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Değer VB, Çifçi S, Ertem M. The effect of socioeconomic factors on malnutrition in Syrian children aged 0-6 years living in Turkey: a cross-sectional study. BMC Public Health 2024; 24:2472. [PMID: 39261868 PMCID: PMC11389438 DOI: 10.1186/s12889-024-19791-1] [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] [Received: 03/10/2024] [Accepted: 08/13/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND This study was conducted to examine the prevalence of malnutrition in Syrian immigrant children living in Turkey. METHODS The study was carried out in the city of Mardin, which is one of the cities with a high Syrian immigrant population in Turkey. Height, body weight and BMI values were recorded to determine the malnutrition status of the children. Z-scores of children were calculated using the malnutrition assessment WHOAntro program. RESULTS The data show that 30.5% of Syrian children between the ages of 0 and 6 months are male, making up 55.8% of the total, and that 55.3% do not follow a regular breakfast schedule. The percentages of body weight for height, height for age, and BMI for age of Syrian children with a score between - 2 and + 2 SD Number were (89.3%), (74.3%), and (79.3%), respectively. Girls are more likely than boys to experience stunting and low body weight in the context of Syrian children (Stunting OR: 0.855(0.761-1.403), Underweight OR: 0.705(0.609-1,208)). Additionally, there is a link between levels of stunting and underweight and elements like the mother's educational level and the family's income. Contrary to the situation of adequate nutrition, it was discovered that the likelihood of stunting and low body weight in children increased by 0.809 and 1.039 times, respectively, when access to an adequate food supply was not available within the family (p < 0.05). CONCLUSION s According to the results of the study, gender, family income, mother's education level and access to food affected the severity of malnutrition in children. Migration is an imporatnt factor affecting children's health. In this study malnutrition was found high im immigrant children. Programs should be developed to monitor the growth and development of disadvantaged children and to support their nutrition.
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Affiliation(s)
- Vasfiye Bayram Değer
- Mardin Artuklu University/faculty of health sciences/public health nursing, Mardin, Turkey.
| | - Sema Çifçi
- Mardin Artuklu University/faculty of health sciences/public health nursing, Mardin, Turkey
| | - Melikşah Ertem
- Melikşah Ertem (MD), Public of Health, Medicine Faculty, University Of Kyrenia, Kyrenia, Kıbrıs, Turkey
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Choudhary P, Padhi BK, Mital AK, Gandhi AP, Mishra SK, Suri N, Baral SS, Satapathy P, Shamim MA, Thangavelu L, Rustagi S, Sah R, Khatib MN, Gaidhane S, Zahiruddin QS, Abd-Alrazaq A, Abu Serhan H. Prevalence of stunting among under-five children in refugee and internally displaced communities: a systematic review and meta-analysis. Front Public Health 2023; 11:1278343. [PMID: 38094233 PMCID: PMC10716242 DOI: 10.3389/fpubh.2023.1278343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/25/2023] [Indexed: 12/18/2023] Open
Abstract
Background A pooled estimate of stunting prevalence in refugee and internally displaced under-five children can help quantify the problem and focus on the nutritional needs of these marginalized groups. We aimed to assess the pooled prevalence of stunting in refugees and internally displaced under-five children from different parts of the globe. Methods In this systematic review and meta-analysis, seven databases (Cochrane, EBSCOHost, EMBASE, ProQuest, PubMed, Scopus, and Web of Science) along with "preprint servers" were searched systematically from the earliest available date to 14 February 2023. Refugee and internally displaced (IDP) under-five children were included, and study quality was assessed using "National Heart, Lung, and Blood Institute (NHLBI)" tools. Results A total of 776 abstracts (PubMed = 208, Scopus = 192, Cochrane = 1, Web of Science = 27, Embase = 8, EBSCOHost = 123, ProQuest = 5, Google Scholar = 209, and Preprints = 3) were retrieved, duplicates removed, and screened, among which 30 studies were found eligible for qualitative and quantitative synthesis. The pooled prevalence of stunting was 26% [95% confidence interval (CI): 21-31]. Heterogeneity was high (I2 = 99%, p < 0.01). A subgroup analysis of the type of study subjects revealed a pooled stunting prevalence of 37% (95% CI: 23-53) in internally displaced populations and 22% (95% CI: 18-28) among refugee children. Based on geographical distribution, the stunting was 32% (95% CI: 24-40) in the African region, 34% (95% CI: 24-46) in the South-East Asian region, and 14% (95% CI: 11-19) in Eastern Mediterranean region. Conclusion The stunting rate is more in the internally displaced population than the refugee population and more in the South-East Asian and African regions. Our recommendation is to conduct further research to evaluate the determinants of undernutrition among under-five children of refugees and internally displaced populations from different regions so that international organizations and responsible stakeholders of that region can take effective remedial actions. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=387156, PROSPERO [CRD42023387156].
