Skip to main content

Medical care for migrant children in Europe: a practical recommendation for first and follow-up appointments

Abstract

Between 2015 and 2017, an estimated 200,000 to 400,000 children were seeking asylum each year in EU/EEA countries. As access to high-quality health care is important, we collected and compared current recommendations across Europe for a consensus recommendation on medical care for migrant (asylum-seeking and refugee) children. Existing recommendations were collected from published literature and identified through national representatives from paediatric societies of 31 EU/EEA countries through the European Academy of Paediatrics (EAP). Recommendations were systematically extracted and collected in a database. Those mentioned in at least one recommendation were evaluated for inclusion, and evidence on recommendations was specifically identified in literature searches focused on recent evidence from Europe. For eight EU/EEA countries, a national recommendation was identified. Growth and development, vision and hearing impairment, skin and dental problems, immunisations, anaemia, micronutrient deficiency, helminths, hepatitis B and C, human immunodeficiency virus, malaria, schistosomiasis, syphilis, tuberculosis, mental health disorder and sexual health were most frequently mentioned and therefore selected for inclusion in the recommendation.

Conclusion: The current document includes general recommendations on ethical standards, use of interpreters and specific recommendations for prevention or early detection of communicable and non-communicable diseases. It may serve as a tool to ensure the fundamental right that migrant children in Europe receive a comprehensive, patient-centred health care.

This is a preview of subscription content, access via your institution.

References

  1. 1.

    Al-Ammouri I, Ayoub F (2016) Heart disease in Syrian refugee children: experience at Jordan University hospital. Ann Glob Health 82:300–306

    Article  PubMed  Google Scholar 

  2. 2.

    Aldridge RW, Zenner D, White PJ, Williamson EJ, Muzyamba MC, Dhavan P, Mosca D, Thomas HL, Lalor MK, Abubakar I, Hayward AC (2016) Tuberculosis in migrants moving from high-incidence to low-incidence countries: a population-based cohort study of 519 955 migrants screened before entry to England, Wales, and Northern Ireland. Lancet 388:2510–2518

    Article  PubMed  PubMed Central  Google Scholar 

  3. 3.

    Baauw A, Slinker K, Goosen S (2017) Komt een vluchtelingenkind op uw spreekuur Praktische Pediatrie 2017;11(1):10–16

  4. 4.

    Basatemur E, Hunter R, Horsfall L, Sutcliffe A, Rait G (2017) Costs of vitamin D testing and prescribing among children in primary care. Eur J Pediatr 176:1405–1409

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. 5.

    Bean TM, Eurelings-Bontekoe E, Spinhoven P (2007) Course and predictors of mental health of unaccompanied refugee minors in the Netherlands: one year follow-up. Soc Sci Med 64:1204–1215

    Article  PubMed  Google Scholar 

  6. 6.

    Belhadj Kouider E, Koglin U, Petermann F (2014) Emotional and behavioral problems in migrant children and adolescents in Europe: a systematic review. Eur Child Adolesc Psychiatry 23:373–391

    Article  PubMed  Google Scholar 

  7. 7.

    Bennett RJ, Brodine S, Waalen J, Moser K, Rodwell TC (2014) Prevalence and treatment of latent tuberculosis infection among newly arrived refugees in San Diego County, January 2010-October 2012. Am J Public Health 104:e95–e102

    Article  PubMed  PubMed Central  Google Scholar 

  8. 8.

    Berg RC, Underland V, Odgaard-Jensen J, Fretheim A, Vist GE (2014) Effects of female genital cutting on physical health outcomes: a systematic review and meta-analysis. BMJ Open 4:e006316

    Article  PubMed  PubMed Central  Google Scholar 

  9. 9.

    Bernhard S, Büttcher M, Heininger U, Ratnam S, Relly C, Trück J, Wagner N, Zucol F, Berger C, Ritz N (2016) Guidance for testing and preventing infections and updating immunisations in asymptomatic refugee children and adolescents in Switzerland. Paediatrica 27:11–18

    Google Scholar 

  10. 10.

    Bilukha OO, Jayasekaran D, Burton A, Faender G, King’ori J, Amiri M, Jessen D, Leidman E, Division of Global Health Protection CfGHCDC, Centers for Disease Control and Prevention (2014) Nutritional status of women and child refugees from Syria-Jordan, April-May 2014. MMWR Morb Mortal Wkly Rep 63:638–639

    PubMed  PubMed Central  Google Scholar 

  11. 11.

    Bird S (2010) Failure to use an interpreter. Aust Fam Physician 39:241–242

    PubMed  Google Scholar 

  12. 12.

    Bischoff A (2006) Caring for migrant and minority patients in European hospitals: a review of effective interventions. Swiss Forum for Migration and Population Studies, Neuchâtel

    Google Scholar 

  13. 13.

    Bottcher S, Neubauer K, Baillot A, Rieder G, Adam M, Diedrich S (2015) Stool screening of Syrian refugees and asylum seekers in Germany, 2013/2014: identification of Sabin like polioviruses. Int J Med Microbiol 305:601–606

    Article  PubMed  Google Scholar 

  14. 14.

    Branda JA, Lin TY, Rosenberg ES, Halpern EF, Ferraro MJ (2006) A rational approach to the stool ova and parasite examination. Clin Infect Dis 42:972–978

    Article  PubMed  Google Scholar 

  15. 15.

    Brandenberger J, Tylleskär T, Sontag K, Peterhans B, Ritz N (2019) A systematic literature review of reported challenges in health care delivery to migrants and refugees in high-income countries—the 3C model. BMC Public Health in press

  16. 16.

    Brodine SK, Thomas A, Huang R, Harbertson J, Mehta S, Leake J, Nutman T, Moser K, Wolf J, Ramanathan R, Burbelo P, Nou J, Wilkins P, Reed SL (2009) Community based parasitic screening and treatment of Sudanese refugees: application and assessment of Centers for Disease Control guidelines. Am J Trop Med Hyg 80:425–430

    Article  PubMed  Google Scholar 

  17. 17.

