Butenop Joost, Brake Tessa, Mauder Sieglinde, Razum Oliver
Sachgebiet 53 - Gesundheit, Regierung von Unterfranken, Würzburg, Germany.
Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Bielefeld, Germany.
Gesundheitswesen. 2022 Aug;84(8-09):679-688. doi: 10.1055/a-1876-2423. Epub 2022 Jul 15.
Health needs of refugees are not only determined by exposure to war and fleeing. Determinants during the life course also play a role. We therefore examined the health situation in Ukraine before Russia's invasion in 2022 and its relevance for health care for Ukrainian refugees in Germany from the perspective of the Public Health Service.
Rapid search in the Medline data base, and in relevant Ukrainian and international health data bases; narrative synthesis of findings, followed by a prioritization of health problems and interventions by two medical doctors, using the risk matrix approach.
Immunization coverage is low for Covid-19, resulting in outbreaks in refugee shelters. There are vaccination gaps for measles and other basic immunizations, particularly in older children; children aged 2-5 years have not received the second measles dose. HIV and TB therapies may be interrupted due to the need to flee. Among elderly refugees, insufficiently treated cardiovascular diseases and pre-existing psychological trauma as well as cancers in need of acute care predominate. Ukrainian refugees may mistrust state-associated health measures, as the vaccination gaps indicate.
Refugees should be able to access curative and preventive health care without bureaucratic obstacles and entitlement restrictions. Analyzing Ukrainian health statistics and respective scientific publications helps the Public Health Service to adapt its interventions, and to avoid inefficient allocation of resources.
难民的健康需求不仅取决于战争经历和逃亡。生命历程中的各种决定因素也起着作用。因此，我们从公共卫生服务的角度，审视了2022年俄罗斯入侵之前乌克兰的健康状况及其与德国乌克兰难民医疗保健的相关性。
在Medline数据库以及乌克兰和国际相关健康数据库中进行快速检索；对研究结果进行叙述性综合，随后由两名医生采用风险矩阵方法对健康问题和干预措施进行优先排序。
新冠病毒疫苗接种覆盖率较低，导致难民收容所出现疫情。麻疹和其他基础免疫存在接种缺口，尤其是大龄儿童；2至5岁儿童未接种第二剂麻疹疫苗。由于需要逃亡，艾滋病毒和结核病治疗可能会中断。在老年难民中，心血管疾病治疗不充分、既往心理创伤以及急需救治的癌症较为普遍。正如接种缺口所显示的，乌克兰难民可能不信任与政府相关的健康措施。
难民应能够在没有官僚障碍和权利限制的情况下获得治疗性和预防性医疗保健。分析乌克兰的健康统计数据和相关科学出版物有助于公共卫生服务机构调整干预措施，避免资源分配效率低下。
