Antenatal depression among pregnant mothers in Afghanistan: A cross-sectional study

BACKGROUND

Approximately one in five pregnant women experience antenatal depression globally. The purpose of the present study was to estimate the prevalence of antenatal depression and explore its relationship between various demographic variables, recent sexual engagement, and recent adverse life events among pregnant Afghan women.

METHODS

A cross-sectional survey study was carried out between January, 2023 and April 2023 among 460 women aged 15-45 years who were recruited using convenience sampling from Herat province (Afghanistan). Logistic regression models were utilized to explore the relationship between antenatal depression and socio-demographic characteristics among the participants.

RESULTS

The prevalence of antenatal depression symptoms was 78.5%. Multiple regression analysis indicated that antenatal depression was significantly associated with (i) being aged 30-45 years (AOR: 4.216, 95% CI: 1.868-9.515, p = .001), (ii) being of low economic status (AOR:2.102, 95% CI: 1.051-4.202, p = .036), (iii) not being employed (AOR: 2.445, 95% CI:1.189-5.025, p = .015), (iv) not having had sex during the past seven days (AOR: 2.335, 95% CI: 1.427-3.822, p = .001), and (v) not experiencing a traumatic event during the past month (AOR:0.263, 95% CI: 0.139-0.495, p < .001).

CONCLUSION

The present study provides insight into the factors associated with the high prevalence of antenatal depression among pregnant Afghan women (e.g., demographic variables, recent adverse life events, and recent sexual engagement). It highlights the urgency of addressing antenatal depression in Afghanistan and provides a foundation for future research and interventions aimed at improving the mental health and well-being of pregnant women in the Afghan context.

Health Profile of Afghan Pediatric Refugees Resettled to Philadelphia in 2021-2022

To elucidate the physical and psychosocial health needs of newly arrived Afghan children, we conducted a retrospective chart review of patients 0 to 19 years re-settled to Philadelphia with ≥1 outpatient visit during August 2021 to August 2022. Findings on 121 patients include dental caries (74%), elevated lead (32%), eosinophilia (29%), malnutrition (25%), schistosomiasis (6%), strongyloidiasis (8%), latent tuberculosis (7%), and two cases of cutaneous leishmaniasis. Mental health symptoms include poor sleep in 16%, low energy in 10%, and behavioral concerns in 13%. Families with low English proficiency were more often met with delayed medical care (26.7% vs 11.5% P = .12). Parents with less than a high school education were more likely to experience delayed care (38.5% vs 9.1%; P = .001). We conclude that recently arrived Afghan children have unique physical and mental health needs that need to be addressed.

A case of fulminant respiratory diphtheria in a 24-year-old Afghan refugee in Austria in May 2022: a case report

PURPOSE

Raising awareness of respiratory diphtheria and for the importance of early antitoxin administration.

METHODS

Report of a case of fulminant, imported respiratory diphtheria in an otherwise healthy 24-year-old Afghan refugee in Austria in May 2022.

RESULT

This was the first case of respiratory diphtheria in Austria since 1993. Diphtheria antitoxin was administered at an already progressed disease stage. This delay contributed to a fulminant disease course with multiorgan failure and death.

CONCLUSION

In high-income countries with low case numbers, awareness of respiratory diphtheria and for the importance of early antitoxin administration must be raised.

A Systematic review of sexual and reproductive health needs, experiences, access to services, and interventions among the rohingya and the afghan refugee women of reproductive age in Asia

INTRODUCTION

Approximately 9.2 million refugees live in Asia, with most originating from Afghanistan and Myanmar, and half of them are women, girls, and children. Humanitarian crises disrupt the existing health-care system, limiting access to sexual and reproductive health (SRH) services. This review explores the SRH status of Afghan and Rohingya refugee women of reproductive age in Asia and their needs and experiences in accessing these services and commodities.