    Buonfrate D, Requena-Mendez A, Angheben A, Munoz J, Gobbi F, Van Den Ende J, Bisoffi Z (2013) Severe strongyloidiasis: a systematic review of case reports. BMC Infect Dis 13:78

    Article  PubMed  PubMed Central  Google Scholar 

  18. 18.

    Cai W, Poethko-Muller C, Hamouda O, Radun D (2011) Hepatitis B virus infections among children and adolescents in Germany: migration background as a risk factor in a low seroprevalence population. Pediatr Infect Dis J 30:19–24

    Article  PubMed  Google Scholar 

  19. 19.

    Caruana SR, Kelly HA, Ngeow JY, Ryan NJ, Bennett CM, Chea L, Nuon S, Bak N, Skull SA, Biggs BA (2006) Undiagnosed and potentially lethal parasite infections among immigrants and refugees in Australia. J Travel Med 13:233–239

    Article  PubMed  Google Scholar 

  20. 20.

    Chaves NJ, Paxton G, Biggs BA, Thambiran A, Smith MWJ, Gardiner J DJ, on behalf of the Australasian Society for Infectious Diseases and Refugee Health Network of Australia Guidelines writing group (2016) Recommendations for comprehensive post-arrival health assessment for people from refugee-like backgrounds. https://www.asid.net.au/documents/item/1225. Accessed 28 Jan 2019

  21. 21.

    Chernet A, Kling K, Sydow V, Kuenzli E, Hatz C, Utzinger J, van Lieshout L, Marti H, Nickel B, Labhardt ND, Neumayr A (2017) Accuracy of diagnostic tests for Schistosoma mansoni infection in asymptomatic Eritrean refugees: serology and POC-CCA against stool microscopy. Clin Infect Dis 65:568–574

    Article  CAS  PubMed  Google Scholar 

  22. 22.

    Coppola N, Alessio L, Gualdieri L, Pisaturo M, Sagnelli C, Minichini C, Di Caprio G, Starace M, Onorato L, Signoriello G, Macera M, Angelillo IF, Pasquale G, Sagnelli E (2017) Hepatitis B virus infection in undocumented immigrants and refugees in southern Italy: demographic, virological, and clinical features. Infect Dis Poverty 6:33

    Article  PubMed  PubMed Central  Google Scholar 

  23. 23.

    Council on Community P (2013) Providing care for immigrant, migrant, and border children. Pediatrics 131:e2028–e2034

    Article  Google Scholar 

  24. 24.

    Crawley J, Chu C, Mtove G, Nosten F (2010) Malaria in children. Lancet 375:1468–1481

    Article  PubMed  Google Scholar 

  25. 25.

    Dawson-Hahn E, Pak-Gorstein S, Matheson J, Zhou C, Yun K, Scott K, Payton C, Stein E, Holland A, Grow HM, Mendoza JA (2016) Growth trajectories of refugee and nonrefugee children in the United States. Pediatrics 138:e20160953

    Article  PubMed  PubMed Central  Google Scholar 

  26. 26.

    Dawson-Hahn EE, Pak-Gorstein S, Hoopes AJ, Matheson J (2016) Comparison of the nutritional status of overseas refugee children with low income children in Washington state. PLoS One 11:e0147854

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. 27.

    de Bot CM, Moed H, Schellevis FG, de Groot H, van Wijk RG, van der Wouden JC (2009) Allergic rhinitis in children: incidence and treatment in Dutch general practice in 1987 and 2001. Pediatr Allergy Immunol 20:571–577

    Article  PubMed  Google Scholar 

  28. 28.

    de la Fuente IG, Wagner N, Siegrist CA, Posfay-Barbe KM (2013) Tetanus immunity as a surrogate for past diphtheria-tetanus-pertussis immunization in migrant children. Pediatr Infect Dis J 32:274–277

    PubMed  Google Scholar 

  29. 29.

    Del Amo J, Likatavicius G, Perez-Cachafeiro S, Hernando V, Gonzalez C, Jarrin I, Noori T, Hamers FF, Bolumar F (2011) The epidemiology of HIV and AIDS reports in migrants in the 27 European Union countries, Norway and Iceland: 1999-2006. Eur J Pub Health 21:620–626

    Article  Google Scholar 

  30. 30.

    Huppertz, HI, Kommission für Infektionskrankheiten und Impffragen, Deutsche Akademie für Kinder- und Jugendmedizin & Kommission für Globale Kindergesundheit, Deutsche Akademie für Kinder- und Jugendmedizin Monatsschr Kinderheilkd (2018) 166: 894. https://doi.org/10.1007/s00112-018-0497-z

  31. 31.

    Disease GBD, Injury I, Prevalence C (2016) Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 388:1545–1602

    Article  Google Scholar 

  32. 32.

    Divi C, Koss RG, Schmaltz SP, Loeb JM (2007) Language proficiency and adverse events in US hospitals: a pilot study. Int J Qual Health Care 19:60–67

    Article  PubMed  Google Scholar 

  33. 33.

    Edmunds WJ, Medley GF, Nokes DJ, Hall AJ, Whittle HC (1993) The influence of age on the development of the hepatitis B carrier state. Proc Biol Sci 253:197–201

    Article  CAS  Google Scholar 

  34. 34.

    Eggemoen AR, Knutsen KV, Dalen I, Jenum AK (2013) Vitamin D status in recently arrived immigrants from Africa and Asia: a cross-sectional study from Norway of children, adolescents and adults. BMJ Open 3:e003293

    Article  PubMed  PubMed Central  Google Scholar 

  35. 35.

    Eonomopoulou A, Pavli A, Stasinopoulou P, Giannopoulos LA, Tsiodras S (2017) Migrant screening: lessons learned from the migrant holding level at the Greek-Turkish borders. J Infect Public Health 10:177–184

    Article  PubMed  Google Scholar 

  36. 36.

    European Centre for Disease Prevention and Control (2016) Systematic review on hepatitis B and C prevalence in the EU/EEA. ECDC, Stockholm

    Google Scholar 

  37. 37.

