenesis of peptic ulcer disease, we found that being a refugee in Turkey is not a negative prognostic factor for PUP.


Assuntos
Úlcera Péptica Perfurada , Refugiados/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Úlcera Péptica Perfurada/diagnóstico , Úlcera Péptica Perfurada/epidemiologia , Úlcera Péptica Perfurada/cirurgia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Turquia , Adulto Jovem
20.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32994177

RESUMO

BACKGROUND: New guidelines support using interferon-γ release assays (IGRAs) in children ≥2 years for diagnosis of latent tuberculosis infection (LTBI). However, lack of experience in young children and concern that IGRAs are less sensitive than tuberculin skin tests (TSTs) limit their use. Our aim was to identify active tuberculosis (TB) cases among high risk children <5 years and tested for LTBI with an IGRA. METHODS: . Retrospective review of domestic TB screening data from California's Refugee Health Electronic Information System for children <5 years old who resettled in California between October, 2013 and December, 2016. Children were crossmatched with the California TB registry to identify cases of TB disease between October 2013 and December 2018. RESULTS: A total of 3371 children <5 years were identified; the majority were born in countries with high TB incidence (>150 cases per 100 000). Half received IGRAs (n = 1878; 56%), a quarter received TSTs (n = 811; 24%); 1.4% of children were IGRA-positive (n = 26) and 13% were TST-positive (n = 106). Twenty-two IGRA results were indeterminate (1.2%). Sixteen children had both tests; 9 were discrepant (positive TST with negative IGRA). No cases of TB disease were identified during 10 797 person-years of follow-up. CONCLUSIONS: IGRA positivity was less than TST positivity in high risk children <5 years old. Despite fewer LTBI diagnoses in the IGRA-tested population, no cases of TB disease among children who tested negative were identified, suggesting IGRA is valuable tool for identifying LTBI in this population.


Assuntos
Testes de Liberação de Interferon-gama/estatística & dados numéricos , Tuberculose Latente/diagnóstico , Refugiados/estatística & dados numéricos , Teste Tuberculínico/estatística & dados numéricos , California/epidemiologia , Pré-Escolar , Feminino , Humanos , Tuberculose Latente/epidemiologia , Masculino , Estudos Retrospectivos
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