MATERIALS AND METHODS

We used the PRISMA checklist and searched for qualitative and quantitative peer-reviewed studies from five online bibliographic databases, SCOPUS, EMBASE (Ovid), MEDLINE (Ovid), CINAHL, and PROQUEST, from January 2000 to April 2021. Content analysis was undertaken following the minimum initial service package objectives.

RESULTS

Fifteen studies were included in this review from four countries: Bangladesh (5), Pakistan (5), Iran (4), and Malaysia (1). Approximately 50.91% of Rohingya and 54% of Afghan refugee women used contraceptives. About 56.6% of Afghan refugee mothers experienced pregnancy-related complications, one-third received antenatal care, and low birth weight was 2.6 times higher among infants born to Afghan refugee mothers than to Pakistani-born mothers. One out of five Rohingya women received delivery-related care. Approximately 72% of Rohingya and 79.8% of Afghan refugee women had experienced gender-based violence, and 56.5% of Rohingya women engaged in unwanted sexual intercourse with their husbands.

CONCLUSION

Social norms, stigma, cultural values, distrust of providers, inadequate staff, and prohibition by family members limit their access to SRH services and influence their needs, knowledge, and perceptions regarding SRH.

War, immigration and COVID-19: The experience of Afghan immigrants to Iran Amid the pandemic

INTRODUCTION

Afghanistan's domestic upheaval following the Taliban's invasion leads to massive displacement of its population. The number of Afghan refugees in Iran has dramatically increased since the Taliban's takeover of Afghanistan in August 2021. Multiple pre-and post-migratory traumatic experiences affect immigrants' physical, psychological, social, and economic wellbeing. The coronavirus outbreak, considered a traumatic experience in human life in the 21st century, added to their problems in Iran and exposed them to new challenges. This qualitative study aimed to investigate their experiences early before, during, and after immigration and the pandemic's challenges to their lives in Iran.

METHODS

In the present qualitative study, ten Afghan residents living in Iran who immigrated to Iran legally or illegally since the summer of 2021 and the last year after the second Taliban invasion were selected via purposive sampling. A semi-structured interview was applied to gather the data, and the data were analyzed through Braun and Clarke's thematic analysis method.

RESULTS

Ten male participants with a mean age of 26 y/o were interviewed. Their residence in Iran was between 20 days and 8 months. Four main themes were extracted. The first theme, the Tsunami of suffering, represents a disruption of the normal flow of life. Six subthemes, including loss, being near death, insecurity, sudden hopelessness, leaving the country involuntarily, and reluctance to explore underlying emotions, are included in this category. The second one, Lost in space, describes the participant's attempt to leave Afghanistan following the extensive losses and violent death threats. Their experiences are categorized into four subthemes: the miserable trip, encountering death, life-threatening experiences, and being physically and verbally abused. The third theme, with its five subthemes, try to demonstrate the participants' experiences after getting to their destination in Iran. The last one, Challenges of the COVID-19 explained the experience of Taliban return, war trauma, running away, and living as a refugee or immigrant coincided with the COVID pandemic.

DISCUSSION

Our interviewees explained multiple and successive traumatic experiences of war, migration, and the pandemic. The central clinical features of survivors are fears of losing control, being overwhelmed, and inability to cope. They felt abandoned because not only lost their family support in their homeland but could not also receive support in Iran due to the pandemic-related social distancing and isolation. They were dissociated and emotionally numb when describing their experience, which is a hallmark of experiencing severe, unprocessed traumas.

CONCLUSION

Gaining a better understanding of Afghan refugees lived experiences may help provide them with better social and health care support. Proper mental and physical healthcare support and de-stigmatization programs may reduce the impact of multiple traumas on their wellbeing.