    European Centre for Disease Prevention and Control (2018) Cost-effectiveness analysis of programmatic screening strategies for latent tuberculosis infection in the EU/EEA. ECDC, Stockholm

    Google Scholar 

  38. 38.

    Ferrara P, Amato M, Hadjipanayis A, del Torso S, Stiris T (2015) The rights of children arriving in Europe. Lancet 386:1939–1940

    Article  PubMed  Google Scholar 

  39. 39.

    Flores G, Abreu M, Barone CP, Bachur R, Lin H (2012) Errors of medical interpretation and their potential clinical consequences: a comparison of professional versus ad hoc versus no interpreters. Ann Emerg Med 60:545–553

    Article  PubMed  Google Scholar 

  40. 40.

    Franco-Paredes C, Dismukes R, Nicolls D, Hidron A, Workowski K, Rodriguez-Morales A, Wilson M, Jones D, Manyang P, Kozarsky P (2007) Persistent and untreated tropical infectious diseases among Sudanese refugees in the United States. Am J Trop Med Hyg 77:633–635

    Article  PubMed  Google Scholar 

  41. 41.

    Garcia EA, Roy LC, Okada PJ, Perkins SD, Wiebe RA (2004) A comparison of the influence of hospital-trained, ad hoc, and telephone interpreters on perceived satisfaction of limited English-proficient parents presenting to a pediatric emergency department. Pediatr Emerg Care 20:373–378

    Article  PubMed  Google Scholar 

  42. 42.

    Gehri M, Jäger F, Wagner N, Gehri M (2016) Klinische Betreuung von Migranten: Fokus Pädiatrie. Paediatrica 27:3–10

    Google Scholar 

  43. 43.

    GGD GHOR Nederland (2014) Basistakenpakket JGZ asielzoekerkinderen 0–19 jaar. https://www.ggdghorkennisnet.nl/?file=32797&m=1489581867&action=file.download. Accessed 28 Jan 2019

  44. 44.

    Gray K, Wood N, Gunasekera H, Sheikh M, Hazelton B, Barzi F, Isaacs D (2012) Vitamin d and tuberculosis status in refugee children. Pediatr Infect Dis J 31:521–523

    Article  PubMed  Google Scholar 

  45. 45.

    Greaves D, Coggle S, Pollard C, Aliyu SH, Moore EM (2013) Strongyloides stercoralis infection. BMJ 347:f4610

    Article  PubMed  Google Scholar 

  46. 46.

    Greier K, Riechelmann H (2014) Effects of migration background on weight status and motor performance of preschool children. Wien Klin Wochenschr 126:95–100

    Article  PubMed  Google Scholar 

  47. 47.

    Grois N, Auer H, Beeretz I, Blaha-Hauser B, Fohler O, Forstner A, Fröhlich C, Grisold A, Huemer M, Kasper D, Kollaritsch H, Roithner-Kolarik B, Strenger V, Ulreich R, Wiedermann U (2016) Empfehlungen für medizinische Maßnahmen bei immigrierenden Kindern und Jugendlichen. Pädiatrie Pädologie 51:51–58

    Article  Google Scholar 

  48. 48.

    Group IMW (2018) (2017) ISSOP position statement on migrant child health. Child Care Health Dev 44(1):161–170

    Article  Google Scholar 

  49. 49.

    Group IMW (2018) ISSOP position statement on migrant child health. Child Care Health Dev 44:161–170

    Article  Google Scholar 

  50. 50.

    Gualdi-Russo E, Toselli S, Masotti S, Marzouk D, Sundquist K, Sundquist J (2014) Health, growth and psychosocial adaptation of immigrant children. Eur J Pub Health 24(Suppl 1):16–25

    Article  Google Scholar 

  51. 51.

    Gualdi-Russo E, Zaccagni L, Manzon VS, Masotti S, Rinaldo N, Khyatti M (2014) Obesity and physical activity in children of immigrants. Eur J Pub Health 24(Suppl 1):40–46

    Article  Google Scholar 

  52. 52.

    Hadziabdic E, Heikkila K, Albin B, Hjelm K (2009) Migrants' perceptions of using interpreters in health care. Int Nurs Rev 56:461–469

    Article  CAS  PubMed  Google Scholar 

  53. 53.

    Hadziabdic E, Albin B, Heikkila K, Hjelm K (2014) Family members' experiences of the use of interpreters in healthcare. Prim Health Care Res Dev 15:156–169

    Article  PubMed  Google Scholar 

  54. 54.

    Hadziabdic E, Albin B, Hjelm K (2014) Arabic-speaking migrants' attitudes, opinions, preferences and past experiences concerning the use of interpreters in healthcare: a postal cross-sectional survey. BMC Res Notes 7:71

    Article  PubMed  PubMed Central  Google Scholar 

  55. 55.

    Hahne SJ, Veldhuijzen IK, Wiessing L, Lim TA, Salminen M, Laar M (2013) Infection with hepatitis B and C virus in Europe: a systematic review of prevalence and cost-effectiveness of screening. BMC Infect Dis 13:181

    Article  PubMed  PubMed Central  Google Scholar 

  56. 56.

    Hampers LC, McNulty JE (2002) Professional interpreters and bilingual physicians in a pediatric emergency department: effect on resource utilization. Arch Pediatr Adolesc Med 156:1108–1113

    Article  PubMed  Google Scholar 

  57. 57.

    Hemminki K (2014) Immigrant health, our health. Eur J Pub Health 24(Suppl 1):92–95

    Article  Google Scholar 

  58. 58.

    Heudorf U, Karathana M, Krackhardt B, Huber M, Raupp P, Zinn C (2016) Surveillance for parasites in unaccompanied minor refugees migrating to Germany in 2015. GMS Hyg Infect Control 11:Doc05

    PubMed  PubMed Central  Google Scholar 

  59. 59.

    Hinz R, Schwarz NG, Hahn A, Frickmann H (2017) Serological approaches for the diagnosis of schistosomiasis - a review. Mol Cell Probes 31:2–21

    Article  CAS  PubMed  Google Scholar 

  60. 60.

