Pfeil J, Kobbe R, Trapp S, Kitz C, Hufnagel M
Kinderheilkunde I, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 430, 69120, Heidelberg, Deutschland.
Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 2, 20246, Hamburg, Deutschland.
Internist (Berl). 2016 May;57(5):416-33. doi: 10.1007/s00108-016-0040-z.
Child and adolescent refugees in Germany represent a particularly vulnerable social group and treating infectious diseases forms a crucial part of providing their medical care. From an infectious diseases perspective, refugees themselves, as a result of their difficult personal circumstances, are the ones at highest risk. Even in crisis situations, medical practitioners are medically and ethically obliged to provide a high standard of care. The guidelines presented here propose recommendations for diagnosing and preventing infectious diseases among refugees under 18 in Germany. The guidelines are intended to assist in optimizing vaccine protection and treatment of diseases while taking into consideration factors such as refugees' challenging living conditions, cultural differences and potential language barriers.Upon refugees' arrival at the first housing sites, it is recommended that a basic clinical screening (and not just a brief visual inspection) be provided in order to identify and initiate treatment for acute medical problems and potentially contagious diseases (including tuberculosis), as well as to close gaps in vaccination coverage. Documentation of the clinical findings is critical, both to avoid redundant investigations and to optimize individual medical care. For this, an effective communication system must be established.Once refugees have been transferred into their destination community, outpatient and inpatient care providers should collaborate to bring refugees up-to-date with all vaccines recommended by STIKO (German Standing Committee on Vaccination). The same high standard of medical care should be delivered to refugees as would be to the general population. Due to the high prevalence of multi-resistant organisms (MRO) in the refugees' countries of origin, MRO screening is recommended for most patients receiving inpatient care.
德国的儿童和青少年难民是一个特别脆弱的社会群体，治疗传染病是为他们提供医疗服务的关键部分。从传染病的角度来看，难民自身由于其艰难的个人处境，是风险最高的人群。即使在危机情况下，医生在医学和道德上也有义务提供高标准的医疗服务。这里提出的指南针对德国18岁以下难民的传染病诊断和预防提出了建议。这些指南旨在帮助优化疫苗保护和疾病治疗，同时考虑到难民具有挑战性的生活条件、文化差异和潜在的语言障碍等因素。在难民抵达首个安置点时，建议进行基本的临床筛查（而不仅仅是简单的目视检查），以便识别并开始治疗急性医疗问题和潜在的传染病（包括结核病），同时填补疫苗接种覆盖方面的空白。临床检查结果的记录至关重要，这既能避免重复检查，又能优化个体医疗服务。为此，必须建立一个有效的沟通系统。一旦难民被转移到他们的目的地社区，门诊和住院护理提供者应合作，使难民接种德国疫苗常设委员会（STIKO）推荐的所有疫苗。为难民提供的医疗服务标准应与普通人群相同。由于难民原籍国多重耐药菌（MRO）的高流行率，建议对大多数接受住院治疗的患者进行MRO筛查。
