1
|
Mattelin E, Paidar K, Söderlind N, Fröberg F, Korhonen L. A systematic review of studies on resilience and risk and protective factors for health among refugee children in Nordic countries. Eur Child Adolesc Psychiatry 2024; 33:667-700. [PMID: 35445318 PMCID: PMC10894096 DOI: 10.1007/s00787-022-01975-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/09/2022] [Indexed: 11/03/2022]
Abstract
The Nordic welfare model is often used as an example for the promotion of health and wellbeing, even in vulnerable groups of children, such as refugees. Nonetheless, there are no published reviews on resilience and/or risk and protective factors for physical and mental health among refugee children living in Nordic countries. In this systematic review, we identified 5181 studies on the topic, screened titles, and abstracts, viewed 632, and finally included 26 studies. These studies described 18 samples with a total of 34,080 individuals ranging in ages 0-18 years. Overall, the studies were of good quality. Nearly all studies assessed adversity. Six studies reported physical health outcomes and all studies mental health outcomes, most often post-traumatic stress disorder and anxiety. None explicitly studied resilience. While we found that age and sex are the most frequently studied risk- and protective factors, findings are inconclusive, since the direction of the associations was different in the different studies. This systematic review indicates that there is still a need for well-designed and -powered studies using clear definitions of key study concepts to examine health outcomes and resilience among refugee children in Nordic countries.
Collapse
Affiliation(s)
- Erica Mattelin
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Center for Social and Affective Neuroscience and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Kristina Paidar
- Department of Child and Adolescent Psychiatry, Region Halland, Kungsbacka, Sweden
| | - Natalie Söderlind
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Frida Fröberg
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Laura Korhonen
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
- Center for Social and Affective Neuroscience and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
- Department of Child and Adolescent Psychiatry and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
| |
Collapse
|
2
|
Mohammadi M, Jafari H, Etemadi M, Dalugoda Y, Mohtady Ali H, Phung H, Ahmadvand A, Dwirahmadi F, Barnes P, Chu C. Health Problems of Increasing Man-Made and Climate-Related Disasters on Forcibly Displaced populations: A Scoping Review on Global Evidence. Disaster Med Public Health Prep 2023; 17:e537. [PMID: 37994107 DOI: 10.1017/dmp.2023.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Forcibly displaced populations are among the most vulnerable groups in disasters. They experience poorer health conditions compared with nondisplaced individuals. However, a clear picture is lacking regarding the overall health problems encountered by disaster-induced mid- to long-term displaced people. This study investigated these disorders prevalence and identified their correlates among long-settled displaced populations worldwide. The current scoping review follows the PRISMA-ScR guidelines; a systematic search was conducted on PubMed, Web of Science, and CINAHL and included original peer-reviewed studies, commentary, reviews, and grey literature published in English between January 1990 to June 2022. In the thematic and content analysis, the authors applied the narrative review approach to identify themes and sub-themes. Forty-eight documents were identified as fully relevant to this study. The largest number of published papers were from Asia, followed by the Middle East, the United States, and Europe. IDPs in developed countries were the most researched populations. Human-made disasters were addressed by 89% of the included studies. The four main thematic categories included were "physical health," "mental health," "inadequate facilities," and "lack of healthy behaviour." The worsening of noncommunicable diseases had the highest prevalence, followed by communicable diseases. Due to their condition, forcibly displaced migrants face a triple burden of communicable diseases and noncommunicable diseases such as mental health issues. Health-related research and policy need to consider the links among disasters, health problems, and forced migration as a determinant of health in the new era of climate change-driven displacements.