    Hjern A, Stubbe Østergaard L (2016) Deliverable D3 (D7.1): migrant children in Europe: entitlements to health care. http://www.childhealthservicemodels.eu/wp-content/uploads/2015/09/20160831_Deliverable-D3-D7.1_Migrant-children-in-Europe.pdf. Accessed 28 Jan 2019

  61. 61.

    Hjern A, Ostergaard LS, Norredam M, de Luna CM, Goldfeld S (2017) Health policies for migrant children in Europe and Australia. Lancet 389:249

    Article  PubMed  Google Scholar 

  62. 62.

    Hoch M, Wieser A, Loscher T, Margos G, Purner F, Zuhl J, Seilmaier M, Balzer L, Guggemos W, Rack-Hoch A, von Both U, Hauptvogel K, Schonberger K, Hautmann W, Sing A, Fingerle V (2015) Louse-borne relapsing fever (Borrelia recurrentis) diagnosed in 15 refugees from Northeast Africa: epidemiology and preventive control measures, Bavaria, Germany, July to October 2015. Euro Surveill 20:30046. https://doi.org/10.2807/1560-7917.ES.2015.20.42.30046

    Article  Google Scholar 

  63. 63.

    Hofstraat SHI, Falla AM, Duffell EF, Hahne SJM, Amato-Gauci AJ, Veldhuijzen IK, Tavoschi L (2017) Current prevalence of chronic hepatitis B and C virus infection in the general population, blood donors and pregnant women in the EU/EEA: a systematic review. Epidemiol Infect 145:2873–2885

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. 64.

    Horlings A, Hein I (2018) Psychiatric screening and interventions for minor refugees in Europe: an overview of approaches and tools. Eur J Pediatr 177:163–169

    Article  PubMed  Google Scholar 

  65. 65.

    Hudelson P, Dominice Dao M, Perneger T, Durieux-Paillard S (2014) A “migrant friendly hospital” initiative in Geneva, Switzerland: evaluation of the effects on staff knowledge and practices. PLoS One 9:e106758

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. 66.

    Huntington N, Horan K, Epee-Bounya A, Schonwald A (2016) Developmental screening with Spanish-speaking families in a primary care setting. Clin Pediatr (Phila) 55:347–355

    Article  Google Scholar 

  67. 67.

    Iavazzo C, Sardi TA, Gkegkes ID (2013) Female genital mutilation and infections: a systematic review of the clinical evidence. Arch Gynecol Obstet 287:1137–1149

    Article  PubMed  Google Scholar 

  68. 68.

    International Organization for Migration, European Commission (2015) health assessment of refugees and migrants in the EU/EEA. https://ec.europa.eu/health/sites/health/files/migrants/docs/handbook_healthprofessionals_en.pdf. Accessed 28 Jan 2019

  69. 69.

    Jablonka A, Happle C, Grote U, Schleenvoigt BT, Hampel A, Dopfer C, Hansen G, Schmidt RE, Behrens GM (2016) Measles, mumps, rubella, and varicella seroprevalence in refugees in Germany in 2015. Infection 44:781–787

    Article  PubMed  Google Scholar 

  70. 70.

    Jaeger FN, Hossain M, Kiss L, Zimmerman C (2012) The health of migrant children in Switzerland. Int J Public Health 57:659–671

    Article  PubMed  Google Scholar 

  71. 71.

    Jaeger FN, Kiss L, Hossain M, Zimmerman C (2013) Migrant-friendly hospitals: a paediatric perspective—improving hospital care for migrant children. BMC Health Serv Res 13:389

    Article  PubMed  PubMed Central  Google Scholar 

  72. 72.

    Jazwa A, Coleman MS, Gazmararian J, Wingate LT, Maskery B, Mitchell T, Weinberg M (2015) Cost-benefit comparison of two proposed overseas programs for reducing chronic hepatitis B infection among refugees: is screening essential. Vaccine 33:1393–1399

    Article  PubMed  PubMed Central  Google Scholar 

  73. 73.

    Jenkins HE, Yuen CM, Rodriguez CA, Nathavitharana RR, McLaughlin MM, Donald P, Marais BJ, Becerra MC (2017) Mortality in children diagnosed with tuberculosis: a systematic review and meta-analysis. Lancet Infect Dis 17:285–295

    Article  PubMed  Google Scholar 

  74. 74.

    Kassebaum NJ, Collaborators GBDA (2016) The global burden of anemia. Hematol Oncol Clin North Am 30:247–308

    Article  PubMed  Google Scholar 

  75. 75.

    Khyatti M, Trimbitas RD, Zouheir Y, Benani A, El Messaoudi MD, Hemminki K (2014) Infectious diseases in North Africa and North African immigrants to Europe. Eur J Pub Health 24(Suppl 1):47–56

    Article  Google Scholar 

  76. 76.

    Koroma JB, Peterson J, Gbakima AA, Nylander FE, Sahr F, Soares Magalhaes RJ, Zhang Y, Hodges MH (2010) Geographical distribution of intestinal schistosomiasis and soil-transmitted helminthiasis and preventive chemotherapy strategies in Sierra Leone. PLoS Negl Trop Dis 4:e891

    Article  PubMed  PubMed Central  Google Scholar 

  77. 77.

    Kortas AZ, Polenz J, von Hayek J, Rudiger S, Rottbauer W, Storr U, Wibmer T (2017) Screening for infectious diseases among asylum seekers newly arrived in Germany in 2015: a systematic single-centre analysis. Public Health 153:1–8

    Article  CAS  PubMed  Google Scholar 

  78. 78.

    Kroening AL, Moore JA, Welch TR, Halterman JS, Hyman SL (2016) Developmental screening of refugees: a qualitative study. Pediatrics 138:e20160234

    Article  PubMed  PubMed Central  Google Scholar 

  79. 79.

    Krupic F, Hellstrom M, Biscevic M, Sadic S, Fatahi N (2016) Difficulties in using interpreters in clinical encounters as experienced by immigrants living in Sweden. J Clin Nurs 25:1721–1728

    Article  PubMed  Google Scholar 

  80. 80.