Afghan Women's Use of Violence against Their Children and Associations with IPV, Adverse Childhood Experiences and Poverty: A Cross-Sectional and Structural Equation Modelling Analysis

Children who experience violence from a parent are more likely to experience and perpetrate intimate partner violence (IPV) later in life. Drawing on cross-sectional data among married women enrolled in the baseline of a randomized control trial in Afghanistan, we assess risk factors for women's use of violence against their children, focused on women's own adverse childhood experiences and experiences of IPV, poverty, poor mental health and gender attitudes. Analysis uses logistic regression and structural equation modelling (SEM). In total 744 married women reported on their use of violence against a child, with 71.8% (n = 534) reporting this in the past month. In regression models, their own experiences of witnessing their mother being physically abused, poverty during childhood, current food insecurity, their husband using corporal punishment on their child, current IPV experience, and other violence in the home were all associated with increased likelihood of women reporting corporal punishment. In the SEM, three pathways emerged linking women's childhood trauma and poverty to use of corporal punishment. One pathway was mediated by poor mental health, a second was mediated by wider use of violence in the home and a third from food insecurity mediated by having more gender inequitable attitudes. Addressing the culture of violence in the home is critical to reducing violence against children, as well as enabling treatment of parental mental health problems and generally addressing gender equity.

Information Needs During Pregnancy and Its Associated Factors in Afghan Pregnant Migrant Women in Iran

Background: Access to pregnancy-related information is an important requirement for all pregnant women, especially women at risk, such as immigrants. Regarding this, the present study was conducted to determine the information needs during pregnancy and its associated factors in the Afghan pregnant women. Methods: This cross-sectional study was conducted on 280 Afghan pregnant women who received care at the prenatal clinics of selected health care centers in the southeast of Tehran in 2018. The study population was selected using the continuous sampling method. The sampling was performed through the continuous sampling method from all the Afghan pregnant women who received care at the prenatal health centers of the southeast of Tehran. Results: Among the information needs during pregnancy, the fetal (83.34 ± 20.65) and smoking (62.61 ± 28.88) domains had the highest and lowest mean scores by percentage, respectively. The information needs during pregnancy showed a statistically significant relationship with age, women’s education level, husband’s education level, duration of living in Iran, place of residence, insurance status, number of children, place of the previous delivery, and routine prenatal care. Based on the multiple regression model, only the place of birth and place of residence accounted for 19% of information needs during pregnancy. Conclusion: As the findings indicated, the prenatal care–related education should address the domains that are unknown for Afghan women. Furthermore, in this education, the demographic and reproductive characteristics of the recipients should be taken into account to improve the pregnancy outcome among this population.

Occurrence and correlates of depressive symptoms among the resettled Afghan refugees in a regional area of Australia

AIMS

Refugees and asylum seekers are at high risk of mental health problems such as post-traumatic stress disorder (PTSD) and depression. Elucidating the occurrence and correlates of these problems in specific resettled refugee populations may be helpful in informing tailored prevention and health promotion programs. We sought to elucidate the occurrence and correlates of depressive symptoms among Afghan refugees resettled in Launceston, a regional town of Australia.

METHODS

We conducted a cross-sectional survey of 66 resettled Afghan refugees residing in Launceston in April 2019. We used the Hopkins symptoms checklist (HSCL-25) and the post migration living difficulties scale (PMLD) to measure depression symptoms and post-migration variables, respectively. Demographic characteristics and levels of physical activity were also assessed. Multivariate analysis was used to examine factors associated with depressive symptoms.

RESULTS

High levels of depressive symptoms were reported by 21.2% of participants (95% CI: 12.1%-33.0%) and were more common among female participants (41.2%, 95% CI: 18.4%-67.1%) than male participants (14.3%, 95% CI: 5.9%-27.2%). Isolation (loneliness, being or feeling alone) (OR = 19.5, 95% CI: 1.9-203.5) and physical inactivity (OR = 9.2, 95% CI: 1.8-45.8) were the only variables independently associated with depressive symptoms.

CONCLUSIONS

Depressive symptoms were common among Afghan refugees living in Launceston, particularly women, and were associated with isolation and physical inactivity. Hence these factors might usefully be targeted in local health promotion and prevention programs.