Collapse
Affiliation(s)
- Mahan Mohammadi
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4222, Australia
| | - Hamid Jafari
- Department of Medical Emergencies, School of Medical Sciences, Sirjan, Iran
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Manal Etemadi
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Yohani Dalugoda
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
| | - Heba Mohtady Ali
- Cities Research Institute & School of Engineering and Built Environment, Griffith University, Gold Coast, Australia
| | - Hai Phung
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4222, Australia
| | - Alireza Ahmadvand
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4222, Australia
| | - Febi Dwirahmadi
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4222, Australia
| | - Paul Barnes
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4222, Australia
| | - Cordia Chu
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4222, Australia
| |
Collapse
|
3
|
Das S, Fahim SM, Rasul MG, Afrin S, Alam MA, Uz Zaman M, Chowdhury M, Arifeen SE, Ahmed T. Nutritional and dietary diversity status of under-5 children and adolescent girls among forcibly displaced Myanmar nationals living in Bhasan Char relocation camp, Bangladesh: a cross-sectional survey. BMJ Open 2023; 13:e068875. [PMID: 36990487 PMCID: PMC10069579 DOI: 10.1136/bmjopen-2022-068875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE To generate baseline evidence regarding the nutritional and dietary diversity status of under-5 children and adolescent girls among forcibly displaced Myanmar nationals (FDMN) relocated to Bhasan Char relocation camp of Bangladesh. DESIGN Cross-sectional survey. SETTING Bhasan Char relocation camp, Bangladesh, 7 November 2021-12 November 2021. PARTICIPANTS 299 under-5 children (both male and female) and 248 adolescent girls (11-17 years) were surveyed. OUTCOME MEASURES Anthropometric indices and nutritional status of the study participants. RESULTS Nearly 17% of the adolescent girls were suffering from severe thinness/thinness, while 5% were overweight/obese. Severe thinness was more prevalent (2% vs 3.9%) in older adolescents (15-17 years) than their younger counterparts (11-14 years). The prevalence of severe stunting and stunting in adolescents were 14% (95% CI 11.21 to 16.87%) and 29% (95% CI 25.93 to 31.59%), respectively. One-third of the surveyed under-5 children were severely (8.50% (95% CI 5.60 to 11.33%)) or moderately (23.08% (95% CI 20.24 to 25.90%)) stunted, 27% were either severely (4.43% (95% CI 1.60 to 7.27%)) or moderately (22.98% (95% CI 20.15 to 25.81%)) underweight and 12% were severely (1.21% (95% CI 0.00 to 4.04%)) or moderately (10.88% (95% CI 8.05 to 13.72%)) wasted. The prevalence of moderate and severe acute malnutrition in children was low. Surveyed adolescents took a mean of 3.10 (SD 1.03) of nine food groups and 25% (95% CI 22.97 to 28.64%) of under-5 children took minimum diversified diet. The survey respondents mostly consumed carbohydrate-based poorly diversified diets. Nutritional status of the participants did not show any statistically significant association to the dietary diversity status. CONCLUSION A significant number of surveyed under-5 children and adolescent girls of relocated FDMN living in Bhasan Char of Bangladesh were suffering from thinness, stunting, underweight and wasting. Dietary diversity was poor among the surveyed population.
Collapse
Affiliation(s)
- Subhasish Das
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Shah Mohammad Fahim
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Golam Rasul
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Sazia Afrin
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Ashraful Alam
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mahabub Uz Zaman
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | - Shams El Arifeen
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| |
Collapse
|
4
|
Teketelew BB, Bayleyegn B, Berta DM, Enawgaw B, Woldu B. Anemia and associated factors among internally displaced children at Debark refugee camp, North Gondar, Northwest Ethiopia. PLoS One 2023; 18:e0285627. [PMID: 37163488 PMCID: PMC10171677 DOI: 10.1371/journal.pone.0285627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 04/26/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Children in refugee camps, due to their living conditions, are the most vulnerable groups to suffer from anemia. Nutritional deficiencies, especially iron deficiency is the most common causes of anemia. However, there is limited information on the prevalence and associated factors of anemia in Ethiopia. Hence, this study aimed to assess the prevalence and associated factors of anemia among internally displaced children at Debark refugee camp, Northwest Ethiopia. METHODS A cross-sectional study was conducted on 354 internally displaced children, at Debark refugee camp from March to May 2022. A systematic sampling technique was employed. The socio demographic characteristics were collected by using structured questionnaire via face-to-face interview with the caregivers. The hemoglobin level was determined using HemoCue301+. Form anemic children, venous blood sample was collected for iron profile analysis. Parasitological and anthropometric measurements were also done. The data were entered using Epi-data version 4.6.0.6 and exported to STATA version 14 for analysis. Bi-variable and multivariable binary logistic regression analysis were done. Both crude odds ratio and adjusted odds ratio with the corresponding 95% confidence interval were calculated to measure the strength of association. P-Value < 0.05 was considered as statistically significant association. RESULTS From the total of 354 children included in this study, more than half (54.8%) of them were male. The median age of children was 7 years with interquartile range of (4-10) years. The total prevalence of anemia in this study was 33.62% (95% CI:28.7, 38.7). Moderate type anemia was predominant in this study. From anemic children 30 (25.2%) had iron deficiency anemia. In this study, low dietary diversity (AOR = 4.9; 95% CI: 2.0, 11.7), duration in the camp more than six months (AOR = 4.2; 95% CI:1.9, 9.4), presence of diarrhea (AOR = 2.7; 95% CI:1.3, 5.7), fever (AOR = 3.4; 95% CI:1.6, 7.1), and wasting (AOR = 3.6; 95% CI:1.3, 10.3) were significantly associated with the prevalence of anemia. CONCLUSION Anemia was moderate public health problem in the current study. Focused policies and strategies towards to internally displaced children should be designed to reduce anemia, by preventing the significant risk factors associated with anemia.
