Factors Influencing the Frequency of Airway Infections in Underage Refugees: A Retrospective, Cross Sectional Study

Abstract

Background: Infections are a leading cause of refugee morbidity. Recent data on the rate of airway infections and factors influencing their spread in refugee reception centers is scarce. Methods: A retrospective, cross-sectional study of de-identified medical records with a focus on respiratory infections in underage refugees was conducted at two large German refugee reception centers. Results: In total, medical data from n = 10,431 refugees over an observational period of n = 819 days was analyzed. Among pediatric patients (n = 4289), 55.3% presented at least once to the on-site medical ward with an acute respiratory infection or signs thereof. In 38.4% of pediatric consultations, acute airway infections or signs thereof were present. Airway infections spiked during colder months and were significantly more prevalent amongst preschool and resettled children. Their frequency displayed a positive correlation with the number of refugees housed at the reception centers. Conclusions: We show that respiratory infections are a leading cause for morbidity in young refugees and that their rate is influenced age, season, status, and residential density. This illustrates the need to protect refugee children from contracting airway infections which may also reduce the spread of coronavirus disease 2019 (COVID-19) during the current pandemic.

Keywords: COVID-19; adolescents; children; containment; crowded housing; migrants; refugees; respiratory infection; seasonality.

Figure 1

Chart illustrating analysis flow and number of patients and medical encounters included into calculations.

Figure 2

Reasons for on-site medical consultations in underage refugees and age and visit frequency in children with airway infections or signs and symptoms thereof. (A): Percentage of consultations due to airway infections or signs and symptoms thereof compared to the percentage of remaining consultations due to complains from the five most frequent ICD-10 code groups. (B): The age of children and adolescents with respiratory infections or signs and symptoms thereof. (C): The number of on-site visits of children and adolescents with respiratory infections or signs and symptoms thereof. (Note: *: consultations due to airway infections or related symptoms were subtracted from those categorized to group “R”: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified and “J”: Diseases of the respiratory system. “A/B”: certain infectious and parasitic diseases. “L”: diseases of the skin and subcutaneous tissue. “J”: diseases of the respiratory system. “K”: diseases of the digestive system. *** p ≤ 0.001.