Division of Infectious Diseases and Tropical Medicine, Medical Center of the Ludwig-Maximilians-University (LMU), Munich, Germany.
Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Munich, Germany.
Infection. 2018 Jun;46(3):375-383. doi: 10.1007/s15010-018-1134-4. Epub 2018 Apr 3.
In 2016, the number of refugees worldwide reached 65.6 million. So far, only limited data are available on the health status of refugees and asylum seekers (RAs). Especially, notifiable infectious diseases (NIDs) carry the risk of outbreaks in communal accommodations hosting RAs.
We conducted a monocentric retrolective cross-sectional study including 15,137 RAs treated in a special health care unit for RAs located in the major reception center in Munich from November 2014 to October 2016. Altogether 811 RAs with NIDs according to sections 6 and 7 of the German Infection Protection Act or with other infections relevant in the setting of a communal accommodation (RIDs) could be identified.
The gender and age distribution was generally comparable to that of refugees in Germany. However, patients from East Africa and Nigeria were significantly overrepresented. NIDs/RIDs were dominated by cases of tuberculosis, hepatitis B, and vaccine-preventable and parasitic diseases. Significant risk factors included country of origin (COI) and age for hepatitis B, age for hepatitis C, gender and age for HIV, and COI, gender and age for tuberculosis and ectoparasitosis. Calculated prevalences of hepatitis B, hepatitis C, and HIV were mostly below those of the COI. Incidences of tuberculosis were mostly strongly elevated.
COI, gender, and age have an impact on the occurrence of NIDs/RIDs. Early vaccinations and improved hygiene could be effective in preventing NIDs/RIDs in communal accommodations. Screening, prompt therapy, and infection protection measures are necessary to prevent the transmission of diseases.
2016 年，全球难民人数达到 6560 万。迄今为止，关于难民和寻求庇护者（RAs）的健康状况仅有有限的数据。特别是，法定传染病（NIDs）有在收容难民的集体住所中爆发的风险。
我们进行了一项单中心回顾性横断面研究，纳入了 2014 年 11 月至 2016 年 10 月在慕尼黑主要接待中心的一个专门的难民医疗单位接受治疗的 15137 名 RA。共发现 811 例根据德国感染保护法第 6 和 7 节报告的 NIDs 或在集体住所中具有其他感染（RIDs）的 RA。
性别和年龄分布总体上与德国难民相似。然而，来自东非和尼日利亚的患者明显过多。NIDs/RIDs 以肺结核、乙型肝炎和可通过疫苗预防及寄生虫病为主。显著的危险因素包括原籍国（COI）和年龄对乙型肝炎、年龄对丙型肝炎、性别和年龄对 HIV 以及 COI、性别和年龄对肺结核和外寄生虫病。计算出的乙型肝炎、丙型肝炎和 HIV 流行率大多低于 COI。肺结核的发病率则大多显著升高。
原籍国、性别和年龄对 NIDs/RIDs 的发生有影响。在集体住所中，早期接种疫苗和改善卫生条件可以有效预防 NIDs/RIDs。筛查、及时治疗和感染防护措施对于预防疾病传播是必要的。