Collapse
Affiliation(s)
- Bisrat Birke Teketelew
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Biruk Bayleyegn
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dereje Mengesha Berta
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bamlaku Enawgaw
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Berhanu Woldu
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
5
|
Meyer SC, Montez K, McClung R, Michael L, Namak S, Brown CL. Growth of Pediatric Refugees after Resettlement to the Southeastern United States. Acad Pediatr 2022; 22:777-781. [PMID: 34637931 PMCID: PMC8993936 DOI: 10.1016/j.acap.2021.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 09/25/2021] [Accepted: 10/04/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To compare weight status and body mass index z-scores (BMIz) of refugee children upon arrival to the Southeastern US and after resettlement with age- and sex-matched controls of nonrefugee children. METHODS We identified refugee children resettled between July 2014 and June 2018 to Forsyth County, NC. Refugees were assigned age- and sex-matched controls (3 controls:1 refugee) who received care at the same health care site, were Medicaid insured, and had height and weight recorded at time of their matched refugee's resettlement plus at least 2 additional visits. BMI and BMIz were calculated. Pearson chi-square test assessed differences in weight status at the time of refugee resettlement and at the last measured time point. Multilevel linear mixed-effects regression models assessed change in BMIz by refugee status, adjusting for sex, race/ethnicity, age, and time since resettlement. RESULTS This study examined 139 pediatric refugees and 417 nonrefugee controls; 46% were female. At the time of resettlement, refugees had a higher rate of underweight (3.3% vs 1.9%), higher rate of healthy weight (68.9% vs 48.2%), and lower rate of overweight/obesity (27.8% vs 50%), compared to controls P < .001. At the last available time point, compared to controls, refugees had higher rates of underweight (3.3% vs 3.0%) and healthy weight (69.5% vs 54.2%) and lower rates of overweight/obesity (27.2% vs 42.7%), P = .005. Refugees had a lower predicted BMIz compared with controls (adjusted β: -0.78; 95% confidence interval -0.91, -0.66). CONCLUSIONS Resettled pediatric refugees were found to have significantly lower predicted BMIz than their age- and sex-matched nonrefugee controls.
Collapse
Affiliation(s)
- Stephanie C Meyer
- Department of Student Affairs (SC Meyer), Wake Forest School of Medicine, Winston-Salem, NC
| | - Kimberly Montez
- Department of Pediatrics (K Montez and CL Brown), Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC
| | - Rachel McClung
- Novant Health, Robinhood Pediatrics (R McClung), Winston-Salem, NC
| | - Lemaat Michael
- Department of Student Affairs (L Michael), Wake Forest School of Medicine, Winston-Salem, NC
| | - Shahla Namak
- Department of Family and Community Medicine (S Namak), Wake Forest School of Medicine, Winston-Salem, NC
| | - Callie L Brown
- Department of Pediatrics (K Montez and CL Brown), Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC; Department of Epidemiology and Prevention (CL Brown), Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC.
