Factors Influencing the Frequency of Airway Infections in Underage Refugees: A Retrospective, Cross Sectional Study
Abstract
:1. Background
2. Methods
2.1. Study Population
2.2. Data Collection and Management
2.3. Definitions
2.4. Statistical Analyses
2.5. Ethics Compliance
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Availability of Data and Materials
Abbreviations
CI | confidence interval |
COVID-19 | coronavirus disease 2019 |
GEE | generalized estimating equations |
UNHCR | United Nations High Commissioner for Refugees |
ICD-10 | International Statistical Classification of Diseases and Related Health Problems |
OR | odds ratio |
SD | standard deviation |
SARS-CoV-2 | severe acute respiratory syndrome coronavirus 2 |
References
- Anders, W. Epidemiology and prevention of measles; particularly in refugee children in Berlin. Arch. Hyg. Bakteriol. 1957, 141, 281–296. [Google Scholar] [PubMed]
- Seaman, J.A. Relief work in a refugee camp for Bangladesh refugees in India. Lancet 1972, 300, 866–870. [Google Scholar] [CrossRef]
- Lamb, G.S.; Cruz, A.T.; Camp, E.A.; Javier, M.; Montour, J.; Piper, T.; Shah, U.A.; Starke, J.R. Tuberculosis in Internationally Displaced Children Resettling in Harris County, Texas, USA, 2010–2015(1). Emerg. Infect. Dis. 2020, 26, 1686–1694. [Google Scholar] [CrossRef] [PubMed]
- Feldstein, L.R.; Bennett, S.D.; Estivariz, C.F.; Cooley, G.M.; Weil, L.; Billah, M.M.; Uzzaman, M.S.; Bohara, R.; Vandenent, M.; Adhikari, J.M.; et al. Vaccination coverage survey and seroprevalence among forcibly displaced Rohingya children, Cox’s Bazar, Bangladesh, 2018: A cross-sectional study. PLoS. Med. 2020, 17, e1003071. [Google Scholar] [CrossRef]
- Pohl, C.; Mack, I.; Schmitz, T.; Ritz, N. The spectrum of care for pediatric refugees and asylum seekers at a tertiary health care facility in Switzerland in 2015. Eur. J. Pediatr. 2017, 176, 1681–1687. [Google Scholar] [CrossRef]
- Grote, U.; Schleenvoigt, B.T.; Happle, C.; Dopfer, C.; Wetzke, M.; Ahrenstorf, G.; Holst, H.; Pletz, M.W.; Schmidt, R.E.; Behrens, G.M.N.; et al. Norovirus outbreaks in german refugee camps in 2015. Z. Gastroenterol. 2017, 55, 997–1003. [Google Scholar] [CrossRef]
- Jablonka, A.; Happle, C.; Grote, U.; Schleenvoigt, B.T.; Hampel, A.; Dopfer, C.; Hansen, G.; Schmidt, R.E.; Behrens, G.M.N. Measles, mumps, rubella, and varicella seroprevalence in refugees in Germany in 2015. Infection 2016, 44, 781–787. [Google Scholar] [CrossRef]
- Dopfer, C.; Vakilzadeh, A.; Happle, C.; Kleinert, E.; Müller, F.; Ernst, D.; Schmidt, R.E.; Behrens, G.M.N.; Merkesdal, S.; Wetzke, M.; et al. Pregnancy Related Health Care Needs in Refugees-A Current Three Center Experience in Europe. Int. J. Environ. Res. Public Health 2018, 15, 1943. [Google Scholar] [CrossRef] [Green Version]
- Kleinert, E.; Müller, F.; Furaijat, G.; Hillermann, N.; Jablonka, A.; Happle, C.; Simmenroth, A. Does refugee status matter? Medical needs of newly arrived asylum seekers and resettlement refugees-a retrospective observational study of diagnoses in a primary care setting. Confl. Health 2019, 13, 39. [Google Scholar] [CrossRef] [Green Version]
- Land Niedersachsen: Der Standort GDL Friedland. Available online: https://www.labniedersachsende/friedland/der-standort-gdl-friedland-106937html.2020 (accessed on 19 August 2020).