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Affiliation(s)
- Priyanka Choudhary
- Department of Community Medicine, Shri Atal Bihari Vajpayee Government Medical College, Faridabad, India
| | - Bijaya K. Padhi
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Amit Kumar Mital
- Department of Paediatrics, Shri Atal Bihari Vajpayee Government Medical College, Faridabad, India
| | - Aravind P. Gandhi
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
| | - Sanjeeb Kumar Mishra
- Department of Community Medicine, Veer Surendra Sai Institute of Medical Science and Research (VIMSAR), Sambalpur, Odisha, India
| | - Neha Suri
- Department of Physical Medicine and Rehabilitation, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sudhansu Sekhar Baral
- Department of Physical Medicine and Rehabilitation, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Prakasini Satapathy
- School of Pharmacy, Graphic Era Hill University, Dehradun, India
- Evidence Synthesis Lab, Kolkata, India
| | | | - Lakshmi Thangavelu
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Sarvesh Rustagi
- School of Applied and Life Sciences, Uttaranchal University, Dehradun, Uttarakhand, India
| | - Ranjit Sah
- Tribhuvan University Teaching Hospital, Kathmandu, Nepal
- Department of Clinical Microbiology, DY Patil Medical College, Hospital and Research Centre, DY Patil Vidyapeeth, Pune, Maharashtra, India
| | - Mahalaqua Nazli Khatib
- Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Shilpa Gaidhane
- One Health Centre (COHERD), Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education, Wardha, India
| | - Quazi Syed Zahiruddin
- Global Health Academy, Division of Evidence Synthesis, School of Epidemiology and Public Health and Research, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, India
| | - Alaa Abd-Alrazaq
- AI Center for Precision Health, Weill Cornell Medicine, Doha, Qatar
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Skinner A, Tester-Jones MC, Carrieri D. Undernutrition among children living in refugee camps: a systematic review of prevalence. BMJ Open 2023; 13:e070246. [PMID: 37321810 PMCID: PMC10277121 DOI: 10.1136/bmjopen-2022-070246] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 05/23/2023] [Indexed: 06/17/2023] Open
Abstract
OBJECTIVES This review aimed to provide an overview of the prevalence of undernutrition in children under 5 years old in refugee camps according to the different indicators. In addition, we aimed to evaluate the quality and quantity of relevant epidemiological data available. DESIGN We used a systematic review of prevalence study design to achieve the above aims. We sought eligible observational studies through database searching of OVID Medline, CAB Global Health, Scopus and PubMed; citation chasing; and grey literature searching. SETTING The setting of interest was refugee camps across the globe. PARTICIPANTS Participants in the studies included in the review were children under 5 years old. PRIMARY AND SECONDARY OUTCOME MEASURES Outcome measures of interest were the prevalence of wasting, global acute malnutrition, stunting and underweight. RESULTS The review included 33 cross-sectional studies in 86 sites and a total of 36 750 participants. Overall, the quality of the studies was moderate to high, but some reports lacked clarity around data collection or outcome definitions. The results showed a wide variation in prevalence estimates across the different indicators and between different refugee camps. The median prevalence estimates of global acute malnutrition based on weight-for-height z-score, stunting and underweight were 7.1%, 23.8% and 16.7%, respectively. Using weight-for-height z-score identified a higher prevalence of acute malnutrition than using mid-upper arm circumference in the majority of studies. CONCLUSIONS Acute malnutrition remains a public health problem in many refugee camps, but chronic malnutrition has a high prevalence in more locations. Research and policy must, therefore, focus not only on nutrition but also on the wider determinants of both acute and chronic undernutrition. The difference in prevalence of global acute malnutrition depending on the measure used has implications for screening and diagnosis.