| |
Collapse
|
6
|
Lieberman Lawry L. Review of Humanitarian Guidelines to Ensure the Health and Well-being of Afghan Refugees on U.S. Military Bases. Mil Med 2022; 187:1299-1309. [PMID: 35383836 DOI: 10.1093/milmed/usac086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/28/2022] [Accepted: 03/16/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The U.S. military has a 50-year history of managing resettlement or refugee camps on bases. In July and August 2021, more than 124,000 persons were evacuated from Afghanistan, with 55,000 Afghans temporarily housed at U.S. military bases around the world during Operation Allies Welcome (OAW) at its peak. METHODS PubMed was searched for papers published in English between January 1, 1980, and February 1, 2021, using "Afghanistan" and "health" (including "public health," "maternal health," and "child health"), "maternal, newborn, and child health," and "health situation" as search terms and specific topics of interest. Where scholarly work was unavailable, reports of the United States Agency for International Development, implementing partners, gray literature, donor reports, Afghanistan Ministry of Health documents, national health plans, policies, and strategies, DoD after-action reviews (AARs), and guidance from previous refugee airlifts were also included in the search. RESULTS Although AARs may provide some helpful guidance for these refugee settings, a review of open-source AARs and had little to no health guidance, focused primarily on administrative issues, and do not follow humanitarian guidelines. DoD guidance for refugee settings is dated and requires updating to be useful. There is a well-developed body of literature of international standards, guidelines, and best practices for refugee settings. Using the standardized Needs Assessment for Refugee Emergencies checklist as a guide, this review provides a standardized refugee health assessment framework for ensuring the health and well-being of Afghan refugees on U.S. military bases is based on humanitarian response guidelines and best practices to ensure their care meets international standards. All groups, especially minority ethnic groups (e.g., Hazaras), sexual and gender minorities, elderly, disabled, or mentally ill persons, need equal access to protection to ensure they are not targeted. Water, sanitation, and hygiene must be gender-sensitive and inclusive which includes well-lit separate facilities for males and females to decrease vulnerability to violence. The displaced population must be involved in the management of the camp through community participation and representation. All providers in OAW should be briefed on the food security and nutrition context of those in their care. Medical providers are most effective if they have significant experience with the refugee population health context. Understanding refugee medicine, the ability to work with illiterate and uneducated populations and translators are important skills. Abiding by international standards of care and being up-to-date with current guidelines for refugee care is important. Reproductive health must be a core component of the overall health response to decrease mortality, morbidity, and disability among reproductive-age women in crisis situations. Immediate and exclusive breastfeeding and international standards for breastfeeding must be adhered to, especially among nutritionally at-risk Afghans who are part of OAW. Education implementors familiar with education in refugee settings are an important contributor to establish formal, informal, non-formal, accelerated, and essence-based education programs. CONCLUSIONS Partners and providers involved in any refugee setting should become familiar with updated guidelines, standards, and best practices and apply them to any operation to ensure a rights-based approach to protection, care, and the health and well-being of refugees.
Collapse
Affiliation(s)
- Lynn Lieberman Lawry
- Preventive Medicine and Biostatistics Department, Uniformed Service University, Bethesda, MD 20814-4799, USA
| |
Collapse
|
7
|
Common Hematologic, Nutritional, Asthma/Allergic Conditions and Lead Screening/Management. Prim Care 2020; 48:67-81. [PMID: 33516425 DOI: 10.1016/j.pop.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This article describes hematologic, nutritional, allergic/asthmatic conditions, lead screening, and management of these among immigrants and refugees. Some of these conditions present more frequently or differently in the newcomer population. Early identification and treatment are key to improving health outcomes. Screening and treatment suggested in this article are based on current guidelines and are intended for primary care providers who are caring for refugee and immigrant patients, especially within a medical home. Special considerations include level of education, instruction, demonstration, and cultural humility.
Collapse
|
8
|
Towards identifying malnutrition among infants under 6 months: a mixed-methods study of South-Sudanese refugees in Ethiopia. Public Health Nutr 2020; 24:1265-1274. [PMID: 33059792 DOI: 10.1017/s1368980020004048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To determine (i) whether distinct groups of infants under 6 months old (U6M) were identifiable as malnourished based on anthropometric measures and if so to determine the probability of admittance to GOAL Ethiopia's Management of At Risk Mothers and Infants (MAMI) programme based on group membership; (ii) whether there were discrepancies in admission using recognised anthropometric criteria, compared with group membership and (iii) the barriers and potential solutions to identifying malnutrition within U6M. DESIGN Mixed-methods approaches were used, whereby data collected by GOAL Ethiopia underwent: factor mixture modelling, χ2 analysis and logistic regression analysis. Qualitative analysis was performed through coding of key informant interviews. SETTING Data were collected in two refugee camps in Ethiopia. Key informant interviews were conducted remotely with international MAMI programmers and nutrition experts. PARTICIPANTS Participants were 3444 South-Sudanese U6M and eleven key informants experienced in MAMI programming. RESULTS Well-nourished and malnourished groups were identified, with notable discrepancies between group membership and MAMI programme admittance. Despite weight for age z-scores (WAZ) emerging as the most discriminant measure to identify malnutrition, admittance was most strongly associated with mid-upper arm circumference (MUAC). Misconceptions surrounding malnutrition, a dearth of evidence and issues with the current identification protocol emerged as barriers to identifying malnutrition among U6M. CONCLUSIONS Our model suggests that WAZ is the most discriminating anthropometric measure for malnutrition in this population. However, the challenges of using WAZ should be weighed up against the more scalable, but potentially overly sensitive and less accurate use of MUAC among U6M.