- World Bank Group. Atlas of Sustainable Development Goals 2018; World Bank Group: Washington, DC, USA, 2018; ISBN 9781464812514. [Google Scholar]
- Dopfer, C.; Wetzke, M.; Zychlinsky Scharff, A.; Mueller, F.; Dressler, F.; Baumann, U.; Sasse, M.; Hansen, G.; Jablonka, A.; Happle, C. Covid-19 Related Reduction in Paediatric Emergency Healthcare Utilization—A Concerning Trend. BMC Pediatr. 2020, 427. [Google Scholar] [CrossRef]
- Moriyama, M.; Hugentobler, W.J.; Iwasaki, A. Seasonality of Respiratory Viral Infections. Annu. Rev. Virol. 2020, 7. [Google Scholar] [CrossRef]
- Bayoh, M.N.; Akhwale, W.; Ombok, M.; Sang, D.; Engoki, S.C.; Koros, D.; Walker, E.D.; Williams, H.A.; Burke, H.; Armstrong, G.L.; et al. Malaria in Kakuma refugee camp, Turkana, Kenya: Facilitation of Anopheles arabiensis vector populations by installed water distribution and catchment systems. Malar. J. 2011, 10, 149. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Hansen, L.; Huston, P. Health considerations in the Syrian refugee resettlement process in Canada. Can. Commun. Dis. Rep. 2016, 42, S3–S7. [Google Scholar] [CrossRef] [PubMed]
- Bloch-Infanger, C.; Battig, V.; Kremo, J.; Widmer, A.F.; Egli, A.; Bingisser, R.; Battegay, M.; Erb, S. Increasing prevalence of infectious diseases in asylum seekers at a tertiary care hospital in Switzerland. PLoS ONE 2017, 12, e0179537. [Google Scholar] [CrossRef] [PubMed]
- Renzaho, A.M.N. The Need for the Right Socio-Economic and Cultural Fit in the COVID-19 Response in Sub-Saharan Africa: Examining Demographic, Economic Political, Health, and Socio-Cultural Differentials in COVID-19 Morbidity and Mortality. Int. J. Environ. Res. Public Health 2020, 17, 3445. [Google Scholar] [CrossRef] [PubMed]
- Liu, H.; Manzoor, A.; Wang, C.; Zhang, L.; Manzoor, Z. The COVID-19 Outbreak and Affected Countries Stock Markets Response. Int. J. Environ. Res. Public Health 2020, 17, 2800. [Google Scholar] [CrossRef] [Green Version]
- Headey, D.; Heidkamp, R.; Osendarp, S.; Ruel, M.; Scott, N.; Black, R.; Shekar, M.; Bouis, H.; Flory, A.; Haddad, L.; et al. Impacts of COVID-19 on childhood malnutrition and nutrition-related mortality. Lancet 2020, 396, 519–521. [Google Scholar] [CrossRef]
- Viner, R.M.; Bonell, C.; Drake, L.; Jourdan, D.; Davies, N.; Baltag, V.; Jerrim, J.; Proimos, J.; Darzi, A. Reopening schools during the COVID-19 pandemic: Governments must balance the uncertainty and risks of reopening schools against the clear harms associated with prolonged closure. Arch. Dis. Child. 2020, 319963. [Google Scholar] [CrossRef]
- Li, X.; Xu, W.; Dozier, M.; He, Y.; Kirolos, A.; Theodoratou, E.; UNCOVER. The role of children in transmission of SARS-CoV-2: A rapid review. J. Glob. Health 2020, 10, 011101. [Google Scholar] [CrossRef]
- Armitage, R.; Nellums, L.B. Considering inequalities in the school closure response to COVID-19. Lancet Glob. Health 2020, 8, e644. [Google Scholar] [CrossRef] [Green Version]
- Bedford, J.; Enria, D.; Giesecke, J.; Heymann, D.L.; Ihekweazu, C.; Kobinger, G.; Lane, H.C.; Memish, Z.; Oh, M.D.; Sall, A.A.; et al. COVID-19: Towards controlling of a pandemic. Lancet 2020, 395, 1015–1018. [Google Scholar] [CrossRef]
- Razum, O.; Penning, V.; Mohsenpour, A.; Bozorgmehr, K. Covid-19 in Refugee Shelters: The German Public Health Service Needs Strengthening Now. Gesundheitswesen 2020, 82, 392–396. [Google Scholar] [PubMed] [Green Version]
Characteristic | All Cases (n = 4289) | Cases with Acute Respiratory Symptoms or Signs Thereof (n = 1649) | ||||
---|---|---|---|---|---|---|
Multivariable Analysis | ||||||
n (%) | n (%) | % Ratio | OR (95% CI) | sig. | ||
