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PubMed1984

Health status of Southeast Asian refugees.

The rates of several diseases have been reported to be higher among Southeast Asian refugees compared with those of indigenous North Americans. When we prospectively evaluated 991 refugees new to the Denver metropolitan area for their health and immunization status over a 12-month period, 38% were found to be tuberculin-positive, 71% carried one or more enteric parasites, 15% were HBsAg-positive, 13% had anemia and 31% either presented without immunization records or required continuation of vaccination sequences begun in overseas camps. Age and ethnicity were important variables with regard to tuberculosis, hepatitis B and anemia. The rates of specific parasitic infestations varied among the four ethnic groups, though the overall rates of parasitosis remained constant across ethnic lines.

Adolescent↗
PubMed1984

Hepatitis B follow-up among Indochinese refugees.

During 1979 and 1980 the Department of National Health and Welfare carried out a survey and later routine testing to determine the prevalence of serologic markers of hepatitis B in Indochinese refugees entering Canada. Between March and July 1981 the hepatitis-B-marker status of 220 selected refugees in the Ottawa-Hull area was reassessed. Overall, 173 (79%) of the participants had the same serologic markers when retested, but in 47 (21%) the markers had changed. The most significant changes were the loss of antigenemia in 22% of those who had been HBsAg-positive and the appearance of evidence of infection in 18% of those who had been seronegative. Most of these changes occurred among persons under 30 years of age, especially females aged 10 to 19 years.

Adolescent↗
PubMed1983

Sudden death among Southeast Asian refugees. An unexplained nocturnal phenomenon.

In the period July 15, 1977, through March 30, 1982, there were at least 51 sudden, unexplained deaths in the United States among refugees from Southeast Asia. These deaths involved relatively young (median age, 33 years), previously healthy persons. All except one were male, and all died at night. Available data from studies among young adults in this country suggest that this specific phenomenon has an unusually high incidence among Laotian and Kampuchean refugees and, furthermore, has not previously been observed in the United States. Interviews with families of the decedents and a case-control study have failed to establish causal factors, but emotional stress cannot be ruled out as a contributing element. While reviews of the forensic investigations have confirmed the absence of important common pathological or toxicological findings, preliminary findings of special postmortem cardiac studies, now in progress, suggest that at least some of these deaths may be associated with developmentally abnormal conduction system pathways. Further studies are required to confirm this association, to define the apparently sleep-induced mechanism that triggers these deaths, and to explain the male preponderance in this disorder.

Adult↗
PubMedDate not supplied

[Hepatic distomatosis caused by Clonorchis/Opisthorchis spp. in refugees from South-East Asia. Effects of treatment with praziquantel].

The prevalence of liver infection (percentage of patients voiding Clonorchis or Opistorchis spp. eggs in faeces) is 18.5% in the South East Asian refugees. Both sexes are equally affected and the older the refugees are, the more often they are found infected. Laotians, who like to eat the fishes raw, are harboring leverflukes more often than other Far-east inhabitants. Praziquantel, prescribed at a dose of 25 mg/kg body weight given 3 times on a single day, is very efficient in the treatment of the Far-east hepatic distomatosis. Tolerability to praziquantel is excellent. Side effects are few and of moderate intensity.

Adolescent↗
PubMed1983

Indochinese refugee health assessment and treatment.

Many Southeast Asian refugees have resettled in the United States. This report reviews data from 426 refugees who underwent comprehensive examination and treatment at the Mayo Clinic. Health problems identified were primarily selected contagious illnesses and stress syndromes with functional complaints. Counseling was necessary in 17 percent of adults for psychosomatic problems or psychiatric disorders. When family-planning issues were applicable and addressed, 80 percent of women chose some method of contraception. The prevalence rate of intestinal parasites was 82 percent, and pathogens necessitated persistent treatment and follow-up. Tuberculosis skin-sensitivity testing was positive in 54 percent; the risk of active disease warrants prophylactic treatment until age 35 years. Hepatitis antigen was positive in 13 percent; precautions should be taken for potentially exposed professionals. Hematologic genetic disorders were very common and accounted for most of the 25 percent incidence of microcytosis. Physicians should become aware of cultural attitudes and treatment acceptance among Indochinese patients and should carefully investigate for infectious diseases.

Adolescent↗
PubMed1983

Hematologic abnormalities in Southeast Asian refugees.

Since 1979, we have provided comprehensive medical care to a group of 142 Southeast Asian refugees who relocated in Connecticut. In this group, we identified many hematologic abnormalities in both adults and children (18% anemias, 35% microcytosis). The majority of anemias were microcytic, secondary to iron deficiency and inherited disorders of hemoglobin synthesis. The latter were present in at least 7.5% of our population and accounted for the majority of patients with microcytosis. We conclude that hemoglobin electrophoresis and serological tests for iron stores can detect the cause of anemia found in most Southeast Asian refugees.

Adolescent↗
PubMed1982

Pulmonary paragonimiasis in Laotian refugee children.

