Abstract
BackgroundThe German Military Medical Service contributed to the medical screening of unaccompanied minor refugees (UMRs) coming to Germany in 2014 and 2015. In this study, a broad range of diagnostic procedures was applied to identify microorganisms with clinical or public health significance. Previously, those tests had only been used to screen soldiers returning from tropical deployments. This instance is the first time the approach has been studied in a humanitarian context.MethodsThe offered screenings included blood cell counts, hepatitis B serology and microscopy of the stool to look for protozoa and worm eggs as well as PCR from stool samples targeting pathogenic bacteria, protozoa and helminths. If individuals refused certain assessments, their decision to do so was accepted. A total of 219 apparently healthy male UMRs coming from Afghanistan, Egypt, Somalia, Eritrea, Syria, Ghana, Guinea, Iran, Algeria, Iraq, Benin, Gambia, Libya, Morocco, Pakistan, and Palestine were assessed. All UMRs who were examined at the study department were included in the assessment.ResultsWe detected decreasing frequencies of pathogens that included diarrhoea-associated bacteria [Campylobacter (C.) jejuni, enteropathogenic Escherichia (E.) coli (EPEC), enterotoxic E. coli (ETEC), enteroaggregative E. coli (EAEC), enteroinvasive E. coli (EIEC)/Shigella spp.), Giardia (G.) duodenalis, helminths (comprising Schistosoma spp., Hymenolepis (H.) nana, Strongyloides (S.) stercoralis] as well as hepatitis B virus. Pathogenic microorganisms dominated the samples by far. While G. duodenalis was detected in 11.4% of the assessed UMRs, the incidence of newly identified cases in the German population was 4.5 cases per 100,000 inhabitants.ConclusionsWe conclude that the applied in-house PCR screening systems, which have proven to be useful for screening military returnees from tropical deployments, can also be used for health assessment of immigrants from the respective sites. Apparently healthy UMRs may be enterically colonized with a broad variety of pathogenic and apathogenic microorganisms. Increased colonization rates, as shown for G. duodenalis, can pose a hygiene problem in centralized homes for asylum seekers.
Highlights
The German Military Medical Service contributed to the medical screening of unaccompanied minor refugees (UMRs) coming to Germany in 2014 and 2015
Results of stool screenings Fixed stool samples for microscopy were provided by 158 UMRs, while non-fixed stool for Polymerase chain reaction (PCR) was provided by 157 UMRs
Interpretable results could be obtained by using PCR targeting invasive bacteria and enteropathogenic protozoa in 151 and 157 instances, respectively
Summary
The German Military Medical Service contributed to the medical screening of unaccompanied minor refugees (UMRs) coming to Germany in 2014 and 2015. A broad range of diagnostic procedures was applied to identify microorganisms with clinical or public health significance. Those tests had only been used to screen soldiers returning from tropical deployments. These health checks are intended to exclude infectious diseases, which are likely to spread in vulnerable populations, such as those in reception centres, posing a considerable hygiene problem. Primary and booster immunizations are administered according to the recommendations of the German Standing Committee on Vaccination (STIKO), which includes Tdap-IPV (tetanus, diphtheria, poliomyelitis, pertussis) and MMR (measles, mumps, rubella) vaccines
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have