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PubMed1980

Intestinal parasites in Southeast-Asian refugees. Prevalence in a community of Laotians.

In response to public concerns, 165 Meo Laotians had stools screened for intestinal parasites by the Illinois Department of Public Health. One hundred twenty-nine had at least one pathogenic parasite detected. Hookworm was detected most frequently, followed by Giardia lamblia, Trichuris trichiura, and Ascaris lumbricoides. Hookworm and overall infection were more frequent in persons 4 years of age and older, while giardiasis, ascariasis, and trichuriasis were most common in the 4- to 14-year age group. Most infections were helminthic and of no public health consequence in the United States. However, giardiasis was seven times as prevalent in refugee children as in the general US population, posing a potential public health risk in child-care settings.

Adolescent↗
PubMed1988

Refugees' repetitive nightmares.

Of 100 Czechoslovak refugees (82 men, 18 women, living in Switzerland) interviewed about their dreams, 56% reported nightmares in which they were again in their home country, wishing to or attempting to escape. These nightmares were reported less frequently by older white collar professionals with previous experience of life abroad than by younger blue collar workers without past experience of life outside their native country.

Adaptation, Psychological↗
PubMed2003

Posttraumatic growth after war: a study with former refugees and displaced people in Sarajevo.

Research carried out with survivors of a variety of different traumata indicates that a large proportion of them perceive positive changes in themselves after the trauma. This study investigated whether posttraumatic growth also could be found among people who had been exposed to particularly severe traumata over a period of several years (1991 to 1995) during the war in the area of the former Yugoslavia. Included in the study were two representative samples of adult former refugees and displaced people who lived anywhere in former Yugoslavia before the war and were currently living in Sarajevo, Bosnia and Herzegovina, three and a half years after the war. The main instrument was a new Bosnian translation of the Posttraumatic Growth Inventory. Results indicated some differences in the factor structure as compared with the original instrument. The overall means for the scale were considerably lower than reported in most studies on other kinds of trauma. Younger people reported considerably more growth than older people.

Adaptation, Psychological↗
PubMed2001

Hepatitis B virus genotypes and HBsAg subtypes in refugees and injection drug users in the United States determined by LiPA and monoclonal EIA.

Hepatitis B virus (HBV) genotyping and hepatitis B surface antigen (HBsAg) subtyping were carried out on sera from 196 HBsAg-positive patients, including 151 refugees entering the United States and 45 injection drug users in Seattle. HBsAg subtyping was performed by enzyme immunoassay (EIA) using a panel of monoclonal antibodies and the HBV genotype was determined by polymerase chain reaction (PCR) followed by detection of amplified HBV DNA by a reverse-phase hybridization line probe assay (LiPA) using genotype-specific probes. HBV DNA was detected by PCR in 155 (79%) of the 196 sera and all 155 were genotyped by LiPA. Samples from Southeast Asia were predominantly genotype B/subtype ayw1 and genotype C/adr; samples from the former Soviet Union and eastern Europe were mostly genotype D/ayw2 and genotype D/ayw3; samples from east Africa were mainly genotype A/adw2 and genotype D/ayw2; and samples from injection drug users were mostly genotype D/ayw3 and genotype A/adw2. Some strains of ayw3 gave atypical monoclonal antibody reactivity patterns in the subtyping assay due to a Val/Ala instead of a Thr at amino acid residue 118 and a Thr instead of a Met at residue 125. A strain of ayw2 also gave an atypical monoclonal antibody reactivity pattern due to an Ala instead of a Thr at amino acid residue 123. LiPA genotyping and monoclonal EIA subtyping can provide useful information for epidemiological studies.

Africa, Eastern↗
PubMed1981

Viral hepatitis in southeast Asian refugees.

Five hundred sixty-four Vietnam refugees were studied for past or present infection with hepatitis A and B virus (HAV and HBV) by sensitive serological assays for hepatitis B surface and e-antigen and antibodies to HBsAg, HBeAg, HBcAg, and HAV. Fifteen percent of the men and 6% of the women were HBsAg-positive. Of these 66% were also positive for HBeAg. Serum transaminase values did not effectively differentiate between the infectious HBeAg carriers and the less infectious anti-HBe carriers. The HBsAg carrier rate did not increase by age after infancy, and among children, carriers clustered around HBsAg carrier mothers only. In contrast, the distribution of antibodies to the three HBV-associated antigens suggested continuous exposure throughout childhood, and a 90% prevalence rate was found at the age of 20 years. Screening for HBeAg in this new population group is necessary if appropriate precautions are to be taken, and if medical management of these patients is to be optimal. The prevalence of antibody to hepatitis A increases with age to 90% at 15 years. Among anti-HAV-positive children and adults IgM- anti-HAV was found in 8% of the children and none of the adults, indicating that only a few children may be in an infectious stage at the time of study, and therefore no specific prophylactic precautions are necessary.