Family planning and Afghan refugee women and men living in Melbourne, Australia: new opportunities and transcultural tensions

This research aimed to explore the family planning perspectives and experiences of Afghan women and men living in Melbourne. A total of 57 Afghan women and men participated in six focus groups and 20 semi-structured interviews. The majority of participants indicated a preference for two or three children and were open to using modern contraception. However, many women described experiencing negative side effects when using hormone-based contraception and expressed difficulty negotiating condom use with their husbands as an alternative. Some women described how these difficulties resulted in inconsistent contraceptive practices and, at times, unintended pregnancy. Participants recognised that health professionals have an important role in addressing their family planning needs. This study highlights the ways in which Afghan women and men are changing in relation to their family planning beliefs and practices, and the opportunities, challenges and transcultural tensions they experience as they navigate these issues in Australia.

Posttraumatic Stress Disorder, Social Support and Coping Among Afghan Refugees in Canada

Posttraumatic-stress-disorder (PTSD) is one of the common mental health conditions among Afghan refugees resettled in developed countries. The current study explores how social support, coping and other factors correlate with PTSD in this population. A survey was conducted with 49 adult Afghan refugees (males 41%, female 59%) who completed Harvard Trauma Questionnaire during their visit to a Community Health Centre in Toronto. Bivariate analysis and structural-equation-modeling (SEM) were used to examine associations and pathways between PTSD and other variables. Mean PTSD score was 2.53 (SD 0.92) with 53% showing symptoms of PTSD which was significantly associated with age, unemployment, social support and self-rated health. SEM showed that higher social support scores were significantly associated with lower PTSD scores, and the effect of coping and English language were mediated through social support. The high prevalence of PTSD, its association with social support and self-rated health are important issues to be considered for refugee resettlement programs.

The prevalence and correlates of symptoms of post-traumatic stress disorder (PTSD) among resettled Afghan refugees in a regional area of Australia

Background: Post-traumatic stress disorder (PTSD) is common among resettled refugee populations and may be particularly problematic for refugees who have resettled in rural and regional areas.Aims: The aim of this study was to examine the occurrence and correlates of PTSD among Afghan refugees resettled in a regional area of Australia, namely, Launceston, Tasmania.Methods: A cross-sectional survey was conducted with 66 resettled Afghan refugees living in Launceston using the Post Migration Living Difficulties Scale (PMLD) and Impact of Event Scale-Revised (IES-R). Descriptive statistics and multivariable analysis of variables associated with a probable diagnosis of PTSD were conducted.Results: Approximately half of participants 48.8% (95% CI: 36.0-61.1%) met an operational definition of probable PTSD diagnosis according to the IES-R. In multivariable logistic regression analysis, communication difficulties (OR = 14.6, 95% CI: 1.7-124.7), separation from family (OR = 9.9, 95% CI: 1.8-55.5), and self-recognition of a mental health problem (OR = 13.8, 95% CI: 2.4-80.0) were strongly and independently associated with probable PTSD diagnosis. While most participants (81.2%) with a probable PTSD diagnosis recognised that they had a mental health problem, less than half (46.9%) had sought professional help for such a problem.Conclusions: The findings suggest that there are high rates of PTSD, and relatively low uptake of mental health care by sufferers, among resettled Afghan refugees in the regional area of Launceston, Australia. Factors that might usefully be targeted in health promotion, prevention and early intervention program include communication difficulties, issues of family separation and isolation and aspects of "mental health literacy" likely to detract from help-seeking.

Depression and suicidality in an Afghan refugee: A case report

We report the case of a young male refugee from Afghanistan who presented after a violent suicide attempt, likely precipitated in part by discrimination and social isolation experienced after immigrating to the United States. Common psychiatric comorbidities associated with immigration from war-torn nations are reviewed with a particular emphasis on how adequate screening and additional resources for vulnerable refugees during and after immigration continues to be an unmet need. Our findings suggest that there is a critical need and additional studies should be conducted, not only to identify at risk refugee populations but also to prevent potentially violent behavior. Our findings also suggest a lack of an optimal screening tool and shed light on the struggles of refugees, particularly those from Afghanistan.