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Affiliation(s)
- Annabel Skinner
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | | | - Daniele Carrieri
- University of Exeter Medical School, University of Exeter, Exeter, UK
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Mroue T, Heras B, Soriano JM, Morales-Suarez-Varela M. Prevalence of Malnutrition among Syrian Refugee Children from Lebanon. Life (Basel) 2023; 13:life13020453. [PMID: 36836811 PMCID: PMC9961820 DOI: 10.3390/life13020453] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 02/08/2023] Open
Abstract
Today, the situation of Syrian refugees is one of the world's worst humanitarian crises. To estimate the prevalence of malnutrition among pediatric populations of Syrian refugees, 176 Syrian refugee children, with stays of more than two years at three refugee camps (Zalhé, Deddeh, and Kfar Jouz) or from the town of Yohmor, Lebanon were authorized by their parents to participate in this study. The children were anthropometrically evaluated and height-for-age Z-score (HAZ), weight-for-age Z-score (WAZ), and weight-for-height (WHZ) Z-scores were obtained and compared with WHO standards. Furthermore, mid-upper arm circumference (MUAC) was analyzed for screening children 6-59 months old. According to the anthropometric measures, no child met the criteria for chronic, global, acute malnutrition (CGAM), severe acute malnutrition (SAM), or moderate acute malnutrition (MAM). In the total sample, 49.4% of participants were moderately thin, with girls presenting a higher prevalence of thinness than that of boys. Thus, the absence of high rates of malnutrition was verified despite the magnitude of the Syrian refugee's problem. The data provided by this study identify the need to carry out further research to assess anthropometric growth and nutritional status among long-staying refugee children in order to prevent any health issues that may arise in the future.
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Affiliation(s)
- Tamara Mroue
- Observatory of Nutrition and Food Safety for Developing Countries, Food & Health Lab, Institute of Materials Science, University of Valencia, 46980 Paterna, Spain
| | - Betlem Heras
- Observatory of Nutrition and Food Safety for Developing Countries, Food & Health Lab, Institute of Materials Science, University of Valencia, 46980 Paterna, Spain
| | - Jose M. Soriano
- Observatory of Nutrition and Food Safety for Developing Countries, Food & Health Lab, Institute of Materials Science, University of Valencia, 46980 Paterna, Spain
- Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, Health Research Institute La Fe-University of Valencia, 46026 Valencia, Spain
- Correspondence: ; Tel.: +34-963543056
| | - María Morales-Suarez-Varela
- Unit of Preventive Medicine and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, University of Valencia, 46100 Burjassot, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, 28029 Madrid, Spain
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Nutritional and health status of adult Syrian refugees in the early years of asylum in Germany: a cross-sectional pilot study. BMC Public Health 2022; 22:2217. [PMID: 36447164 PMCID: PMC9706931 DOI: 10.1186/s12889-022-14684-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 11/21/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Migration is usually accompanied by changes in the social, cultural, and religious environment, socioeconomic status, and housing conditions, all of which affect nutritional health. In a cross-sectional study, we assessed the dietary intake as well as nutritional and health situation in a population of Syrian refugees who have resided in Germany for at least six months up to four years since 2015. The primary aim of this pilot study was to evaluate the nutritional and health status in comparison to reference values. METHODS Between December 2018 and March 2020, 114 adult Syrian refugees were included in the study. The subjects filled out questionnaires on sociodemographic variables, exercise, and nutrition behavior (three-day nutrition record). After a fasting blood draw, the subjects were examined for anthropometric parameters (height, weight, body