    Las Heras Manso G, Junca Piera J, Feliu Frasnedo E, Rovira Fernandez JM, Gil Garcia M (2008) Hemoglobinopathies and glucose-6-phosphate dehydrogenase deficiency in the Sub-Saharan immigrant population of the center and south Maresme region, Catalonia, Spain. Med Clin (Barc) 131:5–9

    Article  Google Scholar 

  81. 81.

    Liu Y, Weinberg MS, Ortega LS, Painter JA, Maloney SA (2009) Overseas screening for tuberculosis in U.S.-bound immigrants and refugees. N Engl J Med 360:2406–2415

    Article  CAS  PubMed  Google Scholar 

  82. 82.

    Lopez-Velez R, Huerga H, Turrientes MC (2003) Infectious diseases in immigrants from the perspective of a tropical medicine referral unit. Am J Trop Med Hyg 69:115–121

    Article  CAS  PubMed  Google Scholar 

  83. 83.

    Lowy G (1992) Sexually transmitted diseases in children. Pediatr Dermatol 9:329–334

    Article  CAS  PubMed  Google Scholar 

  84. 84.

    Lucas M, Nicol P, McKinnon E, Whidborne R, Lucas A, Thambiran A, Burgner D, Waring J, French M (2010) A prospective large-scale study of methods for the detection of latent mycobacterium tuberculosis infection in refugee children. Thorax 65:442–448

    Article  PubMed  Google Scholar 

  85. 85.

    MacPherson DW, Zencovich M, Gushulak BD (2006) Emerging pediatric HIV epidemic related to migration. Emerg Infect Dis 12:612–617

    Article  PubMed  PubMed Central  Google Scholar 

  86. 86.

    Manganelli L, Berrilli F, Di Cave D, Ercoli L, Capelli G, Otranto D, Giangaspero A (2012) Intestinal parasite infections in immigrant children in the city of Rome, related risk factors and possible impact on nutritional status. Parasit Vectors 5:265

    Article  PubMed  PubMed Central  Google Scholar 

  87. 87.

    Manzardo C, Trevino B, Gomez i Prat J, Cabezos J, Mongui E, Claveria I, Luis Del Val J, Zabaleta E, Zarzuela F, Navarro R (2008) Communicable diseases in the immigrant population attended to in a tropical medicine unit: epidemiological aspects and public health issues. Travel Med Infect Dis 6:4–11

    Article  PubMed  Google Scholar 

  88. 88.

    Marcenes W, Kassebaum NJ, Bernabe E, Flaxman A, Naghavi M, Lopez A, Murray CJ (2013) Global burden of oral conditions in 1990-2010: a systematic analysis. J Dent Res 92:592–597

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  89. 89.

    Marquardt L, Kramer A, Fischer F, Prufer-Kramer L (2016) Health status and disease burden of unaccompanied asylum-seeking adolescents in Bielefeld, Germany: cross-sectional pilot study. Tropical Med Int Health 21:210–218

    Article  CAS  Google Scholar 

  90. 90.

    Marras TK, Wilson J, Wang EE, Avendano M, Yang JW (2003) Tuberculosis among Tibetan refugee claimants in Toronto: 1998 to 2000. Chest 124:915–921

    Article  PubMed  Google Scholar 

  91. 91.

    Marsanic VB, Franic T, Curkovic KD (2017) Mental health issues of refugee children: lessons from Croatia. Eur Child Adolesc Psychiatry 26:377–381

    Article  PubMed  Google Scholar 

  92. 92.

    Masvidal i Aliberch RM, Canadell Villaret D, Grupo de Cooperación IyAdlA (2017) Actualización del Protocolo de Atención a las Niñas y Niños Inmigrantes. Revisión 2016. Form Act Pediatr Aten Prim 10:3–15

    Google Scholar 

  93. 93.

    McCann JC, Ames BN (2007) An overview of evidence for a causal relation between iron deficiency during development and deficits in cognitive or behavioral function. Am J Clin Nutr 85:931–945

    Article  CAS  Google Scholar 

  94. 94.

    Oxford Centre for Evidence-based Medicine – Levels of Evidence (2009). https://www.cebm.net/2009/06/oxford-centre-evidence-based-medicine-levels-evidence-march-2009/. Accessed 28 Jan 2019

  95. 95.

    Meinel DM, Kuehl R, Zbinden R, Boskova V, Garzoni C, Fadini D, Dolina M, Blumel B, Weibel T, Tschudin-Sutter S, Widmer AF, Bielicki JA, Dierig A, Heininger U, Konrad R, Berger A, Hinic V, Goldenberger D, Blaich A, Stadler T, Battegay M, Sing A, Egli A (2016) Outbreak investigation for toxigenic Corynebacterium diphtheriae wound infections in refugees from Northeast Africa and Syria in Switzerland and Germany by whole genome sequencing. Clin Microbiol Infect 22:1003 e1001–1003 e1008

    Article  CAS  Google Scholar 

  96. 96.

    Messina JP, Humphreys I, Flaxman A, Brown A, Cooke GS, Pybus OG, Barnes E (2015) Global distribution and prevalence of hepatitis C virus genotypes. Hepatology 61:77–87

    Article  PubMed  Google Scholar 

  97. 97.

    Mikolajczyk RT, Akmatov MK, Stich H, Kramer A, Kretzschmar M (2008) Association between acculturation and childhood vaccination coverage in migrant populations: a population based study from a rural region in Bavaria, Germany. Int J Public Health 53:180–187

    Article  PubMed  Google Scholar 

  98. 98.

    Mipatrini D, Stefanelli P, Severoni S, Rezza G (2017) Vaccinations in migrants and refugees: a challenge for European health systems. A systematic review of current scientific evidence. Pathog Glob Health 111:59–68

    Article  PubMed  PubMed Central  Google Scholar 

  99. 99.