Three Laotian refugee children with chronic pulmonary complaints and findings were found to have pulmonary paragonimiasis during a one-year period in Chicago. These patients ranged from 8 to 11 years of age and the diagnosis was delayed five to six months in two children because of the unfamiliarity of American physicians with signs and symptoms of this disorder. Clinical manifestations included chronic cough for up to two years, apparent hemoptysis in two patients, lack of fever or sweats, and family history negative for tuberculosis. Physical findings included rales and dullness to percussion, clubbing (one patient), and lack of fever or respiratory distress. All three patients showed interstitial infiltrates on chest roentgenogram whereas two had multiple small cystic areas. Moderate eosinophilia was present. Paragonimus westermani ova were found in stools of two patients, in sputum of two patients, and in bronchoscopic specimens in one patient. All patients demonstrated striking clinical and radiologic improvement following treatment with bithionol (50 mg/kg every other day for 15 doses), which was well tolerated. Lung fluke infestation must be considered in Indochinese refugee children with apparent hemoptysis or chronic pulmonary symptoms, and sputum and stool should be examined for P westermani ova.

Child↗
PubMed1982

High rate of tuberculin conversion in Indochinese refugees.

From January 1979 through December 1980, a total of 664 Indochinese refugees were screened for tuberculosis in Monroe County, New York; 307 (46%) had positive 5-tuberculin unit PPD Mantoux tests. When 217 refugees with initially negative tests were retested at 60 days, 94 (43%) had converted from a negative to a positive test. Although none of the converters had evidence of active tuberculosis disease, 90 (96%) were given isoniazid preventive therapy. This conversion phenomenon has continued over time, discounting an effect of local, national, or international policy changes. The conversions do not seem to be a function of antigen, tester, or reader; criteria for testing, retesting, or reading; home country, camp country, or length of time in camp; or history of prior BCG vaccination, tuberculosis, or immunization exposure, current illness, or testing intervals since arrival in the United States and subsequent testing. Further studies to evaluate boosting or anergy are in progress to assess this potential public health problem.

Adolescent↗
PubMed1982

[Parasitic infestation and haemoglobinopathies in a population of 1170 refugees from South East Asia].

One thousand one hundred and seventy refugees from Cambodia, Laos and Vietnam were examined in the north of France from 1976 to 1980. 58% of them carried digestive parasites, 22% had anti-Plasmodium antibodies and 2% showed circulating Plasmodium. The most frequent parasites were hookworms (28%), Opisthorchiidae (15%) and Giardia intestinalis (12%). Strongyloides stercoralis (5,7%), Entamoeba histolytica (4,5%), tapeworms (3,3%), human coccidia (1,3%) and Trichostrongylus sp. (1%) were less frequent. Four cases of japonicum schistosomiasis were diagnosed by rectal biopsy. Three species of Plasmodium were identified: P. falciparum (10 cases), P. vivax (3 cases) and P. malariae (2 cases). 16% of the refugees displayed E haemoglobin (Hb E). The occurrence of parasitic infestation and Hb E were more frequent in Cambodians and Laotians than in Vietnameses. Specific anti-P. falciparum antibodies were observed with a significant higher frequency in patients carrying Hb E.

Adolescent↗
PubMed1982

Schistosomiasis in Cambodian refugees at Ban-Kaeng Holding Centre, Prachinburi province, Thailand.

The epidemiologic investigation on schistosomiasis in 21,496 Cambodian refugees residing at Ban-Kaeng Holding Centre was conducted by using the skin sensitivity test as a screening test. A positive diagnosis of Schistosoma mekongi was confirmed in 74 of these cases through ova recovery in the stool. The resultant prevalence of schistosomiasis in Ban-Kaeng refugee Holding Center was 3.44 cases per 1,000 population. All of positive cases came from areas in Cambodia where schistosomiasis has not been previously reported. Sixty out of 74 schistosomiasis cases were from Battambang province in Cambodia. This study indicates that schistosomiasis in Cambodia at present is more widespread than has previously been reported.

Adolescent↗
PubMed1981

Prevalence of hepatitis B markers in Indochinese refugees.

The prevalence of hepatitis B surface antigen (HBsAg) in 14 347 Indochinese refugees was 11.6%; the rate was significantly higher (P less than 0.01) in males (14.0%) than in females (8.8%). Most of the HBsAg-positive refugees were in the age group 20 to 29 years. Antibody to HBsAg was detected in 50.9% of the males and 46.6% of the females, a significant difference (P less than 0.01). Antibody to core antigen alone was found in 2.4% of the males and 2.2% of the females. The cumulative prevalence of one or more hepatitis B markers was significantly higher (P less than 0.001) in the males (67.3%) than in the females (57.5%). The hepatitis B e antigen and its antibody were detected in 54.8% and 39.2% respectively of 1050 HBsAg-positive blood samples. The adw, adr and ayw determinants of HBsAg were found in 23%, 35% and 42% respectively of 74 samples.

Adolescent↗
PubMed1980

Medical care of Cambodian refugees.