Adolescent↗
PubMed1992

Prevalence of herpesvirus, human T-lymphotropic virus type 1, and treponemal infections in Southeast Asian refugees.

Sera obtained for treponemal serology (VDRL) from 193 Southeast Asian refugees representing five ethnic groups seen in a primary care clinic were examined for antibodies to human T-lymphotropic virus type 1 (HTLV-1), human herpes-virus-6 (HHV-6), Epstein-Barr virus (EBV), and cytomegalovirus (CMV). The seroprevalence was highest for EBV (99%), followed in decreasing order by CMV (95%), HHV-6 (26%), and HTLV-1 (0.6%). The VDRL was positive in 15% of patients. The highest seroprevalence to HHV-6 was noted in the Chinese (33%) and the lowest in the Laotian hilltribes, the Mien and Hmong (14%). Antibody to HHV-6 was most prevalent among patients under 20 and those between 60 and 69 years of age. Differences were not found among ethnic groups in the seroprevalence of HTLV-1, EBV, or CMV.

Adult↗
PubMed2005

A randomized controlled trial of cognitive-behavior therapy for Cambodian refugees with treatment-resistant PTSD and panic attacks: a cross-over design.

We examined the therapeutic efficacy of a culturally adapted cognitive-behavior therapy for Cambodian refugees with treatment-resistant posttraumatic stress disorder (PTSD) and comordid panic attacks. We used a cross-over design, with 20 patients in the initial treatment (IT) condition and 20 in delayed treatment (DT). Repeated measures MANOVA, Group & times; Time ANOVAs, and planned contrasts indicated significantly greater improvement in the IT condition, with large effect sizes (Cohen's d) for all outcome measures: Anxiety Sensitivity Index (d = 3.78), Clinician-Administered PTSD Scale (d = 2.17), and Symptom Checklist 90-R subscales (d = 2.77). Likewise, the severity of (culturally related) neck-focused and orthostasis-cued panic attacks, including flashbacks associated with these subtypes, improved across treatment.

Cambodia↗
PubMed2006

Assessment of posttraumatic stress disorder in Cambodian refugees using the Clinician-Administered PTSD Scale: psychometric properties and symptom severity.

Posttraumatic stress disorder (PTSD) symptoms were assessed by using the Clinician-Administered PTSD Scale (CAPS) in a consecutive sample of Cambodian refugees attending a psychiatric clinic in the United States. Psychometric properties of the translated CAPS and severity of PTSD-related symptoms were examined. The CAPS demonstrated adequate psychometric properties, including coefficient alpha (.92) and item-total correlations (.48-.85). Of the sample 56% (101/179) met Diagnostic and Statistical Manual of Mental Disorders, fourth edition, criteria for current PTSD. Those patients who met criteria for current PTSD had significantly higher CAPS total scores (M = 65.3, SD = 18.1) than those who did not meet the criteria (M = 13.9, SD = 16.7).

Cambodia↗
PubMed1999

Smoking and lipid cardiovascular risk factors in Vietnamese refugees in Australia.

BACKGROUND: The effects of smoking and sex on lipid risk factors for cardiovascular disease were examined among Vietnamese people newly arrived in Australia. METHODS: Immigrants recruited through Refugee Screening had anthropometric data recorded and blood collected to measure total cholesterol (TC), high-density lipoprotein cholesterol (HDL), and triglyceride (TG) by Reflotron; apolipoprotein A-1 (apo A-1) and apolipoprotein B-100 (apo B) by immunoturbidimetric analyses (Turbitimer); and lipoprotein (a) (LP (a)) by ELISA. A questionnaire determined behavioral variables known to influence cardiovascular risk and Statview, Minitab, and SPSS were employed for data analysis. RESULTS: Lipoprotein profiles of men (n = 242) and women (n = 159) were compared. Crude TC and apo B were similar; HDL, apo A-1, and LP (a) were higher in women, TG was higher in men. After adjustment (age, BMI, WHR, years of smoking, and drinks per week), only apo A-1 and LP (a), were higher in women. "At risk" levels of TC or apo B did not differ by gender; risk of low apo A-1 was higher among men. Smokers had a significant risk (crude and adjusted) of low HDL, low apo A-1, and high LP (a). The sex difference in HDL was removed by a single adjustment for smoking; male smokers had higher LP (a) than male nonsmokers. CONCLUSION: Male and female Vietnamese immigrants had similar adjusted lipid profiles. Smoking had a marked detrimental effect on lipids.