Prevalence of and risk factors for substance use among Afghan refugees in Iran: An exploratory study

Afghan refugees may be a high-risk group for substance use problems. However, research is scarce in this area, specifically among Afghan refugees in one of their main host countries, Iran. This study aimed to estimate the prevalence of substance use among this population and explore the associated risk factors using a mixed-methods design. Findings suggest that 4.2% of the surveyed households had at least one adult member using illicit drugs. Moreover, results show that substance use among Afghans had statistically significant associations with illiteracy, lack of documentation, living in slum areas, and multidimensional poverty. Policy implications are discussed and recommendations provided.

Engaging new refugee in Australian communities at risk for chronic hepatitis B infection into care: A peer-educator intervention

Chronic Hepatitis B (CHB) infection and subsequent liver complications are rising in prevalence in Australia due to increased migration from endemic regions. Nearly 50% of all those living with CHB in Australia are undiagnosed, leading to missed opportunities for liver cancer and cirrhosis prevention. Health literacy around CHB among refugee communities such as Afghan, Rohingyan, and Sudanese populations (all with a high prevalence of CHB) is low, partly due to a paucity of targeted health promotion programmes; despite the release of the Victorian Hepatitis B Strategy (2016-2020). We developed a peer-education intervention in these three communities to deliver CHB focused radio programmes and community forums in their own language, following a needs assessment consisting of semistructured interviews and surveys. Effectiveness of this intervention was measured through paired comparison of disease-knowledge assessment pre and post forum. Community forums were held between 2015 and 2016, with 25 attendees at the Rohingyan forum (68% male), 10 attendees at the Afghan forum (90% male) and 0 attendees at the Sudanese forum. Participants demonstrated a significant improvement in CHB knowledge between pre- and post-forum surveys (p-value < 0.05). A peer-educator approach was a cost-effective health promotion strategy in building CHB knowledge and dispelling misconceptions within the Afghan and Rohingya communities. There were significant barriers in the engagement of the South Sudanese community, which will inform future strategies for health promotion.

Determinants of Health Care Services Utilization among First Generation Afghan Migrants in Istanbul

There is insufficient empirical evidence on the correlates of health care utilization of irregular migrants currently living in Turkey. The aim of this study was to identify individual level determinants associated with health service and medication use. One hundred and fifty-five Afghans completed surveys assessing service utilization including encounters with primary care physicians and outpatient specialists in addition to the use of prescription and nonprescription medicines. Multivariate logistic regression analyses were employed to examine associations between service use and a range of predisposing, enabling, and perceived need factors. Health services utilization was lowest for outpatient specialists (20%) and highest for nonprescription medications (37%). Female gender and higher income predicted encounters with primary care physicians. Income, and other enabling factors such as family presence in Turkey predicted encounters with outpatient specialists. Perceived illness-related need factors had little to no influence on use of services; however, asylum difficulties increased the likelihood for encounters with primary care physicians, outpatient services, and the use of prescription medications. This study suggests that health services use among Afghan migrants in Turkey is low considering the extent of their perceived illness-related needs, which may be further exacerbated by the precarious conditions in which they live.

Gendered Sources of Distress and Resilience among Afghan Refugees in Northern California: A Cross-Sectional Study

Recent studies have emphasized the influence of resettlement factors on the mental health of refugees resettling in developed countries. However, little research has addressed gender differences in the nature and influence of resettlement stressors and sources of resilience. We address this gap in knowledge by investigating how gender moderates and mediates the influence of several sources of distress and resilience among 259 Afghan refugees residing in Northern California (USA). Gender moderated the effects of four factors on levels of distress. Intimate and extended family ties have little correlation with men’s distress levels, but are strongly associated with lower distress for women. English ability is positively associated with lower distress for women, but not men. In terms of gender ideology, traditionally oriented women and egalitarian men have lower levels of distress. And experiencing greater dissonant acculturation increases distress for men, but not women. The influence of gender interaction terms is substantial and patterns may reflect difficulty adapting to a different gender order. Future studies of similar populations should investigate gender differences in sources of distress and resilience, and efforts to assist new arrivals might inform them of changes in gender roles they may experience, and facilitate opportunities to renegotiate gender roles.