Collapse
|
9
|
Pehlivanturk-Kizilkan M, Ozmert EN, Derman O, Okur İ, Kaynak MO, Adiguzel A, Sahan-Seref I, Kurekci F, Bideci A, Hasanoglu E. Nutritional Status of Syrian Refugees in Early Adolescence Living in Turkey. J Immigr Minor Health 2020; 22:1149-1154. [PMID: 32124154 DOI: 10.1007/s10903-020-00991-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study evaluated the nutritional status of Syrian refugees in the early adolescent period living in different vulnerable settings. Nutritional assessment of Syrian refugee adolescents is often neglected but essential for a healthy physical, pubertal and mental development. Growth parameters of Syrian refugee adolescents going to a public school in an urban area and in a temporary protection center (TPC) were recorded along with the Turkish adolescents. Stunting percentages were similar between the groups (p = 0.811). While the proportion of children with a BMI over 85th percentile were significantly higher among Syrian adolescents living in TPC, Turkish children have the highest percentage of underweight (p = 0.01). Both food insecurity and unhealthy weight gain continue to be major concerns for refugee adolescents after their resettlement to a host country. The findings suggest that nutritional assessment and intervention at early adolescence is critical for Syrian refugees depending on their living conditions.
Collapse
Affiliation(s)
- Melis Pehlivanturk-Kizilkan
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Medical School, 06610, Ankara, Turkey.
| | - Elif N Ozmert
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Hacettepe University Medical School, Ankara, Turkey
| | - Orhan Derman
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Medical School, 06610, Ankara, Turkey
| | - İlyas Okur
- Division of Pediatric Metabolism and Nutrition, Department of Pediatrics, Gazi University Medical School, Ankara, Turkey
| | - Mustafa Oguz Kaynak
- Department of Pediatrics, Hacettepe University Medical School, Ankara, Turkey
| | - Aydin Adiguzel
- Department of Pediatrics, Hacettepe University Medical School, Ankara, Turkey
| | - Irem Sahan-Seref
- Department of Pediatrics, Gazi University Medical School, Ankara, Turkey
| | - Fulya Kurekci
- Department of Pediatrics, Gazi University Medical School, Ankara, Turkey
| | - Aysun Bideci
- Division of Pediatric Endocrinology, Department of Pediatrics, Gazi University Medical School, Ankara, Turkey
| | | |
Collapse
|
10
|
Al-Amer R, Salamonson Y, Villarosa AR, Subih M, Darwish R, Maneze D. Accuracy of Body Weight Estimation Among Palestinian Refugee Adolescents Living in Jordan: A Cross-Sectional Study. J Nurs Scholarsh 2019; 51:642-650. [PMID: 31571411 DOI: 10.1111/jnu.12517] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE We aimed to examine the prevalence of obesity among adolescents living in a refugee camp in Jordan and analyze the factors influencing their weight perceptions. DESIGN Cross-sectional survey. METHODS We examined the body weight perception, and the influence of psychological, cultural, and social factors, among Palestinian refugee adolescents living in Jordan using a cross-sectional survey. Univariate, bivariate, and multiple logistic regression analyses were used to investigate the relationships between body weight status, weight perception, satisfaction with weight, screen time, and depression status of these adolescents. RESULTS A total of 620 adolescents participated in the study, of which 24% were either overweight or obese. Overweight or obese adolescents were more likely to underestimate their weight (p < .001), while those with depressive symptoms (Patient Health Questionnaire for Adolescents score > 14), were more likely to overestimate their body weight (p = .021). Having symptoms indicative of depression (adjusted odds ratio [AOR] = 1.70; 95% confidence interval [CI] = 1.16-2.50) and having a body mass index in the overweight/obese range (AOR = 4.16; 95% CI = 2.73-6.35) were predictors of discordant weight perception. CONCLUSIONS This study showed that excess body weight is a significant issue among Palestinian refugee adolescents living in a refugee camp in Jordan. Underlying depression is an important factor in excess weight and distorted weight perceptions especially among this vulnerable group. CLINICAL RELEVANCE The study highlights the importance of addressing discordant body weight perception and depression in weight management in nursing interventions for vulnerable adolescent groups.
