Nutritional status of refugee children living in temporary settlements in Europe and MENA region: a systematic review and meta-analysis.

An estimated 41% of all forcibly displaced people are children [1]. Many of these children may live in refugee camps, under poor conditions, for years. The health status of children when arriving in these camps is often not recorded, nor is there a good insight into the impact of camp life on their health. We systematically reviewed the evidence concerning the nutritional status of children living in refugee camps in the European and Middle East and North Africa (MENA) regions. We searched Pubmed, Embase, and Global Index Medicus. The primary outcome was the prevalence of stunting, and the secondary outcome was the prevalence of wasting and being overweight. Out of 1385 studies identified, 12 studies were selected, covering 7009 children from fourteen different refugee camps in the Europe and MENA region. There was great heterogeneity among the included studies, which showed that there was a pooled prevalence of stunting of 16% (95% confidence interval 9.9-23%, I2 95%, p < 0.01) and of wasting of 4.2% (95% CI 1.82-6.49%, I2 97%, p < 0.01). Anthropometric measurements were done at random points in time during the children's camp period. However, no study had a longitudinal design, describing the effect of camp life on the nutritional status.   Conclusion: This review showed that there is a relatively high prevalence of stunting and a low prevalence of wasting among refugee children. However, the nutritional status of children when entering the camp and the effect of camp life on their health is not known. This information is critical in order to inform policymakers and to create awareness concerning the health of the most vulnerable group of refugees. What is Known: • Migration is a core determinant of health for children. • There are risk factors at every stage of a refugee child's journey that lead to compromised health. What is New: • There is a relatively high prevalence of stunting (16%) and a low prevalence of wasting (4.2%) among refugee children living in refugee camps in Europe and the Middle East and North Africa region.

[An infant with an asymmetric mouth when crying or laughing]. / Een zuigeling met een asymmetrische mond bij huilen en lachen.

BACKGROUND: If a child cries with an asymmetrical mouth it can be a sign of a nerve compression or a developmental defect in a facial muscle. In the latter case, a 22q11 deletion can be the cause, and multiple organs might be involved. CASE DESCRIPTION: A 2-month-old infant was referred to the paediatric outpatient clinic because he had an asymmetrical mouth when crying or laughing. There were no further symptoms. Genetic investigations and ultrasounds of the heart and kidneys were performed to exclude an underlying syndrome caused by a 22q11 deletion. These revealed no significant findings. It appeared to be a case of isolated 'asymmetric crying facies' as a result of hypoplasia of the depressor anguli oris muscle. CONCLUSION: An asymmetrical mouth in an infant can be a part of a genetic syndrome, in which there can be anomalies in multiple organ systems. For this reason, additional investigations are essential in cases of 'asymmetric crying facies'.