The spectrum of care for pediatric refugees and asylum seekers at a tertiary health care facility in Switzerland in 2015

Eur J Pediatr. 2017 Dec;176(12):1681-1687. doi: 10.1007/s00431-017-3014-9. Epub 2017 Sep 30.

Abstract

The aim of this retrospective study was to describe the epidemiology and spectrum of infections of admitted pediatric refugees and asylum seekers in a tertiary referral hospital in a high-income country in Europe. We identified recent refugees and asylum seekers < 18 years of age admitted to the University Children's Hospital in Basel, Switzerland, in 2015. A retrospective analysis was performed using electronic patient records. We identified 105 admissions in 93 patients with a median age of 5.7 (IQR 2.6-14.5) years. Eritrea, Syria, and Afghanistan were the most frequent countries of origin. The median duration of admission was 4 (IQR 2-6) days with infections and elective surgical interventions being the most common reason (54.8 and 16.1%, respectively). Most infections were airway, skin, and gastrointestinal in 46.4, 20.2, and 11.9%, respectively. The prevalence of tropical infections was 11.9%. The main pathogens identified were influenza A virus (13.8%), Staphylococcus aureus (10.3%), and rhino/enterovirus (10.3%). Previous medical non-infectious conditions were recorded in 13%.

Conclusion: The study revealed a high burden of infections in admitted patients mostly caused by well-known pathogens prevalent also in the local population. Both tropical infections and pre-existing non-infectious conditions are also important in admitted patients. Better epidemiological data is required to optimize health care for this medically most vulnerable population in refugee crises. What is Known: • Pediatric refugees and asylum seekers are the most vulnerable population in refugee crises. • Data on health concerns and needs in this population is scarce. What is New: • This is one of the first studies on the epidemiology of pediatric refugees and asylum seekers treated as inpatients in a European high-income country. • The high burden of infections is mostly caused by well-known pathogens prevalent also in the local population.

Keywords: Children; Europe; Immigrant health; Infections in refugees; Refugee crisis; Unaccompanied refugee minor.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Infections / epidemiology*
  • Male
  • Prevalence
  • Refugees*
  • Retrospective Studies
  • Switzerland / epidemiology
  • Tertiary Care Centers