Sex * | male | 2239 (52.2) | 863 (38.5) | 52.3 | 1.07 (0.94–1.22) | 0.312 |
Age (years) | <1 | 521 (12.1) | 168 (35.3) | 10.2 | reference cat. | n.a. |
1 to 3 | 1121 (26.1) | 492 (47.5) | 29.8 | 1.51 (1.17–1.95) | 0.001 | |
4 to 6 | 842 (19.6) | 375 (47.4) | 22.7 | 1.52 (1.18–1.98) | 0.001 | |
7 to 12 | 997 (23.2) | 362 (38.9) | 22.0 | 1.04 (0.80–1.34) | 0.780 | |
13 to 15 | 360 (8.4) | 120 (34.9) | 7.3 | 0.98 (0.71–1.36) | 0.919 | |
16 to 18 | 448 (10.4) | 132 (31.3) | 8.0 | 0.78 (0.58–1.07) | 0.119 | |
Region of origin # | Europe & Central Asia | 398 (9.4) | 134 (35.1) | 8.2 | reference cat. | n.a. |
Latin America & Caribbean | 9 (0.2) | 3 (33.3) | 0.2 | 0.73 (0.27–2.03) | 0.553 | |
Middle East & North Africa | 2688 (63.2) | 1106 (44) | 67.7 | 1.03 (0.76–1.40) | 0.839 | |
South Asia | 965 (22.7) | 327 (37.2) | 20.0 | 1.08 (0.78–1.50) | 0.648 | |
Sub-Saharan Africa | 128 (3) | 36 (29.8) | 2.2 | 0.79 (0.47–1.32) | 0.368 | |
unknown/stateless | 63 (1.5) | 26 (44.8) | 1.6 | 1.07 (0.61–1.88) | 0.813 | |
Reception facility | Celle | 2488 (58) | 921 (40.4) | 55.9 | reference cat. | n.a. |
Friedland | 1801 (42) | 728 (42.4) | 44.1 | 0.90 (0.69–1.18) | 0.458 | |
Residential density (in % occupancy) | ≤20% | 175 (4.1) | 59 (36.0) | 3.6 | 1.48 (0.96–2.28) | 0.077 |
21–40% | 925 (21.6) | 285 (33.8) | 17.3 | reference cat. | n.a. | |
41–60% | 1454 (33.9) | 604 (43.6) | 36.6 | 1.12 (0.91–1.37) | 0.305 | |
61–80% | 1414 (33.0) | 557 (42.7) | 33.8 | 1.02 (0.77–1.35) | 0.876 | |
≥80% | 321 (7.5) | 144 (47.5) | 8.7 | 1.64 (1.12–2.39) | 0.010 | |
Calendar month | January | 708 (16.5) | 280 (43) | 17.0 | reference cat. | n.a. |
February | 638 (14.9) | 260 (43.9) | 15.8 | 1.00 (0.79–1.27) | 0.999 | |
March | 445 (10.4) | 165 (39) | 10.0 | 0.71 (0.50–1.02) | 0.060 | |
April | 314 (7.3) | 86 (31.4) | 5.2 | 0.57 (0.38–0.86) | 0.008 | |
May | 186 (4.3) | 66 (38.2) | 4.0 | 0.50 (0.31–0.82) | 0.006 | |
June | 73 (1.7) | 31 (44.9) | 1.9 | 0.67 (0.37–1.22) | 0.191 | |
July | 80 (1.9) | 21 (27.6) | 1.3 | 0.39 (0.20–0.76) | 0.005 | |
August | 154 (3.6) | 35 (23.3) | 2.1 | 0.39 (0.24–0.64) | <0.001 | |
September | 388 (9) | 156 (42.1) | 9.5 | 0.80 (0.58–1.10) | 0.162 | |
October | 468 (10.9) | 196 (44.4) | 11.9 | 0.79 (0.57–1.08) | 0.139 | |
November | 256 (6) | 99 (42.5) | 6.0 | 0.80 (0.54–1.18) | 0.255 | |
December | 579 (13.5) | 254 (46.7) | 15.4 | 1.01 (0.73–1.40) | 0.955 | |
Refugee category | Asylum seeker | 3541 (82.6) | 1244 (37.9) | 75.4 | reference cat. | n.a. |
Resettlement refugee | 748 (17.4) | 406 (56.3) | 24.6 | 2.55 (1.94–3.35) | <0.001 |
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Müller, F.; Hummers, E.; Hillermann, N.; Dopfer, C.; Jablonka, A.; Friede, T.; Simmenroth, A.; Wetzke, M. Factors Influencing the Frequency of Airway Infections in Underage Refugees: A Retrospective, Cross Sectional Study. Int. J. Environ. Res. Public Health 2020, 17, 6823. https://doi.org/10.3390/ijerph17186823
Müller F, Hummers E, Hillermann N, Dopfer C, Jablonka A, Friede T, Simmenroth A, Wetzke M. Factors Influencing the Frequency of Airway Infections in Underage Refugees: A Retrospective, Cross Sectional Study. International Journal of Environmental Research and Public Health. 2020; 17(18):6823. https://doi.org/10.3390/ijerph17186823
Chicago/Turabian StyleMüller, Frank, Eva Hummers, Nele Hillermann, Christian Dopfer, Alexandra Jablonka, Tim Friede, Anne Simmenroth, and Martin Wetzke. 2020. "Factors Influencing the Frequency of Airway Infections in Underage Refugees: A Retrospective, Cross Sectional Study" International Journal of Environmental Research and Public Health 17, no. 18: 6823. https://doi.org/10.3390/ijerph17186823