mass index, waist circumference, waist-hip ratio, and body composition via a bioelectrical impedance analyzer). Various blood markers including iron status, hematological parameters, Vitamin D status, lipid metabolism, glucose metabolism, and total homocysteine (tHcy) were measured. RESULTS About half of the participants (71 male, 43 female) had lived in Germany for less than three years. Over 60% of men and 30% of women were overweight (BMI 25-30 kg/m2) or obese (BMI > 30 kg/m2), while 79% of men and 74% of women observed an elevated body fat mass. The evaluation of the three-day nutrition records revealed an unfavorable supply situation for numerous critical nutrients. More than half of the women (53.5%) had depleted iron stores (serum ferritin < 15 µg/l). The 25-OH-Vitamin D blood levels showed a high prevalence of Vitamin D insufficiency (25-49.9 nmol/l: 38% of men and 21% of women) and deficiency (< 25 nmol/l: 44% of men and 70% of women). 83% of men and 67% of women showed tHcy levels in plasma > 10 nmol/l. Fasting insulin levels and the HOMA-IR index indicate a risk for insulin resistance. Hyperlipidemia was prevalent, especially in males with 24% showing hypertriglyceridemia (> 150 mg/dl) and LDL-hypercholesterolemia (> 130 mg/dl). CONCLUSIONS The nutritional and health status of the cohort of Syrian refugees in Germany examined in this study is unsatisfactory, and many of the investigated refugees are at risk for developing cardiovascular disease and type 2 diabetes mellitus. Further studies are required to investigate the nutritional and health situation of refugees. This is obligatory to find ways to avoid malnutrition with all its associated health, sociodemographic, and economic consequences.
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Ankomah A, Byaruhanga J, Woolley E, Boamah S, Akombi-Inyang B. Double burden of malnutrition among migrants and refugees in developed countries: A mixed-methods systematic review. PLoS One 2022; 17:e0273382. [PMID: 35981085 PMCID: PMC9387835 DOI: 10.1371/journal.pone.0273382] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 08/08/2022] [Indexed: 11/19/2022] Open
Abstract
Migrants and refugees living in high income countries (HICs) have an increased risk of developing non-communicable diseases (NCDs) due to malnutrition at different stages over their life course. This systematic review aims to examine the double burden of malnutrition (DBM) among migrants and refugees in developed countries. This review was informed by the standard Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. Eligible studies were peer-reviewed observational studies that focused on the DBM in refugee or migrant populations; and were written in English with full texts available and accessible. A combination of keywords was used to search 8 electronic bibliographic databases including Ovid MEDLINE, EMBASE, PsycINFO, CINAHL, ProQuest, Scopus, PubMed, and web of science. There is a paucity of research into the DBM among migrants and refugees residing in HICs. Of a total of 2344 articles retrieved from eight databases, 5 studies met the inclusion criteria. All included studies showed the co-existence of some form of undernutrition and overnutrition within the same population. Overnutrition (overweight and obesity) in the studied populations ranged from 11.1% to 42% while undernutrition (stunting, wasting and underweight) ranged from 0.3% to 17%. Standard measures for anthropometry as determined by World Health Organization (WHO) were used for data collection in all included studies. A piloted form informed by the Cochrane Public Health Group Data Extraction and Assessment Template was used in the extraction of data from retrieved studies. Quality assessment of included studies was performed using the study assessment tools of the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) and showed that all studies were of fair quality. Interventions that simultaneously target more than one form of malnutrition especially amongst migrant and refugee populations must be implemented for policy solutions to be effective. This review has been registered by the PROSPERO international prospective registry for systematic reviews, reference CRD42020192416.