    Mockenhaupt FP, Barbre KA, Jensenius M, Larsen CS, Barnett ED, Stauffer W, Rothe C, Asgeirsson H, Hamer DH, Esposito DH, Gautret P, Schlagenhauf P (2016) Profile of illness in Syrian refugees: a GeoSentinel analysis, 2013 to 2015. Euro Surveill 21:30160

    Article  PubMed  Google Scholar 

  100. 100.

    Moeller MP, McCleary E, Putman C, Tyler-Krings A, Hoover B, Stelmachowicz P (2010) Longitudinal development of phonology and morphology in children with late-identified mild-moderate sensorineural hearing loss. Ear Hear 31:625–635

    Article  PubMed  PubMed Central  Google Scholar 

  101. 101.

    Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, Michigami T, Tiosano D, Mughal MZ, Makitie O, Ramos-Abad L, Ward L, DiMeglio LA, Atapattu N, Cassinelli H, Braegger C, Pettifor JM, Seth A, Idris HW, Bhatia V, Fu J, Goldberg G, Savendahl L, Khadgawat R, Pludowski P, Maddock J, Hypponen E, Oduwole A, Frew E, Aguiar M, Tulchinsky T, Butler G, Hogler W (2016) Global consensus recommendations on prevention and management of nutritional rickets. J Clin Endocrinol Metab 101:394–415

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  102. 102.

    National Advisory Commission on Biomedical Ethics (2017) Migrants allophones et système de soins. https://www.nekcne.admin.ch/inhalte/Themen/Stellungnahmen/fr/DEF_NEK_Stellungnahme_Migranten_A4_FR_web.pdf. Accessed 28 Jan 2019

  103. 103.

    National Institute for Health and Welfare (THL). Pakolaisten ja turvapaikanhakijoiden infektio-ongelmien ehkäisy [prevention of infection problems among refugees and asylum seekers]. Saatavilla. 2009;21. [Available at]: http://urn.fi/URN:ISBN:978-952-00-2939-5. Accessed 28 Jan 2019

  104. 104.

    National Working Group for Migrant Children of the Italian Society of Pediatrics (2013) Standard operating procedure for health assistance of newly arrived migrant minors. https://www.sip.it/wp-content/uploads/2017/09/GLNBM_SIP_SOP.pdf. Accessed 28 Jan 2019

  105. 105.

    Odone A, Tillmann T, Sandgren A, Williams G, Rechel B, Ingleby D, Noori T, Mladovsky P, McKee M (2015) Tuberculosis among migrant populations in the European Union and the European economic area. Eur J Pub Health 25:506–512

    Article  Google Scholar 

  106. 106.

    Oesch Nemeth G, Nemeth J, Altpeter E, Ritz N (2014) Epidemiology of childhood tuberculosis in Switzerland between 1996 and 2011. Eur J Pediatr 173:457–462

    Article  PubMed  Google Scholar 

  107. 107.

    Okunseri C, Gonzalez C, Hodgson B (2015) Children’s oral health assessment, prevention, and treatment. Pediatr Clin N Am 62:1215–1226

    Article  Google Scholar 

  108. 108.

    Ott JJ, Stevens GA, Groeger J, Wiersma ST (2012) Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity. Vaccine 30:2212–2219

    Article  CAS  PubMed  Google Scholar 

  109. 109.

    Padovese V, Egidi AM, Melillo TF, Farrugia B, Carabot P, Didero D, Costanzo G, Mirisola C (2014) Prevalence of latent tuberculosis, syphilis, hepatitis B and C among asylum seekers in Malta. J Public Health (Oxf) 36:22–27

    Article  CAS  Google Scholar 

  110. 110.

    Pai M, Zwerling A, Menzies D (2008) Systematic review: T-cell-based assays for the diagnosis of latent tuberculosis infection: an update. Ann Intern Med 149:177–184

    Article  PubMed  PubMed Central  Google Scholar 

  111. 111.

    Palacios C, Gonzalez L (2014) Is vitamin D deficiency a major global public health problem? J Steroid Biochem Mol Biol 144(Pt A):138–145

    Article  CAS  PubMed  Google Scholar 

  112. 112.

    Pareek M, Baussano I, Abubakar I, Dye C, Lalvani A (2012) Evaluation of immigrant tuberculosis screening in industrialized countries. Emerg Infect Dis 18:1422–1429

    Article  PubMed  PubMed Central  Google Scholar 

  113. 113.

    Pavlopoulou ID, Tanaka M, Dikalioti S, Samoli E, Nisianakis P, Boleti OD, Tsoumakas K (2017) Clinical and laboratory evaluation of new immigrant and refugee children arriving in Greece. BMC Pediatr 17:132

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  114. 114.

    Paxton GA, Sangster KJ, Maxwell EL, McBride CR, Drewe RH (2012) Post-arrival health screening in Karen refugees in Australia. PLoS One 7:e38194

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  115. 115.

    Pfeil J, Kobbe R, Trapp S, Kitz C, Hufnagel M (2015) Empfehlungen zur infektiologischen Versorgung von Flüchtlingen im Kindes- und Jugendalter in Deutschland. Monatsschr Kinderheilkd 163:1269–1286

    Article  Google Scholar 

  116. 116.

    Piel FB, Steinberg MH, Rees DC (2017) Sickle cell disease. N Engl J Med 377:305

    Article  PubMed  Google Scholar 

  117. 117.

    Pohl C, Mack I, Schmitz T, Ritz N (2017) The spectrum of care for pediatric refugees and asylum seekers at a tertiary health care facility in Switzerland in 2015. Eur J Pediatr 176:1681–1687

    Article  Google Scholar 

  118. 118.

    Pottie K, Greenaway C, Feightner J, Welch V, Swinkels H, Rashid M, Narasiah L, Kirmayer LJ, Ueffing E, MacDonald NE, Hassan G, McNally M, Khan K, Buhrmann R, Dunn S, Dominic A, McCarthy AE, Gagnon AJ, Rousseau C, Tugwell P, coauthors of the Canadian Collaboration for Immigrant and Refugee Health (2011) Evidence-based clinical guidelines for immigrants and refugees. CMAJ 183:E824–E925

    Article  PubMed  PubMed Central  Google Scholar 

  119. 119.

