Adult Asylum Seekers from the Middle East Including Syria in Central Europe: What Are Their Health Care Problems?

Background

Forced displacement related to persecution and violent conflict has reached a new peak in recent years. The primary aim of this study is to provide an initial overview of the acute and chronic health care problems of asylum seekers from the Middle East, with special emphasis on asylum seekers from Syria.

Methods

Our retrospective data analysis comprised adult patients presenting to our emergency department between 01.11.2011 and 30.06.2014 with the official resident status of an “asylum seeker” or “refugee” from the Middle East.

Results

In total, 880 patients were included in the study. Of these, 625 (71.0%) were male and 255 (29.0%) female. The median age was 34 (range 16–84). 222 (25.2%) of our patients were from Syria. The most common reason for presentation was surgical (381, 43.3%), followed by medical (321, 36.5%) and psychiatric (137, 15.6%). In patients with surgical presentations, trauma-related problems were most common (n = 196, 50.6%). Within the group of patients with medical presentation, acute infectious diseases were most common (n = 141, 43.9%), followed by neurological problems (n = 70, 21.8%) and gastrointestinal problems (n = 47, 14.6%). There were no differences between Syrian and non-Syrian refugees concerning surgical or medical admissions. The most common chronic disorder of unclear significance was chronic gastrointestinal problems (n = 132, 15%), followed by chronic musculoskeletal problems (n = 108, 12.3%) and chronic headaches (n = 78, 8.9%). Patients from Syria were significantly younger and more often suffered from a post-traumatic stress disorder than patients of other nationalities (p<0.0001, and p = 0.05, respectively).

Conclusion

Overall a remarkable number of our very young group of patients suffered from psychiatric disorders and unspecified somatic symptoms. Asylum seekers should be carefully evaluated when presenting to a medical facility and physicians should be aware of the high incidence of unspecified somatic symptoms in this patient population.In general, there is no major difference between asylum seekers from Syria when compared to other nationalities of asylum seekers from the Middle East.

Below:  Overview of patients' origins

Below:  Number of patients presenting to emergency department by year and country of origin

Below:  Overview of psychiatric co-morbidities by country of origin

Full article at:   http://goo.gl/b3lkMD

By:  Carmen Andrea Pfortmueller,1,* Miriam Schwetlick,2 Thomas Mueller,3 Beat Lehmann,2 and Aristomenis Konstantinos Exadaktylos2

¹Department of General Anaesthesiology, Intensive Care and Pain Management, Medical University of Vienna, Vienna, Austria

²University Department of Emergency Medicine, University Hospital and University of Bern, Bern, Switzerland

³University Hospital of Psychiatry and University of Bern, Bern, Switzerland

Queensland University of Technology, AUSTRALIA

Competing Interests: The authors have declared that no competing interests exist.

Conceived and designed the experiments: CAP TM AKE. Performed the experiments: CAP MS TM BL. Analyzed the data: CAP AKE. Wrote the paper: CAP MS TM BL AKE.

* E-mail: moc.liamg@relleumtrofpc

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HIV Infection in Migrant Populations in the European Union and European Economic Area in 2007-2012: An Epidemic on the Move

Migrants are considered a key group at risk for HIV infection. This study describes the epidemiology of HIV and the distribution of late HIV presentation among migrants within the European Union/European Economic Area during 2007-2012.

HIV cases reported to European Surveillance System (TESSy) were analyzed. Migrants were defined as people whose geographical origin was different than the reporting country. Multiple logistic regression was used to model late HIV presentation.

Overall, 156,817 HIV cases were reported, of which 60,446 (38%) were migrants. Of these, 

• 53% were from Sub-Saharan Africa, 
• 12% from Latin America, 
• 9% from Western Europe, 
• 7% from Central Europe, 
• 5% from South and Southeast Asia, 
• 4% from East Europe, 
• 4% from Caribbean, and 
• 3% from North Africa and Middle East. 

Male and female migrants from Sub-Saharan Africa and Latin America had higher odds of late HIV presentation than native men and women. Migrants accounted for 40% of all HIV notifications in 2007 versus 35% in 2012. HIV cases in women from Sub-Saharan Africa decreased from 3725 in 2007 to 2354 in 2012. The number of HIV cases from Latin America peaked in 2010 to decrease thereafter. HIV diagnoses in migrant men who have sex with men increased from 1927 in 2007 to 2459 in 2012.

Migrants represent two-fifths of the HIV cases reported and had higher late HIV presentation. HIV epidemic in migrant populations in European Union/European Economic Area member states is changing, probably reflecting the global changes in the HIV pandemic, the impact of large-scale ART implementation, and migration fluctuations secondary to the economic crisis in Europe.

Purchase full article at: http://goo.gl/1GDUIx

By: Hernando V1, Alvárez-Del Arco D, Alejos B, Monge S, Amato-Gauci AJ, Noori T, Pharris A, Del Amo J.

• 1*Red de Investigación en Sida, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain; †CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; ‡Department of Surgery, Medical and Social Sciences, Universidad Alcalá, Alcalá de Henares, Spain; and §Surveillance and Response Section, European Centre for Disease Prevention and Control, Stockholm, Sweden.  

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