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Affiliation(s)
- Alex Ankomah
- School of Population Health, University of New South Wales, Sydney, Australia
- Obstetrics and Gynaecology Team, Airport Women’s Hospital, Accra, Ghana
| | - Judith Byaruhanga
- School of Medicine and Public health, The University of Newcastle, Callaghan, Australia
| | - Emma Woolley
- School of Education, Macquarie University, Sydney, Australia
| | - Sheila Boamah
- School of Nursing, McMaster University, Hamilton, Canada
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Joulaei H, Keshani P, Ashourpour M, Bemani P, Amiri S, Rahimi J, Aliakbarpour M, Salehi-Abargouei A. The prevalence of stunting among children and adolescents living in the Middle East and North Africa region (MENA): A systematic review and meta-analysis. J Glob Health 2022; 11:04070. [PMID: 35003712 PMCID: PMC8711751 DOI: 10.7189/jogh.11.04070] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Given the strategic importance of the MENA, the state of war and inequity in the region and its effect on malnutrition which leads to mortality and reduced economic development in this region, the current study purposed to examine the prevalence of stunting as an indicator of chronic malnutrition in the MENA region, with consideration given HDI, rural/urban area, and war-involved countries. Methods The electronic databases of PubMed, SCOPUS, Web of science, and Embase were systematically searched, and English-language articles published between January 1, 2009 and December 31, 2019 were included in this study. The POLIS (population, outcome, location, indicator, study design) criteria were used to perform the systematic review, and studies involving children 2 to 18 years of age were selected. Results Fifty-eight (n = 2 202 869) were included based on the study's inclusion criteria. The prevalence of stunting in children in the total MENA region was 22.0% (95% confidence interval (CI) = 20.4-23.6; I2 = 99.92%, P < 0.0001). The studies included in the meta-analysis were analyzed by subgroups. The pooled prevalence of stunting in children aged 2-5 years old and children aged 6 and older was 25.7% and 16.5%, respectively. The pooled prevalence of stunting was 34.1% in rural and 12.4% in urban areas. The pooled prevalence of stunting according to HDI was 30.1%, 28.5%, 13.1%, in low, medium, and high HDI countries, respectively. Furthermore, the pooled prevalence of stunting according to war status was 28.5% in war-involved countries vs 20.6% in others. Conclusions High prevalence of malnutrition was seen based on stunting indicator in the meta-analysis study in the MENA region, and this issue became more pronounced when the data was divided into subgroups based on age, residential area, and HDI. Inequality regarding social, economic, and political factors leads to significant malnutrition in the mentioned region.
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Affiliation(s)
- Hassan Joulaei
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Keshani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahkameh Ashourpour
- Department of Nutrition Sciences, School of Health, Larestan University of Medical Sciences, Larestan, Iran.Emam Reza Teaching Hospital, Larestan University of Medical Sciences, Larestan, Iran
| | - Peyman Bemani
- Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sanaz Amiri
- Department of Epidemiology, Health School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jamileh Rahimi
- Department of Epidemiology and Biostatistics, School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Mohsen Aliakbarpour
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amin Salehi-Abargouei
- Nutrition and Food Security Research Center, Department of nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Belau MH, Bassil M, Laukamp A, Kraemer A. Body mass index and associated factors among refugees living in North Rhine-Westphalia, Germany: a cross-sectional study. BMC Nutr 2021; 7:54. [PMID: 34433497 PMCID: PMC8390186 DOI: 10.1186/s40795-021-00453-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 07/01/2021] [Indexed: 11/18/2022] Open
Abstract
Background This study aims to determine: (i) information on overweight and obesity, represented by body mass index using measured anthropometric data, among refugees living in North Rhine-Westphalia, Germany, (ii) how body mass index changed throughout the migratory journey to Germany, and (iii) factors influencing body mass index. Methods The study utilizes data from the FlueGe health study, a cross-sectional study conducted by Bielefeld University. The data was collected between February and November 2018 in which participants were recruited in several cities in North Rhine-Westphalia (N = 326). We analyzed differences in body mass index before the escape, upon arrival, and since arrival as well as correlations between body mass index since arrival and explanatory variables using linear regression models. Results The overall prevalence of overweight and obesity before the escape (t0), upon arrival (t1) and since arrival (t2) were 55.2% (150/272), 45.6% (133/292) and 54.8% (171/312), respectively, with 16.2% (44/272), 12.0% (35/292) and 16.0% (50/312) being obese. There was a significant change between t0 and t1 (p < 0.001), and between t1 and t2 (p < 0.001), but no change over time (between t0 and t2, p = 0.713). Results from multivariate linear regression showed that high education, male sex, higher body mass index before the escape, Iranian or Iraqi nationality, and sobriety were the significant factors for body mass index since arrival. However, when focusing on those who have reported weight gain only, higher body mass index before the escape, male sex, and Iraqi nationality were the significant factors. Conclusions Overweight and obesity were common among refugees after settlement in Germany. In particular, sociodemographic factors were associated with a higher body mass index since arrival. Thus, it is important to develop and apply nutrition-related intervention programs for adult refugees that are culturally appropriate and tailored to education level and sex.
