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      Special Aspects in Pediatric Surgical Inpatient Care of Refugee Children: A Comparative Cohort Study

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          Abstract

          Background: Recently, the number of refugees in Germany has skyrocketed, leading to a marked increase in refugee children admitted to hospitals. This study describes the special characteristics encountered in pediatric surgical inpatient refugees compared to locally residing patients. Methods: Hospital records of minor refugees admitted to our department from 2005 up to and including 2015 were retrospectively reviewed. Demographic data, diagnoses, comorbidities, body mass indexes, hemoglobin values, and lengths of stay were extracted and statistically compared to local patients. Results: A total of 63 refugee children were analyzed and compared to 24,983 locally residing children. There was no difference in median body mass index (16.2 vs. 16.3, respectively, p = 0.26). However, refugee children had significantly lower hemoglobin values (11.95 vs. 12.79 g/dL, p < 0.0001) and were more likely to be colonized with methicillin-resistant Staphylococcus. aureus (8% vs. 0.04%, p < 0.01). Refugees were much more likely to present with burn injuries (16% versus 3% of admissions, p < 0.001), esophageal foreign bodies (4% vs. 0.5%, p < 0.001), as well as trauma, except for closed head injury. Conclusion: The cohort of refugee children in this study was found to be at a particular risk for suffering from burn injuries, trauma, foreign body aspirations, and anemia. Appropriate preventive measures and screening programs should be implemented accordingly.

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          Most cited references31

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          Mental health and associated stress factors in accompanied and unaccompanied refugee minors resettled in Germany: a cross-sectional study

          Background Studies throughout Europe have shown that asylum-seeking children and adolescents (ASC) are at risk of developing mental disorders. The most common mental-health problems in ASC include posttraumatic stress symptoms (PTSS), internalizing symptoms such as depression and anxiety, and externalizing behaviour. Being an unaccompanied refugee minor (URM) was found to be highly predictive for higher levels of psychological distress within ASC. Nevertheless, and even though Germany is Europe’s biggest host country for ASC, studies that reliably examine the mental health of both URM and accompanied refugee minors (ARM) in Germany with psychometrically tested measures are still lacking. Methods A cross-sectional survey in 19 facilities for minor refugees in Bavaria, Germany, screening for PTSS, depression, anxiety, externalizing behaviour, and post-migration factors was conducted. Participants were 98 ASC (URM, n = 68; ARM, n = 30) primarily from Afghanistan, Syria, and Eritrea. In 35.7% of interviews, interpreters were involved. Results Both URM and ARM reported high levels of psychological distress and large numbers of potentially traumatic events, with 64.7% of URM and 36.7% of ARM scoring above the clinical cut-off for PTSS, 42.6% of URM and 30% of ARM for depression, and 38.2% of URM and 23.3% of ARM for anxiety. The total number of traumatic experiences was found to be the most robust predictor for PTSS, depression, and anxiety. Lower levels of individual resources, lower levels of social support in the host country, and poorer German language proficiency were associated with higher levels of psychological distress within both groups. URM reported significantly more traumatic events than ARM. Conclusions ASC in Germany are severely distressed and burdened by the experiences of various types of potentially traumatic events. The levels of distress found in the current study correspond with rates that have been reported in previous studies with ASC throughout Europe. Limitations of the present study include the convenience sample and the cross-sectional nature of findings.
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            Epidemiology of burn injuries: highlighting cultural and socio-demographic aspects.

            Burns are devastating injuries that disproportionately affect people in developing countries, including children. In addition to a high mortality rate, survivors are burdened with life-long physical and emotional scars. The etiology and nature of burn injuries varies significantly by country, and this chapter explores the predominant causes and patterns of burn injury in both the developing and industrialized worlds. Gender differences play a significant role in the risk of burn injuries, across a spectrum with a predominance of women injured in fires from cooking and heating fuels in the developing world and industrial accidents primarily affecting men in developed nations. Children are particularly vulnerable to burn injuries, accounting for almost 50% of all burn patients in some studies. A majority of pediatric burns are scald injuries usually affecting very young children below the age of 5 years, and we discuss the behavioral patterns underlying this finding. Finally, the elderly form a rapidly increasing proportion of the population in many countries, and are often burdened with comorbidities that are likely to pose significant challenges in burn care.
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              Acute Malnutrition and Anemia Among Rohingya Children in Kutupalong Camp, Bangladesh

              This survey study assesses the health and nutritional status of Rohingya children aged 6 to 59 months in the Kutupalong refugee camp in Bangladesh.
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                Author and article information

                Journal
                Children (Basel)
                Children (Basel)
                children
                Children
                MDPI
                2227-9067
                30 April 2019
                May 2019
                : 6
                : 5
                : 62
                Affiliations
                Department of Pediatric Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; nina-friedl@ 123456gmx.de
                Author notes
                [* ]Correspondence: oliver.muensterer@ 123456unimedizin-mainz.de ; Tel.: +49-6131-17-3865; Fax: +49-6131-17-6523
                Author information
                https://orcid.org/0000-0003-2790-4395
                Article
                children-06-00062
                10.3390/children6050062
                6560456
                31052220
                07ceea8b-b738-4818-9b8b-be71b2587d57
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 01 March 2019
                : 28 April 2019
                Categories
                Article

                refugee,children,anemia,burns,trauma,foreign bodies,methicillin-resistant staphylococcus aureus,multidrugresistant gram negative bacteria

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