Tens of thousands of Cambodian refugees are entering Thailand. Many of the new arrivals are survivors of months of starvation and are critically ill with marasmus, kwashiorkor, beriberi, anemia, malaria, diarrhea, and respiratory diseases. With volunteer medical help, field hospitals are treating patients under primitive conditions that are gradually improving. Based on experience at the Sa Kaeo refugee camp, a brief survey of the nutritional and other diseases likely to be encountered is given for the potential volunteer who may be unfamiliar with tropical medicine.

Cambodia↗
PubMed1995

Screening for depression among newly arrived Vietnamese refugees in primary care settings.

A brief, culture-specific, self-report screening measure for depression, the Vietnamese Depression Scale, was used to determine the prevalence of depressive symptoms among 1,998 consecutive adult Vietnamese refugees who presented at 10 public health clinics within 2 months of their arrival in the United States. Of these patients, 6% met the criterion for a probable case of depression ("positive"). Being divorced, separated, or widowed and poorly educated were strongly associated with a greater likelihood of screening positive. Somatic complaints were common and induced considerable anxiety about physical health status. Nearly a third of the patients reported sadness and dysphoria; culture-specific symptoms of depression also were prevalent. Our findings document the feasibility of screening for depression using the Vietnamese Depression Scale among Vietnamese refugees, particularly in primary care settings where they are first likely to be seen by health professionals after arrival in their host country.

Adult↗
PubMed1995

[A simple survey of post-traumatic stress disorders among Bosnian war refugees in Norway].

150 Bosnian war refugees (100 men and 50 women) were followed for 12 months by means of a brief screening procedure to determine prevalence and course of symptoms of post-traumatic stress disorder. 88 men and 18 women had spent some time in Serbian concentration camps before arriving in Norway. A short check list for interview and a simple self-assessment questionnaire based on stressor and symptom criteria for post-traumatic stress disorders according to DSM-III-R were used three times. The number of persons with a diagnosis of post-traumatic stress disorder remained high throughout the period of observation. The presented diagnostic approach was compared with a comprehensive, standardized diagnostic test battery applied in a similar population of refugees by comparing the outcomes. For the majority of outcomes, no significant difference in prevalence was found. The experiences and results indicate that our approach is practicable, and can deliver diagnostic outcomes with acceptable validity.

Bosnia and Herzegovina↗
PubMedDate not supplied

Effects of family disruption on Southeast Asian refugee women.

Identifying refugee women at a high risk of depression, anxiety and post-traumatic stress is an important role of the nurse, so that appropriate interventions--including family and community support--can be implemented. Below, an assessment of Southeast Asian refugee women experiencing emotional distress from the disruption of family ties that occurred during war, escape and resettlement.

Adaptation, Psychological↗
PubMed1994

[Short-term ciprofloxacin treatment of bacillary dysentery due to Shigella dysenteriae type 1 in Rwandan refugees].

In 1994, an outbreak of dysentery caused by Shigella dysenteriae type I resistant to all public health antibiotics in vitro occurred among rwandan refugees in Zaïre. The only active antimicrobial agent available was ciprofloxacin. It was administered to hospitalized patients in a conventional 5-day schedule. To ration the supply for the benefit of the greatest number, a randomized blinded study was performed to compare the effectiveness of short-term treatment (1 g of ciprofloxacin in a single daily doses for 2 days) with that of the standard treatment (1 g of ciprofloxacin in two daily doses for 5 days). The study included 57 refugees over the age of 15 years with dysentery. Shigella dysenteriae type I was identified in 26 patients. Except for sex distribution, there was no significant difference in clinical and bacteriologic features of the two populations. Treatment failed in 12 cases, i.e., 7 of 29 patients who received the short-term treatment and 5 of 28 patients who received the standard treatment. Efficacy of ciprofloxacin was not dependent on the mode of treatment, taking into account clinical or bacteriologic criteria. These results indicated that the duration of ciprofloxacin treatment for dysentery caused by Shigella dysenteriae type 1 could be shortened to two days. Short-term treatment has several advantages. One is cost-effectiveness since fluoroquinolones are costly and scarce. Another is to allow treatment of a greater number of patients by improving compliance.

Adult↗
PubMed1995

Fenitrothion intoxication during spraying operations in the malaria programme for Afghan refugees in North West Frontier Province of Pakistan.

During the experimental use of fenitrothion to replace malathion for the control of malaria in North West Frontier Province of Pakistan, serious intoxication of Afghan refugee spraymen occurred. A few weeks after commencement of the spraying operations, cholinesterase levels had fallen to 43.8% in personnel mixing the insecticide, and to 60.7% in spraymen, as measured by tintometry. Most of the personnel reported symptoms of overexposure and the spraying operations had to be discontinued. Intoxication of personnel resulted in poor coverage of the target area. High ambient temperatures during Pakistan's spray season discourage the use of full-protective clothing. Fenitrothion intoxication observed in the Afghan refugee programme, and similar experiences in Pakistan in the past, suggest that this insecticide is too toxic for routine use, when the compliance with safety precautions cannot be effectively supervised.

Afghanistan↗