    Pottie K, Mayhew AD, Morton RL, Greenaway C, Akl EA, Rahman P, Zenner D, Pareek M, Tugwell P, Welch V, Meerpohl J, Alonso-Coello P, Hui C, Biggs BA, Requena-Mendez A, Agbata E, Noori T, Schunemann HJ (2017) Prevention and assessment of infectious diseases among children and adult migrants arriving to the European Union/European economic association: a protocol for a suite of systematic reviews for public health and health systems. BMJ Open 7:e014608

    Article  PubMed  PubMed Central  Google Scholar 

  120. 120.

    Puthiyakunnon S, Boddu S, Li Y, Zhou X, Wang C, Li J, Chen X (2014) Strongyloidiasis--an insight into its global prevalence and management. PLoS Negl Trop Dis 8:e3018

    Article  PubMed  PubMed Central  Google Scholar 

  121. 121.

    Ramirez D, Engel KG, Tang TS (2008) Language interpreter utilization in the emergency department setting: a clinical review. J Health Care Poor Underserved 19:352–362

    Article  PubMed  Google Scholar 

  122. 122.

    Redditt VJ, Janakiram P, Graziano D, Rashid M (2015) Health status of newly arrived refugees in Toronto, Ont: part 1: infectious diseases. Can Fam Physician 61:e303–e309

    PubMed  PubMed Central  Google Scholar 

  123. 123.

    Ritz N, Curtis N (2014) Novel concepts in the epidemiology, diagnosis and prevention of childhood tuberculosis. Swiss Med Wkly 144:w14000

    PubMed  Google Scholar 

  124. 124.

    Ritz N, Brinkmann F, Santiago Garcia B, Tebruegge M, Kampmann B, Paediatric Tuberculosis Network European Trials Group (2015) Tuberculosis in young refugees. Lancet 386:2475–2476

    Article  PubMed  Google Scholar 

  125. 125.

    Rossi C, Shrier I, Marshall L, Cnossen S, Schwartzman K, Klein MB, Schwarzer G, Greenaway C (2012) Seroprevalence of chronic hepatitis B virus infection and prior immunity in immigrants and refugees: a systematic review and meta-analysis. PLoS One 7:e44611

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  126. 126.

    Royal College of Paediatrics and Child Health (2017) Refugee and unaccompanied asylum seeking children and young people: paediatric health assessment. https://www.rcpch.ac.uk/resources/refugee-unaccompanied-asylum-seeking-children-young-people. Accessed 28 Jan 2019

  127. 127.

    Rungan S, Reeve AM, Reed PW, Voss L (2013) Health needs of refugee children younger than 5 years arriving in New Zealand. Pediatr Infect Dis J 32:e432–e436

    Article  PubMed  Google Scholar 

  128. 128.

    Ryan ET (2018) Antiparasitic agents. In: S Long, C Prober, M Fischer (eds) Principles and practice of pediatric infectious diseases. Elsevier, pp 1567–1587.e1562

  129. 129.

    Sachdev H, Gera T, Nestel P (2005) Effect of iron supplementation on mental and motor development in children: systematic review of randomised controlled trials. Public Health Nutr 8:117–132

    Article  PubMed  Google Scholar 

  130. 130.

    Salehi L, Lofters AK, Hoffmann SM, Polsky JY, Rouleau KD (2015) Health and growth status of immigrant and refugee children in Toronto, Ontario: a retrospective chart review. Paediatr Child Health 20:e38–e42

    Article  PubMed  PubMed Central  Google Scholar 

  131. 131.

    Sanati Pour M, Kumble S, Hanieh S, Biggs BA (2014) Prevalence of dyslipidaemia and micronutrient deficiencies among newly arrived Afghan refugees in rural Australia: a cross-sectional study. BMC Public Health 14:896

    Article  PubMed  PubMed Central  Google Scholar 

  132. 132.

    Schwarzwald H (2005) Illnesses among recently immigrated children. Semin Pediatr Infect Dis 16:78–83

    Article  PubMed  Google Scholar 

  133. 133.

    Serre Delcor N, Maruri BT, Arandes AS, Guiu IC, Essadik HO, Soley ME, Romero IM, Ascaso C (2016) Infectious diseases in Sub-Saharan immigrants to Spain. Am J Trop Med Hyg 94:750–756

    Article  PubMed  PubMed Central  Google Scholar 

  134. 134.

    Sokal E, Nannini P (2017) Hepatitis C virus in children: the global picture. Arch Dis Child 102:668–671

    Article  PubMed  Google Scholar 

  135. 135.

    Stellinga-Boelen AA, Storm H, Wiegersma PA, Bijleveld CM, Verkade HJ (2007) Iron deficiency among children of asylum seekers in the Netherlands. J Pediatr Gastroenterol Nutr 45:591–595

    Article  CAS  PubMed  Google Scholar 

  136. 136.

    Stevens GA, Finucane MM, De-Regil LM, Paciorek CJ, Flaxman SR, Branca F, Pena-Rosas JP, Bhutta ZA, Ezzati M, Nutrition Impact Model Study Group (2013) Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995-2011: a systematic analysis of population-representative data. Lancet Glob Health 1:e16–e25

    Article  PubMed  PubMed Central  Google Scholar 

  137. 137.

    Swanson SJ, Phares CR, Mamo B, Smith KE, Cetron MS, Stauffer WM (2012) Albendazole therapy and enteric parasites in United States-bound refugees. N Engl J Med 366:1498–1507

    Article  CAS  PubMed  Google Scholar 

  138. 138.

    Tebruegge M, Ritz N, Curtis N, Shingadia D (2015) Diagnostic tests for childhood tuberculosis: past imperfect, present tense and future perfect? Pediatr Infect Dis J 34:1014–1019

    Article  PubMed  Google Scholar 

  139. 139.