Contextualizing Afghan refugee views of depression through narratives of trauma, resettlement stress, and coping

This qualitative study explored how Afghan refugees conceptualize frames of mind that may reflect depression in general and as it relates to trauma they experienced. We performed in-depth interviews with 18 Afghans residing in the San Diego area. Views regarding the causes, symptoms, and perceived treatments of depression were gathered through free-listing techniques, and supplemented with narratives relating to pre- and post-resettlement stressors and coping mechanisms. Data were analyzed with standard qualitative content analysis methods. Items endorsed with relation to depression causality included pre-migration war traumas, notably separation from family, and post-migration stressors including status dissonance and cultural conflicts that ranged from linguistic challenges to intergenerational problems. Depressive symptoms were viewed as highly debilitating, and included changes in temperament, altered cognitions, avoidance and dissociative behaviors, and somatic complaints. Relief was sought through family reunification and community support, reliance on prayer, and the academic success of their children in the US. The findings underscore the need for practitioners to take into account situational stressors, cultural aspects of mourning and symptomatology, and existing coping mechanisms in developing interventions that are based on refugees' articulated needs.

Afghan Refugee Explanatory Models of Depression: Exploring Core Cultural Beliefs and Gender Variations

Relatively little empirical attention has been paid to understanding how refugees conceptualize depression and how this concept varies between genders. The purpose of this study was to explore beliefs about depression among Afghans residing in San Diego County, California, using cultural consensus analysis. Using the prescribed mixed-method approach, we employed results from in-depth interviews to develop a culturally meaningful questionnaire about depression. Consensus analysis of responses to questionnaire items from 93 Afghans (50 men, 43 women) indicates shared beliefs that associates depression causality with mild traumatic experiences and post-resettlement stressors, symptomatology to include culturally salient idioms of distress, and treatment selections ranging from lay techniques to professional care. Divergence between genders occurred most in the symptoms subdomain, with women associating depression with more somatic items. This study contributes to understanding the etiology of and cultural responses to depression among this population, which is critical to improving culturally sensitive intervention for Afghan refugees.

Management of breast cancer in an Asian man with post-traumatic stress disorder: a case report

Background

Migration to the UK has increased considerably, which is reflected in the diverse multicultural population which includes asylum seekers and economic migrants. Differences in ethnic and cultural values between the host and newcomer populations could impact on effective health care provision, especially in gender-biased conditions such as breast cancer. Breast cancer is rare in men and the diagnosis is often met with disbelief. This case report describes an unusual case of breast cancer in an Afghan man who is an asylum seeker of Asian ethnic origin.

Case presentation

A focused ethnographic case study and in-depth interview was used to gain qualitative data and insight into the personal experiences of a male Afghan asylum seeker, age unknown (estimated to be in his 30s), with post-traumatic stress disorder who was electively admitted into hospital for the investigation of a suspicious lump in his left breast, which was subsequently found to be breast cancer. He was extremely reluctant to accept a breast cancer diagnosis and initially would not consent to any treatment, preferring to seek further opinion. During consultation with various members of the breast team he continually declined to accept the diagnosis and felt there was an error in the investigative protocol. Through the involvement of a Muslim nurse, fluent in Urdu and knowledgeable of the Afghan culture and religious background, we learned about his experiences and feelings; he opened up to her about his experiences in Afghanistan, detailing his experiences of trauma as a result of war, and disclosing that he had been diagnosed as having post-traumatic stress disorder by his physician. He saw breast cancer as a “woman’s disease” which deeply affected his feelings of masculinity and left him feeling vulnerable.