Adult↗
PubMed2000

No evidence for multiple-drug prophylaxis for tuberculosis compared with isoniazid alone in Southeast Asian refugees and migrants: completion and compliance are major determinants of effectiveness.

BACKGROUND: The use of multiple-drug prophylaxis for tuberculosis (TB) has not been shown to be more effective than prophylaxis with isoniazid alone. The boundary between inactive pulmonary TB (class 4 TB) and culture-negative "active" pulmonary TB (class 3 TB) is often unclear, as is the intention to treat such patients as a preventive measure or as a curative measure. METHODS: We compared the effectiveness of single drug preventive therapy with isoniazid to the effectiveness of multiple drug preventive therapy for patients with asymptomatic, inactive TB, in a retrospective cohort study of 984 Southeast (SE) Asian migrants and refugees who received prophylaxis between 1978 and 1980. RESULTS: The rate of TB developing in this cohort was 122 per 100,000 person-years. There was no significant difference in development of TB between people who received isoniazid only and those who received multiple drugs. The only significant predictor of TB was noncompletion of prophylaxis [relative risk (RR) = 62, 95% confidence interval (CI) = 20-194]. Subgroup analysis on people who had completed therapy showed noncompliance as a significant predictor of TB (RR = 16, 95% CI = 1.4-179). The risk of noncompletion (RR = 4.7, 95% CI = 2.37-9.39, P < 0.0001) and noncompliance (RR = 2.2, 95% CI = 1.03-4.7, P = 0.03) was higher for patients who received multiple drugs compared with isoniazid alone. Multiple-drug therapy cost 30 times more than isoniazid alone. CONCLUSIONS: We did not find evidence in support of the empirical practice of giving multiple drugs for prevention of TB. This practice is also more costly and more likely to result in noncompliance and adverse drug reactions.

Adult↗
PubMed1996

Oral health status and treatment needs in immigrants and refugees in Italy.

The caries prevalence, oral hygiene status, periodontal health and the treatment needs were assessed in immigrants and refugees in Catanzaro and Crotone, Italy. The mean DMFT and DMFS scores of adults, 18 or more years, were 8.1 and 33.1 for Yugoslavs, 7.4 and 28.8 for Moroccans, and 1.4 and 4.5 for Senegalese. The analysis of variance carried out on the three groups showed a significant inequality in their DMFT and DMFS scores. The stepwise linear regression showed that in the Moroccans and Yugoslavs the DMFT increased with age. The needs for dental extractions and for conservative dental care were respectively 15.8% and 39.5% in the Senegalese, 28.6% and 73.8% in the Yugoslavs, 32.7% and 77% in the Moroccans. Good oral hygiene status was scored for 26.3% Senegalese, 7.1% Yugoslavs, and 5.5% Moroccans. Good periodontal health was scored for 7.9%, 2.4%, and 1.2% of these groups. The analysis of variance carried out on the three groups showed a significant inequality in their OHI-S and PI, and the Bonferroni test showed a significant differences in both indices comparing the Senegalese with the Moroccans and in the OHI-S between Senegalese and Yugoslavs. The stepwise linear regression showed that in the Yugoslavs the OHI-S and in the Moroccans and Yugoslavs the PI increased with age. The results of this investigation demonstrated high caries prevalence, poor oral hygiene and periodontal health, and unmet needs for dental treatment in particular Moroccans and Yugoslavs, and a systematic and comprehensive implementation of oral health promotion program for these groups is a priority need.

Adolescent↗
PubMed1993

Prevalence of hepatitis virus infections in Albanian refugees.

A sample of 393 Albanian refugees, including both children and adults, was tested for serological HAV, HBV, HDV and HCV markers. A high prevalence of infection with both the hepatitis A and B viruses was found, while HDV and HCV infections were uncommon. The overall prevalence of anti-HAV was 96%; it was very high in children 0-10 years, suggesting that HAV infection is largely acquired during childhood and that poor ambiental conditions influence the spreading of this viral infection. One or more serological markers of HBV infection were found in 295 Albanians (75%), confirming the endemic nature of this virus in the Albanian community. The overall prevalence of HBsAg was 19%, and the carrier rate was higher in males than in females. The high HBsAg prevalence among children suggests that HBV infection is usually acquired in early childhood. The serological data obtained in the Albanian sample examined clearly indicate the urgent need for measures to reduce the incidence of HAV and HBV infections and to avoid the further spread of HDV and HCV infections. Finally, the high prevalence of type B hepatitis indicates the necessity of vaccination against HBV for all risk groups and for all children at birth.

Adolescent↗
PubMed1988

Group therapy with Southeast Asian refugees.