Collapse
Affiliation(s)
- Rasmieh Al-Amer
- Assistant Professor, Isra University of Jordan, School of Nursing and Midwifery, Amman, Jordan and Adjunct Research Fellow, Western Sydney University, School of Nursing and Midwifery, Penrith, NSW, Australia
| | - Yenna Salamonson
- Professor, Western Sydney University, School of Nursing and Midwifery, and Centre for Oral Health Outcomes & Research Translation (COHORT), Ingham Institute for Applied Medical Research, Penrith, NSW, Australia
| | - Amy R Villarosa
- Research Assistant, Western Sydney University, School of Nursing and Midwifery, and Centre for Oral Health Outcomes & Research Translation (COHORT), Ingham Institute for Applied Medical Research, Penrith, NSW, Australia
| | - Maha Subih
- Assistant Professor, Al-Zaytoonah University of Jordan (ZUJ), School of Nursing and Midwifery, Amman, Jordan
| | | | - Della Maneze
- Multicultural Health Promotion Officer, South Western Sydney Local Health District (SWSLHD), Adjunct Research Fellow, Western Sydney University, School of Nursing and Midwifery, and Centre for Oral Health Outcomes & Research Translation (COHORT), Ingham Institute for Applied Medical Research, Campbelltown, NSW, Australia
| |
Collapse
|
11
|
Tuangratananon T, Julchoo S, Wanwong Y, Sinam P, Suphanchaimat R. School health for migrant children: a myth or a must? Healthc Policy 2019; 12:123-132. [PMID: 31372074 PMCID: PMC6628157 DOI: 10.2147/rmhp.s189081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 05/29/2019] [Indexed: 11/23/2022] Open
Abstract
Background School health plays a vital role in lifelong health outcomes. Migrant children are a vulnerable population that seem to have inadequate health promotion interventions, and limited studies have assessed their health status and personal hygiene at schools. This study aimed to evaluate school health promotion and health outcomes of migrant children in Thai public schools (TPSs) and migrant learning centers (MLCs). Methods A cross-sectional study was applied. Data were collected from questionnaires focusing on health care access, nutritional status, and personal hygiene of migrant children in two MLCs and four TPSs, along with Thai children in the same TPSs. Descriptive analysis and logistic regression model were used to compare access to health promotion and the health status of migrant children with the Thai counterparts. Results Blended school health services were generally found in TPSs, which led to indifferent vaccination rates between Thai and migrant children in TPSs (odds ratio [OR] 0.457 (0.186–1.120)). However, vaccination rates of migrant children in MLCs are noticeably around fourfold lower. Overall, migrant children received fewer dental health services than Thai children, both in TPSs (OR 0.198 (0.076,0.517)) and MLCs (OR 0.156 (0.004,0.055)). Other personal hygiene behaviors and nutritional statuses saw no significant difference between Thai children and migrant children in either TPSs or MLCs. The uninsured status among migrant children posed another challenge to health care access, as 81.7% of the migrant children in MLCs and 56.6% in TPSs were uninsured. Conclusion Migrant children in MLCs received a lower rate of essential vaccinations compared to those in TPSs. Dental services appeared to be the most neglected area of care in migrant children. The findings indicate the necessity of supportive policy for MLCs, while regulating quality and standards concurrently. Multisectoral collaboration is critically needed for sustainably improving the quality of life of migrant children.