    The Royal Australasian College of Physicians (2016) refugee and asylum seeker health position statement. https://www.racp.edu.au/docs/defaultsource/default-document-library/refugee-and-asylum-seeker-health-position-statement.pdf. Accessed 28 Jan 2019

  140. 140.

    Theuring S, Friedrich-Janicke B, Portner K, Trebesch I, Durst A, Dieckmann S, Steiner F, Harms G, Mockenhaupt FP (2016) Screening for infectious diseases among unaccompanied minor refugees in Berlin, 2014-2015. Eur J Epidemiol 31:707–710

    Article  PubMed  Google Scholar 

  141. 141.

    UN Children’s Fund (UNICEF) (2016) Female genital mutilation/cutting: a global concern. https://data.unicef.org/resources/female-genitalmutilationcutting-global-concern/. Accessed 28 Jan 2019

  142. 142.

    UN Children’s Fund (UNICEF) (2017) A child is a child: protecting children on the move from violence, abuse and exploitation. https://www.unicef.org/publications/files/UNICEF_A_child_is_a_child_May_2017_EN.pdf. Accessed 28 Jan 2019

  143. 143.

    UN Children’s Fund (UNICEF) (2018) Latest statistics and graphics on refugee and migrant children. https://www.unicef.org/eca/emergencies/refugee-andmigrant-children-europe. Accessed 28 Jan 2019

  144. 144.

    United Nations (1989) Convention on the rights of the child. https://www.ohchr.org/en/professionalinterest/pages/crc.aspx. Accessed 28 Jan 2019

  145. 145.

    United Nations high commissioner for refugees (UNHCR) (2017) Gobal report. https://www.unhcr.org/publications/fundraising/5b4c89bf17/unhcrglobal-report-2017.html. Accessed 28 Jan 2019

  146. 146.

    Usemann J, Ledergerber M, Fink G, Ritz N (2019) Cost-effectiveness of tuberculosis screening for migrant children in a low-incidence country. Int J Tuberc Lung Dis 23:579–586

    Article  CAS  PubMed  Google Scholar 

  147. 147.

    Van Baelen L, Ortensi L, Leye E (2016) Estimates of first-generation women and girls with female genital mutilation in the European Union, Norway and Switzerland. Eur J Contracept Reprod Health Care 21:474–482

    Article  PubMed  Google Scholar 

  148. 148.

    van der Linde D, Konings EE, Slager MA, Witsenburg M, Helbing WA, Takkenberg JJ, Roos-Hesselink JW (2011) Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis. J Am Coll Cardiol 58:2241–2247

    Article  PubMed  Google Scholar 

  149. 149.

    Vloeberghs E, van der Kwaak A, Knipscheer J, van den Muijsenbergh M (2012) Coping and chronic psychosocial consequences of female genital mutilation in the Netherlands. Ethn Health 17:677–695

    Article  PubMed  Google Scholar 

  150. 150.

    von Both U, Alberer M (2016) Images in clinical medicine. Borrelia recurrentis infection. N Engl J Med 375:e5

    Article  Google Scholar 

  151. 151.

    Woods CR (2005) Syphilis in children: congenital and acquired. Semin Pediatr Infect Dis 16:245–257

    Article  PubMed  Google Scholar 

  152. 152.

    World Health Organization (2012) Global incidence and prevalence of selected curable sexually transmitted infections—2008. https://apps.who.int/iris/handle/10665/75181. Accessed 28 Jan 2019

  153. 153.

    World Health Organization (2016a) World malaria report 2016. https://www.who.int/malaria/publications/world-malaria-report-2016/report/en/. Accessed 28 Jan 2019

  154. 154.

    World Health Organization (2016b) WHO guidelines on the management of health complications from female genital mutilation. https://www.who.int/reproductivehealth/topics/fgm/management-health-complications-fgm/en/. Accessed 28 Jan 2019

  155. 155.

    World Health Organization (2017) Preventive chemotherapy to control soil-transmitted helminth infections in at-risk population groups. https://www.who.int/nutrition/publications/guidelines/deworming/en/. Accessed 28 Jan 2019

  156. 156.

    Yun K, Hebrank K, Graber LK, Sullivan MC, Chen I, Gupta J (2012) High prevalence of chronic non-communicable conditions among adult refugees: implications for practice and policy. J Community Health 37:1110–1118

    Article  PubMed  Google Scholar 

  157. 157.

    Yun K, Matheson J, Payton C, Scott KC, Stone BL, Song L, Stauffer WM, Urban K, Young J, Mamo B (2016) Health profiles of newly arrived refugee children in the United States, 2006-2012. Am J Public Health 106:128–135

    Article  PubMed  PubMed Central  Google Scholar 

  158. 158.

    Zammarchi L, Casadei G, Strohmeyer M, Bartalesi F, Liendo C, Matteelli A, Bonati M, Gotuzzo E, Bartoloni A, COHEMI Project Study Group (2015) A scoping review of cost-effectiveness of screening and treatment for latent tubercolosis infection in migrants from high-incidence countries. BMC Health Serv Res 15:412

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The author would like to thank Ayesha Kadir and Anders Hjern for helpful comments on the manuscript. We would like to thank René-Marie Meignan for designing the icons.

Author information

Affiliations

Authors

Contributions

LS, CW, SdT and NR conceived the manuscript. LS, CW and NR performed the acquisition. LS And NR

wrote the first draft of the manuscript. TS, UvB and JB critically and substantially revised the draft of the manuscript. All authors approved the final manuscript.

Corresponding author

Correspondence to Nicole Ritz.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Communicated by Peter de Winter

Electronic supplementary material

ESM 1

(DOCX 18 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Schrier, L., Wyder, C., del Torso, S. et al. Medical care for migrant children in Europe: a practical recommendation for first and follow-up appointments. Eur J Pediatr 178, 1449–1467 (2019). https://doi.org/10.1007/s00431-019-03405-9

Download citation

Keywords

  • Asylum-seeking children
  • Refugee
  • Check-up
  • Health care
  • Immigrant
  • Unaccompanied minor
  • Vaccination
  • Immunisation
  • Tuberculosis