This report describes a one-year experience with a new program of group therapy for Southeast Asians who were treated in a psychiatric program for Indochinese refugees. Cultural factors involving communication styles, respect for authority, and traditional social relationships greatly influence the group process. Socialization experiences which encouraged traditional activities and practical information were the most acceptable medium by all the groups. Psychological issues of losses, cultural conflicts, and persistent discussion of somatic symptoms were voiced throughout the activities. Formal group psychotherapy was periodically useful in some groups. Flexibility, meeting concrete needs, keeping a bicultural focus, and maintaining the individual therapy sessions contributed to the acceptance by the patient.

Acculturation↗
PubMed1996

Modification of CAPS-1 for diagnosis of PTSD in Afghan refugees.

A DSM-III-R based instrument for the assessment of posttraumatic stress disorder (PTSD), the Clinician-Administered PTSD Scale (CAPS-1), was modified to accommodate cultural differences and translated into the Afghan languages Pushto and Farsi (Dari) and administered to 30 Afghan refugees living in the United States. The modified CAPS-1 was found to be practical and reliable. Inter-item correlations were calculated on the frequency and intensity scores for the 17 cardinal symptoms and the eight associated features items of the modified CAPS-1. The four reexperiencing items demonstrated significant independence from the avoidance and arousal symptom clusters. However, the avoidance and arousal symptom clusters were not found to be independent cardinal components of PTSD in our participants. The CAPS-1 criteria for diagnosis of PTSD were met by 50% of the subjects evaluated.

Adolescent↗
PubMed2004

Research ethics and the plight of refugees in detention.

Health researchers may have a strategic role to play in confronting the predicament of refugee detainees because they can lend their analytic skills and authority to document the personal cost and impact of this practice. The justification for such 'subversive' research comes from the discrepancy between the sources of legitimacy and legality for government action. The practice of detention may be legal but illegitimate, judged against the standards of international human rights. Hence, research to explore the consequences of this policy is both morally and politically legitimate. Morally, it reflects a commitment to uncover and oppose unjustified violence against others; politically, it represents an attempt to identify and challenge abuses of power by the state. However, doing research without official approval or with the use of deception raises concerns for the safety of detainees as vulnerable research subjects as well as the credibility of researchers and the research enterprise. Researchers also may face sanctions that will limit their future effectiveness. An international network of researchers working on issues of human rights and the health of asylum seekers can provide an institutional basis to support work that challenges local practices.

Australia↗
PubMed2005

Refugee children--a concern for European paediatricians.

Many refugees, about 33% of them children, come to Europe from several different countries. Their somatic state of health is sometimes impaired and they have often been exposed to persecution, war and atrocities with consequences for their psychological health status. The period of application for asylum is often long and strenuous, both socially and psychologically. Their needs are often disregarded. According to the United Nations Convention on the Rights of the Child, European paediatricians should take it as their responsibility to provide health care for them at the same level as that for children of the host country.

Adolescent↗
PubMed2000

War trauma and psychopathology in Bosnian refugee children.

This paper describes the pattern of psychopathology in a sample of 95 children of 8-13 years, who had experienced war in Bosnia. The children were assessed with a battery of standardised measures during a psychosocial support programme in Northern Greece. They either came from refugee families (44%) or had suffered significant family loss (a parent had been killed in 28% and the father was injured or absent in 27% of cases). Children recalled a substantial number of war traumatic experiences. According to previously established cut-off scores on self-report measures, 45 children (47%) scored within the clinical range on the Depression Self-Rating Scale for Children, 28 (23%) on the Revised Children's Manifest Anxiety Scale, and 65 (28%) on the Impact of Event Scale (IES) measuring PTSD reactions. There was a significant association between the number of war traumatic experiences and the intrusion and avoidance scores on the IES. The findings are discussed in relation to setting up intervention programmes for children victims of war and their families.

Adolescent↗
PubMed2006

HIV education needs among Sudanese immigrants and refugees in the Midwestern United States.

Migrant populations may be particularly vulnerable to infectious diseases and often need special considerations in terms of health care. In particular, migrant populations can be at high risk for HIV infection, in part due to lack of education about disease acquisition. This study evaluated knowledge, attitudes, and beliefs about HIV/AIDS as well as risk behavior in the Sudanese immigrant and refugee population of Nebraska (N = 47). The results demonstrated that a significant proportion of individuals from this population are poorly educated about HIV infection, exhibit attitudes and beliefs that may increase their risk for disease acquisition, and create barriers to HIV prevention and care, and engage in high-risk sexual behaviors. Appropriate educational materials are lacking, and there is a pressing need for improved access to culturally appropriate HIV education for this vulnerable population.

Adult↗