The spectrum of care for pediatric refugees and asylum seekers at a tertiary health care facility in Switzerland in 2015

Abstract

The aim of this retrospective study was to describe the epidemiology and spectrum of infections of admitted pediatric refugees and asylum seekers in a tertiary referral hospital in a high-income country in Europe. We identified recent refugees and asylum seekers < 18 years of age admitted to the University Children's Hospital in Basel, Switzerland, in 2015. A retrospective analysis was performed using electronic patient records. We identified 105 admissions in 93 patients with a median age of 5.7 (IQR 2.6-14.5) years. Eritrea, Syria, and Afghanistan were the most frequent countries of origin. The median duration of admission was 4 (IQR 2-6) days with infections and elective surgical interventions being the most common reason (54.8 and 16.1%, respectively). Most infections were airway, skin, and gastrointestinal in 46.4, 20.2, and 11.9%, respectively. The prevalence of tropical infections was 11.9%. The main pathogens identified were influenza A virus (13.8%), Staphylococcus aureus (10.3%), and rhino/enterovirus (10.3%). Previous medical non-infectious conditions were recorded in 13%.

Conclusion: The study revealed a high burden of infections in admitted patients mostly caused by well-known pathogens prevalent also in the local population. Both tropical infections and pre-existing non-infectious conditions are also important in admitted patients. Better epidemiological data is required to optimize health care for this medically most vulnerable population in refugee crises. What is Known: • Pediatric refugees and asylum seekers are the most vulnerable population in refugee crises. • Data on health concerns and needs in this population is scarce. What is New: • This is one of the first studies on the epidemiology of pediatric refugees and asylum seekers treated as inpatients in a European high-income country. • The high burden of infections is mostly caused by well-known pathogens prevalent also in the local population.

Keywords: Children; Europe; Immigrant health; Infections in refugees; Refugee crisis; Unaccompanied refugee minor.

Fig. 1

Cases included in the final analysis

Fig. 2

Sites of infection in 84 infections diagnosed in 55 admissions. CNS central nervous system, ENT ear, nose, and throat, GIT gastrointestinal tract