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德国乌克兰未成年人及其家庭的健康与社会人口背景——难民医学面临的挑战:德国大学医学网络(NUM)的一项横断面研究

Health and socio-demographic background of Ukrainian minors and their families in Germany - challenges for refugee medicine : A cross-sectional study from the German Network University Medicine (NUM).

作者信息

Hoffmann Anna Teresa, Kobbe Robin, Denz Robin, Maier Christoph, Toepfner Nicole, Timmesfeld Nina, Petersmann Astrid, Giesbrecht Katharina, Hovardovska Olga, Vehreschild Jörg Janne, Scherer Margarete, de Miranda Susana M Nunes, Mitrov Lazar, Friedrichs Anette, Caliebe Amke, Skipiol Katarzyna Emilia, Holzwarth Sarah, Kaur Yadwinder, Schlegtendal Anne, Hojenski Leonhard, Ruß Anne-Kathrin, Vehreschild Maria J G T, Brinkmann Folke

机构信息

University Children's Hospital, Katholisches Klinikum Bochum, Ruhr-University Bochum, 44791, Bochum, Germany.

Institute for Infection Research and Vaccine Development (IIRVD), University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.

出版信息

Eur J Pediatr. 2024 Dec 5;184(1):64. doi: 10.1007/s00431-024-05847-2.

Abstract

UNLABELLED

In 2022, over 1,000,000 people from Ukraine fled to Germany, mostly women and children. The aim of this study was to determine health status and socio-demographic background of Ukrainian refugee minors in Germany and to compare that to German minors. In this study, Ukrainian refugees of all ages, who voluntarily made contact with the study centres via flyers or refugee shelters, were interviewed with the help of trained interpreters from 09-12/2022. We assessed data from minors and their families on socio-economic status, general health perception, current and pre-existing infectious and non-contagious diseases, and vaccination status. The data for the minors were collected by interviewing the accompanying adults. In addition, a physical examination and serological screening for infectious and vaccine-preventable diseases were performed. Overall, 392 minors and accompanying adults (358) were included. Minors' general and mental health were reported as "at least good" in 83% (316) and 80% (304), respectively. In 16% (63), infectious or other underlying diseases were recorded. Tuberculosis infections (7, 1.8%) and hepatitis C (2, 0.5%) were found through the serological tests. HIV could only be detected in one previously known case. Self-reported vaccinations against measles and varicella, for example, did not match serological findings (protection against measles 304; 84%; varicella 230; 64%).

CONCLUSION

Accompanying adults often rate the general health and well-being of Ukrainian refugee minors as rather poor. Frequently, self-reported vaccinations and preexisting diseases did not match serology results; therefore, Ukrainian refugee minors without formal vaccination certificate should be offered all recommended vaccinations and be generously screened for hepatitis B, C and HIV in addition to tuberculosis.

WHAT IS KNOWN

• Infectious diseases (TB, hepatitis B/C, HIV) are more common among Ukrainian minors and vaccine hesitancy is more widespread than in many host countries and require appropriate medical care. • Displacement and war worsen medical care and have negative impact on mental health..

WHAT IS NEW

• Although intrafamilial spread of infectious diseases was rare (in this cohort), perceived general health of Ukrainian minors is rather poor. • Semi-structured interviews-even with interpreters-are often insufficient to collect valid medical information.

摘要

未标注

2022年,超过100万乌克兰人逃往德国,其中大多数是妇女和儿童。本研究的目的是确定德国境内乌克兰未成年难民的健康状况和社会人口背景,并将其与德国未成年人进行比较。在本研究中,所有年龄段的乌克兰难民,通过传单或难民收容所自愿与研究中心取得联系,在2022年9月至12月期间,在经过培训的口译员帮助下接受了访谈。我们评估了未成年人及其家庭的社会经济状况、总体健康认知、当前和既往的传染病及非传染病以及疫苗接种状况。通过与陪同的成年人进行访谈来收集未成年人的数据。此外,还进行了体格检查以及针对传染病和疫苗可预防疾病的血清学筛查。总共纳入了392名未成年人及陪同的成年人(358名)。报告显示,未成年人的总体健康和心理健康状况 “至少良好” 的比例分别为83%(316名)和80%(304名)。有16%(63名)记录到患有传染病或其他基础疾病。通过血清学检测发现了结核病感染(7例,1.8%)和丙型肝炎(2例,0.5%)。仅在1例已知既往病例中检测到艾滋病毒。例如,自我报告的麻疹和水痘疫苗接种情况与血清学结果不符(麻疹疫苗接种保护率为304例;84%;水痘疫苗接种保护率为230例;64%)。

结论

陪同的成年人通常认为乌克兰未成年难民的总体健康和幸福状况相当差。自我报告的疫苗接种情况和既往疾病情况常常与血清学结果不符;因此,对于没有正式疫苗接种证明的乌克兰未成年难民,除了结核病筛查外,还应提供所有推荐的疫苗接种,并对其进行乙肝、丙肝和艾滋病毒的全面筛查。

已知信息

• 传染病(结核病、乙肝/丙肝、艾滋病毒)在乌克兰未成年人中更为常见,而且与许多东道国相比,疫苗犹豫现象更为普遍,需要适当的医疗护理。• 流离失所和战争会使医疗护理恶化,并对心理健康产生负面影响。

新发现

• 尽管在这个队列中传染病的家庭内传播很少见,但乌克兰未成年人的总体健康认知状况相当差。• 即使有口译员协助,半结构化访谈往往也不足以收集到有效的医疗信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d32/11621194/999a9f247e4c/431_2024_5847_Fig1_HTML.jpg

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