Notifiable infectious diseases in refugees and asylum seekers: experience from a major reception center in Munich, Germany
In 2016, the number of refugees worldwide reached 65.6 million. So far, only limited data are available on the health status of refugees and asylum seekers (RAs). Especially, notifiable infectious diseases (NIDs) carry the risk of outbreaks in communal accommodations hosting RAs.
We conducted a monocentric retrolective cross-sectional study including 15,137 RAs treated in a special health care unit for RAs located in the major reception center in Munich from November 2014 to October 2016. Altogether 811 RAs with NIDs according to sections 6 and 7 of the German Infection Protection Act or with other infections relevant in the setting of a communal accommodation (RIDs) could be identified.
The gender and age distribution was generally comparable to that of refugees in Germany. However, patients from East Africa and Nigeria were significantly overrepresented. NIDs/RIDs were dominated by cases of tuberculosis, hepatitis B, and vaccine-preventable and parasitic diseases. Significant risk factors included country of origin (COI) and age for hepatitis B, age for hepatitis C, gender and age for HIV, and COI, gender and age for tuberculosis and ectoparasitosis. Calculated prevalences of hepatitis B, hepatitis C, and HIV were mostly below those of the COI. Incidences of tuberculosis were mostly strongly elevated.
COI, gender, and age have an impact on the occurrence of NIDs/RIDs. Early vaccinations and improved hygiene could be effective in preventing NIDs/RIDs in communal accommodations. Screening, prompt therapy, and infection protection measures are necessary to prevent the transmission of diseases.
KeywordsRefugee Asylum seeker Infectious diseases Tuberculosis Hepatitis B Human immunodeficiency virus
The authors thank REFUDOCS-Verein zur medizinischen Versorgung von Flüchtlingen, Asylsuchenden und deren Kindern e.V. for providing the data. This paper is the result of the doctoral thesis of S.M. The authors have no support or funding to report.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
This study has been approved by the ethics committee of the Ludwig-Maximilians-University (LMU), Munich, Germany and has, therefore, been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
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