Medical Officer, Communicable Disease Control, Auckland Regional Public Health Service, Auckland District Health Board, Auckland.
N Z Med J. 2020 Dec 18;133(1527):51-70.
To update data previously published on the health profile of the refugees resettling in New Zealand, and to draw attention to the change in health profile over time, with a decline of infectious disease/deficiencies, and a rise of non-communicable diseases, a worldwide phenomenon.
Comparative data was extracted from (1) written annual reports prepared by medical officers at the Mangere Refugee Resettlement Centre (1978-1991), (2) a Microsoft ACCESS patient management system between 1995 and 1999 and (3) a MEDTECH patient management system between 2010 and 2014.
Over the period 1979-2014, the rate of infectious diseases has declined markedly in resettling refugees, and the rate of non-communicable diseases has increased. For example, the incidence of tuberculosis has decreased from 4% to 0.2%, gut parasites from more than 40% to, in some intakes, 15% and iron deficiency from 22% to 10%, while the diabetes rate has gone from 0.1% to 2.7%.
While management of unfamiliar infectious diseases and deficiencies (especially vitamin D) still remains an important part of the management of refugee health, their management usually involves limited time and expense, and their burden is much less than before. However, refugees now resettling in New Zealand and the rest of the world often present with familiar non-communicable diseases that require long-term management.
更新之前发表的关于在新西兰重新安置的难民健康状况的数据,并提请注意随着时间的推移健康状况的变化,传染病/缺乏症的减少,以及在全球范围内普遍存在的非传染性疾病的增加。
从以下方面提取了比较数据:(1)曼格雷难民重新安置中心的医务人员编写的年度报告(1978-1991 年);(2)1995 年至 1999 年的 Microsoft ACCESS 患者管理系统;(3)2010 年至 2014 年的 MEDTECH 患者管理系统。
在 1979 年至 2014 年期间,重新安置难民的传染病发病率显著下降,而非传染性疾病的发病率上升。例如,结核病的发病率从 4%下降到 0.2%,肠道寄生虫从 40%以上下降到某些摄入组的 15%,缺铁从 22%下降到 10%,而糖尿病的发病率从 0.1%上升到 2.7%。
尽管管理不熟悉的传染病和缺乏症(特别是维生素 D)仍然是难民健康管理的重要组成部分,但它们的管理通常涉及有限的时间和费用,其负担比以前要小得多。然而,现在在新西兰和世界其他地区重新安置的难民经常出现需要长期管理的熟悉的非传染性疾病。