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Affiliation(s)
- Matthias Hans Belau
- Bielefeld University, School of Public Health, Bielefeld, Germany. .,University Medical Centre Hamburg-Eppendorf, Institute of Medical Biometry and Epidemiology, Hamburg, Germany.
| | - Muriel Bassil
- University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Annika Laukamp
- Bielefeld University, School of Public Health, Bielefeld, Germany
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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.
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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
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Reimer A, Hess M, Schwieger-Briel A, Kiritsi D, Schauer F, Schumann H, Bruckner-Tuderman L, Has C. Natural history of growth and anaemia in children with epidermolysis bullosa: a retrospective cohort study. Br J Dermatol 2019; 182:1437-1448. [PMID: 31487386 DOI: 10.1111/bjd.18475] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Impaired growth and anaemia are major extracutaneous complications of epidermolysis bullosa (EB), but data on their development are lacking. OBJECTIVES To determine the clinical course of growth and anaemia in children with EB and clarify the impact of nutritional compromise, inflammation and genetic factors. METHODS A retrospective study was conducted of 200 children, 157 with recessive dystrophic EB (RDEB) and 43 with junctional EB (JEB)-generalized intermediate, followed at the main referral centre in Germany. Growth charts were calculated using the modified LMS method and were correlated with parameters of anaemia, nutrition, inflammation and the molecular defect in a linear model. RESULTS In our cohort of patients with RDEB, weight impairment started at 12-18 months old; by the age of 10 years, 50% showed wasting. The predicted median weight at age 20 years was 35·2 kg for men and 40·1 kg for women. In JEB, growth resembled that of healthy children. Anaemia was present from the second year of life onwards in RDEB and JEB. Low levels of haemoglobin, iron, vitamin D, zinc and albumin, high levels of C-reactive protein, and absence of collagen VII correlated significantly with low weight in RDEB. No correlation was observed in JEB. CONCLUSIONS The results highlight that nutritional compromise occurs early in children with RDEB and therefore may require interventions as of the first year or two of life. What's already known about this topic? Children with epidermolysis bullosa (EB) suffer from failure to thrive and anaemia as major extracutaneous complications. The course of growth and the development of anaemia in EB are poorly characterized. What does this study add? A molecularly well characterized cohort of 200 children with EB was followed with regard to anthropometrics, anaemia and inflammation. We demonstrate early onset of growth failure and anaemia, most pronounced in the subset of recessive dystrophic EB. Awareness of early growth delay and nutritional deficiencies will improve EB care in daily practice.
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Affiliation(s)
- A Reimer
- Department of Dermatology, University Clinic for Dermatology and Venereology, Faculty of Medicine, University of Freiburg, Hauptstraβe 7, 79104, Freiburg, Germany
| | - M Hess
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - A Schwieger-Briel
- Department of Dermatology, University Clinic for Dermatology and Venereology, Faculty of Medicine, University of Freiburg, Hauptstraβe 7, 79104, Freiburg, Germany.,University Children's Hospital Zurich, Zurich, Switzerland
| | - D Kiritsi
- Department of Dermatology, University Clinic for Dermatology and Venereology, Faculty of Medicine, University of Freiburg, Hauptstraβe 7, 79104, Freiburg, Germany
| | - F Schauer
- Department of Dermatology, University Clinic for Dermatology and Venereology, Faculty of Medicine, University of Freiburg, Hauptstraβe 7, 79104, Freiburg, Germany
| | - H Schumann
- Department of Dermatology, University Clinic for Dermatology and Venereology, Faculty of Medicine, University of Freiburg, Hauptstraβe 7, 79104, Freiburg, Germany
| | - L Bruckner-Tuderman
- Department of Dermatology, University Clinic for Dermatology and Venereology, Faculty of Medicine, University of Freiburg, Hauptstraβe 7, 79104, Freiburg, Germany
| | - C Has
- Department of Dermatology, University Clinic for Dermatology and Venereology, Faculty of Medicine, University of Freiburg, Hauptstraβe 7, 79104, Freiburg, Germany
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