Collapse
Affiliation(s)
- Titiporn Tuangratananon
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand.,Department of Health, Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Sataporn Julchoo
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Yaowaluk Wanwong
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Pigunkaew Sinam
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Rapeepong Suphanchaimat
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand.,Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand
| |
Collapse
|
12
|
Beukeboom C, Arya N. Prevalence of Nutritional Deficiencies Among Populations of Newly Arriving Government Assisted Refugee Children to Kitchener/Waterloo, Ontario, Canada. J Immigr Minor Health 2019; 20:1317-1323. [PMID: 29611017 DOI: 10.1007/s10903-018-0730-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study examined the variation among ethnic populations in prevalence of anemia, vitamin D and B12 deficiencies among refugee children. A retrospective chart review of 388 government assisted refugee children ≤ 16 years of age, seen at the Refugee Health Clinic in Kitchener, Canada from January 2009 to December 2014 was conducted. Vitamin D levels were only collected until December 1st 2010 (116 children). 15.7% were anemic (25% < 5 years, 8.7% 5-11 years, and 18.3% 12-16 years old) with Somali children having the lowest hemoglobin levels compared to those from Iraq, Afghanistan and Myanmar. 53.5% were vitamin D deficient (25(OH)D < 50 nmol/L), seen most commonly in Iraqis and Afghans. 11.2% had vitamin B12 levels < 150 pmol/L. Providers' knowledge of prevalence of nutritional deficiencies related to region of origin, can guide appropriate screening and treatment options to promote longer term cognitive, physical and developmental health.
Collapse
Affiliation(s)
- Carolyn Beukeboom
- School of Nursing, Western University, London, ON, Canada. .,School of Nursing, McMaster University, Hamilton, ON, Canada. .,, London, ON, Canada.
| | - Neil Arya
- Centre for Family Medicine Refugee Health Clinic, Waterloo, ON, Canada.,Family Medicine McMaster University, Hamilton, ON, Canada.,Family Medicine Western University, London, ON, Canada
| |
Collapse
|
13
|
Xu K, Watanabe-Galloway S, Qu M, Grimm B, Kim J. Common Diagnoses among Refugee Populations: Linked Results with Statewide Hospital Discharge Database. Ann Glob Health 2018; 84:541-550. [PMID: 30835394 PMCID: PMC6748192 DOI: 10.29024/aogh.2354] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND According to the U.S. State Department's Refugee Processing Center and the U.S. Census Bureau, in the fiscal year 2016, among all states in the United States, Nebraska resettled the highest number of refugees per capita. OBJECTIVES The objectives of this study were to determine the most common reasons for refugees utilizing hospital services in Nebraska between January 2011 and September 2015, and to examine whether refugee patients had increased risks for adverse health conditions compared to non-refugee patients. METHODS Statewide linkage was performed between Nebraska Medicaid Program's immigration data, and 2011-2015 Nebraska hospital discharge data inpatient and outpatient files. The linkage produced 3017, 5460, and 775 cases for emergency department visits, outpatient clinic visits, and inpatient care for the refugee sample, respectively. FINDINGS Refugee patients were at increased risk for a number of diagnoses or medical conditions, including pregnancy complications, abdominal pain, upper respiratory infections, viral infections, mood disorders, disorders of teeth and jaw, deficiency and anemia, urinary system disorders, headache, nausea and vomiting, limb fractures, spondylosis, essential hypertension, and uncomplicated diabetes mellitus. CONCLUSIONS The findings suggest a greater emphasis on preventive healthcare, especially in areas of maternal health and perinatal outcomes, psychological counseling, screening for infectious diseases, nutrition and healthy eating, and oral health. Additionally, culturally appropriate measures to address prevention, health screening, and treatments should be adopted by health providers who care for refugees.
