Acute respiratory infections in an adult refugee population: an observational study

Alexandra Jablonka,Martin Wetzke,Eva Hummers,Andree Shalabi,Stephanie Heinemann,Tim Friede,Christine Happle,Anne Simmenroth,Nele Hillermann,Christian Dopfer,Frank Müller

doi:10.1038/s41533-021-00261-9

Abstract

The presence of acute infectious respiratory diseases (ARD) is one of the main reasons why recently arrived refugees seek medical help. This paper investigates the incidence rates of acute respiratory diseases in an adult refugee population as well as associated sociodemographic factors and drug treatments. We conducted a retrospective observational study of deidentified medical records. The data were collected between 2015 and 2019 in the health care centers of two large German initial reception centers for refugees. Multivariable analyses controlling for sociodemographics were carried out using generalized estimating equations. Out of 10,431 eligible residents, 6965 medical encounters of 2840 adult patients were recorded over 30 months. Of all the adult patients, 34.4% sought medical help for a respiratory symptom or diagnosis at least once. Older patients and patients from Sub-Saharan Africa sought help less often. The occurrence of ARD showed a typical distribution over the course of the year. Facility occupancy was not associated with ARD occurrence. Acute respiratory symptoms are a leading cause for adult refugee patients to seek medical care. The doctor contact rates due to ARD were consistently two to three times higher among refugees than among German residents.

Highlights

Refugees are at particular risk for transmittable diseases for a variety of reasons[1]
The objective of the present study was to assess the incidence of different respiratory diseases, such as acute infectious respiratory diseases (ARD), influenzalike illness (ILI), and chronic respiratory diseases (CRD), in a large cohort of >10,000 refugees and resettlement refugees collected over several years in Northern Germany
Respiratory symptoms were very common: 34.4% of all refugee patients had a respiratory diagnosis during their stay, but only 2% of patients were diagnosed with a CRD

Summary

Introduction

Refugees are at particular risk for transmittable diseases for a variety of reasons[1]. The circumstances of their journey often make it impossible to take the simplest measures for hygiene, such as regular hand washing. High prevalence rates of scabies infestation[3], reports of outbreaks of measles[4,5] and varicella[6,7,8] and protozoa infections[9] have been described in this population. Acute respiratory infections are among the most common reasons for seeking primary medical care among refugees, migrants, and nonmigrants in Germany[10]

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Conclusion