Review of infectious diseases in refugees and asylum seekers\u2014current status and going forward

Andreas Halgreen Eiset,Christian Wejse

doi:10.1186/s40985-017-0065-4

Abstract

An unprecedented rise in the number of asylum seekers and refugees was seen in Europe in 2015, and it seems that numbers are not going to be reduced considerably in 2016. Several studies have tried to estimate risk of infectious diseases associated with migration but only very rarely these studies make a distinction on reason for migration. In these studies, workers, students, and refugees who have moved to a foreign country are all taken to have the same disease epidemiology. A common disease epidemiology across very different migrant groups is unlikely, so in this review of infectious diseases in asylum seekers and refugees, we describe infectious disease prevalence in various types of migrants. We identified 51 studies eligible for inclusion. The highest infectious disease prevalence in refugee and asylum seeker populations have been reported for latent tuberculosis (9–45%), active tuberculosis (up to 11%), and hepatitis B (up to 12%). The same population had low prevalence of malaria (7%) and hepatitis C (up to 5%). There have been recent case reports from European countries of cutaneous diphtheria, louse-born relapsing fever, and shigella in the asylum-seeking and refugee population. The increased risk that refugees and asylum seekers have for infection with specific diseases can largely be attributed to poor living conditions during and after migration. Even though we see high transmission in the refugee populations, there is very little risk of spread to the autochthonous population. These findings support the efforts towards creating a common European standard for the health reception and reporting of asylum seekers and refugees.

Highlights

In 2015, asylum applications in the EU+ region amounted to approximately 1.35 million—a record since data collection began in 2008 and more than twice the number of applications in 2014 [1]
One example of this is the debated healthy migrant effect that hypothesises that those who migrate are in a favourable health and/or socio-economic condition compared to those who stay in the country of origin [10,11,12]
Publications with a main objective related to other migrant subgroups than asylum seekers or refugees were excluded, as were studies concerned with health literacy and education

Summary

Introduction

In 2015, asylum applications in the EU+ region amounted to approximately 1.35 million—a record since data collection began in 2008 and more than twice the number of applications in 2014 [1]. The disease epidemiology of the country of origin is sometimes used to allocate the individual asylum seeker to a specific screening programme in the receiving country [9]. The asylum seekers can often be considered a subgroup in their home country and as such the estimate for the general population is not applicable One example of this is the debated healthy migrant effect that hypothesises that those who migrate are in a favourable health and/or socio-economic condition compared to those who stay in the country of origin [10,11,12]

Methods

Results

Conclusion