Collapse
Affiliation(s)
- Kerui Xu
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, 984395 Nebraska Medical Center, Omaha, NE 68198-4395, US
| | - Shinobu Watanabe-Galloway
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, 984395 Nebraska Medical Center, Omaha, NE 68198-4395, US
| | - Ming Qu
- Division of Public Health, Nebraska Department of Health and Human Services, 301 Centennial Mall South, Lincoln, NE 68509-5026, US
| | - Brandon Grimm
- Department of Health Promotion, Social and Behavioral Health, College of Public Health, University of Nebraska Medical Center, 986075 Nebraska Medical Center, Omaha, NE 68198-6075, US
| | - Jungyoon Kim
- Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, 984350 Nebraska Medical Center, Omaha, NE 68198-4350, US
| |
Collapse
|
14
|
Abstract
Annually, over 80,000 refugees enter the United States as a result of political or religious persecution. Of these, approximately 35% to 40% are children and adolescents. Refugees are faced with challenges associated with living conditions, cultural and social norms, and socioeconomic status due to problems occurring in their homelands. These challenges include but are not limited to malnutrition, communicable disease, questionable immunization status, lack of formal education, sexual abuse, violence, torture, human trafficking, homelessness, poverty, and a lack of access to health care. Moreover, the psychological impact of relocation and the stress of acculturation may perpetuate many of these existing challenges, particularly for refugee youth, with limited or underdeveloped coping skills. School nurses are uniquely poised to support refugee youth in the transition process, improve overall health, and facilitate access to primary health services. The purpose of this article is to provide an overview of the unique refugee experience, examine the key health care needs of the population, and present school nurses with timely and relevant resources to assist in caring for refugee youth.
Collapse
Affiliation(s)
| | - Joyce Beard
- Assistant Professor, University of North Carolina at Pembroke, Pembroke, NC
| | - Dena Evans
- Associate Professor, University of North Carolina at Charlotte, Charlotte, NC
| |
Collapse
|
15
|
Hirani K, Payne D, Mutch R, Cherian S. Health of adolescent refugees resettling in high-income countries. Arch Dis Child 2016; 101:670-6. [PMID: 26471111 DOI: 10.1136/archdischild-2014-307221] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 09/23/2015] [Indexed: 12/14/2022]
Abstract
Adolescent refugees are a vulnerable population with complex healthcare needs that are distinct from younger and older age groups. Physical health problems are common in this cohort with communicable diseases being the focus of attention followed by an emphasis on nutritional deficiencies and other chronic disorders. Adolescent refugees have also often experienced multiple traumatic stressors and are at a heightened risk of developing mental health problems. Navigating these problems at the time of pubertal development adds further challenges and can exacerbate or lead to the emergence of health risk behaviours. Educational difficulties and acculturation issues further compound these issues. Adolescents who have had experiences in detention or are unaccompanied by parents are particularly at risk. Despite a constantly growing number of adolescent refugees resettling in high-income countries, knowledge regarding their specific healthcare needs is limited. Research data are largely extrapolated from studies conducted within paediatric and adult cohorts. Holistic management of the medical and psychological issues faced by this group is challenging and requires an awareness of the socioeconomic factors that can have an impact on effective healthcare delivery. Legal and ethical issues can further complicate their management and addressing these in a culturally appropriate manner is essential. Early identification and management of the healthcare issues faced by adolescent refugees resettling in high-income countries are key to improving long-term health outcomes and future healthcare burden. This review article aims to increase knowledge and awareness of these issues among paediatricians and other health professionals.
Collapse
Affiliation(s)
- Kajal Hirani
- Department of Adolescent Medicine and Eating Disorders, Princess Margaret Hospital for Children, Perth, Western Australia, Australia School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia
| | - Donald Payne
- Department of Adolescent Medicine and Eating Disorders, Princess Margaret Hospital for Children, Perth, Western Australia, Australia School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia
| | - Raewyn Mutch
- Telethon Kids Institute, Western Australia, Australia Refugee Health Service, Department of General Paediatrics, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
| | - Sarah Cherian
- School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia Refugee Health Service, Department of General Paediatrics, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
| |
Collapse
|
16
|
Murray JS. Displaced and forgotten child refugees: A humanitarian crisis. J SPEC PEDIATR NURS 2016; 21:29-36. [PMID: 26470749 DOI: 10.1111/jspn.12133] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 08/31/2015] [Accepted: 09/13/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe where child refugees are located, the risks they face, leading health problems, and how pediatric healthcare professionals can help. CONCLUSIONS Children constitute approximately 46% of refugees worldwide. These refugees fled their home countries due to conflict and persecution, and cannot return because of race, religion, nationality, political opinion, or membership in a particular social group. PRACTICE IMPLICATIONS Pediatric nurses have an unprecedented opportunity to advocate for child refugees by contributing to the international conversation on the human rights of immigrants.
Collapse
Affiliation(s)
- John S Murray
- Boston, Massachusetts.,Master of Science in Global Health, Northwestern University School of Professional Studies, Chicago, Illinois, USA
| |
Collapse
|