Conclusions

While sensitivity is undoubtedly required when diagnosing gender-biased conditions such as breast cancer in men, our experience showed this is exacerbated in ethnic minority groups where language barriers often exist and awareness of cultural differences is required. Awareness of the possibility of post-traumatic stress disorder in migrant populations from conflict-torn areas is also recommended during consultation.

Correlates and Predictors of Psychological Distress among Afghan Refugees in San Diego County

The psychological effects of war and resulting displacement continue to negatively impact Afghan refugees. The purpose of this study was to investigate factors that are associated with and predict psychological distress symptoms among Afghan refugees. We analyzed data from a diverse sample of 130 Afghan refugees recruited through non-random sampling in the San Diego area. Participants completed self-report questionnaires consisting of a culturally validated measure of psychological distress, the Afghan Symptom Checklist [ASCL] alongside standardized measures of acculturation, social support, and perceived stress. In bivariate analyses, older age, older age at migration, female gender, being widowed, having lower education, being unemployed, unable to comfortably pay monthly bills, lower acculturation and social support, and higher levels of perceived stress were associated with psychological distress. However, only few variables - female gender, being widowed, unable to comfortably pay monthly bills, and perceived stress - remained significant in multivariate analysis. The findings from this study contribute to understanding the social determinants of distress that affect Afghans in exile even after long-term resettlement in the US. These reported outcomes support the need for continued research with Afghans, alongside the implementation of culturally relevant psychosocial interventions that emphasize prevention of post-resettlement stressors immediately upon resettlement.

Major infectious diseases affecting the Afghan immigrant population of Iran: a systematic review and meta-analysis

OBJECTIVES

As Afghans make up the largest group of foreign nationals in Iran, the aim of this study was to assess the proportion of Afghan immigrants among those afflicted by the most prevalent infectious diseases in Iran.

METHODS

National and international online scientific databases were searched through November 2013. The reference lists of included studies were also searched. All descriptive studies concerning the most common infectious diseases in Iran, including tuberculosis, multiple-drug-resistant tuberculosis, malaria, cholera, Crimean-Congo hemorrhagic fever, leishmaniasis, and hepatitis B were retrieved. The nationality of patients was not considered. The selection of studies and data extraction was performed separately by two authors. Results were reported using a random effect model with a 95% confidence interval (CI).

RESULTS

The overall proportion of Afghan immigrants with the aforementioned infectious diseases was 29% (95% CI, 21 to 37). According to a stratified analysis, the proportion of Afghan immigrants afflicted with tuberculosis was (29%), multiple-drug-resistant tuberculosis (56%), malaria (40%), cholera (8%), Crimean-Congo hemorrhagic fever (25%), leishmaniasis (7%), and hepatitis B (14%).

CONCLUSIONS

It is highly recommended to monitor the health status of the Afghan immigrants when entering Iran, to reduce the spread of communicable diseases, which are viewed as serious in international health regulations.

Prevalence of psychiatric disorders among unaccompanied asylum-seeking adolescents in norway

Unaccompanied asylum-seeking children (UASC) are known to be subjected to several potentially traumatic life events, risking more mental health problems than other populations of same age. In this study, we aimed to explore the prevalence of psychiatric morbidity at an early stage after arrival to the host country. We performed structured clinical interviews (CIDI) with 160 male UASC from different countries (Afghanistan, Somalia, Iran), after four months in Norway. Most of the participants had experienced life threatening events (82%), physical abuse (78%), or loss of a close relative (78%) in their former life. Altogether 41.9% of the participants fulfilled diagnostic criteria for a current psychiatric disorder. The most prevalent diagnosis was PTSD (30, 6%), followed by MDD (9, 4%), Agoraphobia (4, 4%) and GAD (3, 8%). Implications of this vulnerability call for more mental health resources in the early stages of the asylum process. Increased awareness of psychiatric morbidity in UASC may improve the prognosis, give more appropriate care, and ease the integration process on all levels of society.