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PubMed1997

Environmental causes and impact of refugee movements: a critique of the current debate.

The relationships between insecurity, environmental change and population displacement are discussed in this paper. It argues that environmental change and concomitant population displacement are the consequences of war and insecurity rather than triggers for it-as postulated in so much of the recent literature. Additionally, the paper critically reviews the state of knowledge concerning the impact of refugees on the environment of host countries. The aim here is not to document the negative or positive impacts as such, but rather to de-mythologise some aspects of the state of knowledge which through repetition have become accepted as 'scientific truth'.

Adult↗
PubMed2005

Efficacy and effectiveness of the combination of sulfadoxine/pyrimethamine and a 3-day course of artesunate for the treatment of uncomplicated falciparum malaria in a refugee settlement in Zambia.

In the Maheba Refugee Settlement, in the clinics supported by Medecins Sans Frontieres, all children aged up to 5 years with a confirmed diagnosis of uncomplicated falciparum malaria are treated with the combination of sulfadoxine/pyrimethamine (SP) and artesunate (AS). We compared the treatment's efficacy and effectiveness. Patients were randomized in order to receive the treatment supervised (efficacy) or unsupervised (effectiveness). Therapeutic response was determined after 28 days of follow up. The difference between recrudescence and re-infection was ascertained by polymerase chain reaction (PCR). We also assessed genetic markers associated to SP resistance (dhfr and dhps). Eighty-five patients received treatment under supervision and 84 received it unsupervised. On day 28, and after PCR adjustment, efficacy was found to be 83.5% (95% CI: 74.1-90.5), and effectiveness 63.4% (95% CI: 52.6-73.3) (P < 0.01). Point mutations on dhfr (108) and dhps (437) were found for 92.0% and 44.2% respectively of the PCR samples analysed. The significant difference in therapeutic response after supervised and unsupervised treatment intake can only be explained by insufficient patient adherence. When implementing new malaria treatment policies, serious investment in ensuring patient adherence is essential to ascertain the effectiveness of the new treatment schedules.

Antimalarials↗
PubMed2005

Cutaneous leishmaniasis in Afghani refugees.

Four Afghani refugees with cutaneous leishmaniasis presented to the dermatology clinic at the Women's and Children's Hospital in Adelaide. Three of the patients had biopsy-proven cutaneous leishmaniasis that was treated initially with topical and then oral ketoconazole, without success. Intralesional sodium stibogluconate was then used for these patients with good results. The fourth patient had several plaques of biopsy-proven cutaneous leishmaniasis, for which cryotherapy was used. This was quite efficacious; however, a small area of recurrence required re-treatment. Leishmaniasis is rarely seen in Australia, but an index of suspicion is warranted when treating persons with typical clinical features who are from endemic regions.

Adolescent↗
PubMed2006

Fever and urticaria in an African refugee.

An 11-year-old African refugee presented with fever and urticaria commencing 2-h after taking praziquantel. He had been well previously, and the praziquantel was given to treat a serological diagnosis of schistosomiasis. The main differential diagnosis was between acute schistosomiasis and a drug reaction.

Africa↗
PubMed1983

Hepatosplenic schistosomiasis in a South-East Asian refugee child in South Australia.

This report documents a case of hepatosplenic schistosomiasis in a South-East Asian refugee boy who presented with malaise, abdominal distension, and was found to have massive splenomegaly and esophageal varices. The diagnosis was confirmed by liver biopsy and he was treated with a highly efficacious schistosomicide, Praziquantel. The case highlights the possible occurrence in Australia of non-endemic tropical diseases in immigrants.

Australia↗
PubMed1985

Safety of thrice-weekly rifampicin for tuberculosis in South-East Asian refugees.

The incidence and types of adverse reactions to rifampicin (in combination with isoniazid, pyrazinamide, and ethambutol) have been studied in 86 South-East Asian refugees treated for tuberculosis in Australia. Most patients received daily therapy initially (mean 3.5 months) followed by supervised thrice-weekly treatment (mean 4.6 months). Minor adverse reactions occurred with similar frequencies during daily (5%) and intermittent (5%) treatment but in no case was modification of rifampicin dosage required. Withdrawal of pyrazinamide was necessary in two patients (2.3%) with clinical hepatitis.

Adolescent↗
PubMed2002

Health issues of asylum seekers and refugees.

This paper is written on behalf of the West Australian Branch of the Australasian Faculty of Public Health Medicine. As public health physicians, we feel it is important that public health professionals should contribute constructively to address the needs of a socially deprived, marginalised group with high rates of physical and psychiatric morbidity. Depending on the definition, there are between 18 and 48 million asylum seekers and refugees in the world. Most seek protection in neighbouring countries, largely in Africa and Asia, rather than coming to North America, Europe and Australasia. Contrary to popular belief, numbers of successful applications to Australia's humanitarian program have actually fallen. This article attempts to correct misperceptions and misapprehensions about the effect of asylum seekers on the public health. Public health professionals should lobby for changes to Govemment policy that at present leave asylum seekers vulnerable to a cycle of poverty, ill-health and limited access to health services.

Emigration and Immigration↗
PubMedDate not supplied

Changing children's intergroup attitudes toward refugees: testing different models of extended contact.

The present research evaluated an intervention, derived from the "extended contact hypothesis," which aimed to change children's intergroup attitudes toward refugees. The study (n=253) tested 3 models of extended contact among 5- to 11-year-old children: dual identity, common ingroup identity, and decategorization. Children read friendship stories based upon these models featuring in- and outgroup members. Outgroup attitudes were significantly more positive in the extended contact conditions, compared with the control, and this was mediated by "inclusion of other in self." The dual identity intervention was the most effective extended contact model at improving outgroup attitudes. The effect of condition on outgroup intended behavior was moderated by subgroup identity. Implications for theoretically based prejudice-reduction interventions among children are discussed.

Attitude↗
PubMed2004

Comorbidity of PTSD and depression among refugee children during war conflict.

BACKGROUND: We examined the prevalence and nature of comorbid post-traumatic stress reactions and depressive symptoms, and the impact of exposure to traumatic events on both types of psychopathology, among Palestinian children during war conflict in the region. METHODS: The 403 children aged 9-15 years, who lived in four refugee camps, were assessed by completing the Gaza Traumatic Events Checklist, the Child Post Traumatic Stress Reaction Index (CPTSD-RI), and the Short Mood and Feelings Questionnaire (MFQ). RESULTS: Children reported experiencing a wide range of traumatic events, both direct experience of violence and through the media. CPTSD-RI and MFQ scores were significantly correlated. Both CPTSD-RI and MFQ scores were independently predicted by the number of experienced traumatic events, and this association remained after adjusting for socioeconomic variables. Exposure to traumatic events strongly predicted MFQ scores while controlling for CPTSD-RI scores. In contrast, the association between traumatic events and CPTSD-RI scores, while controlling for MFQ scores, was weak. The CPTSD-RI items whose frequency was significantly associated with total MFQ scores were: sleep disturbance, somatic complaints, constricted affect, impulse control, and difficulties in concentration. However, not all remaining CPTSD-RI items were significantly associated with exposure to traumatic events, thus raising the possibility that the association between depression and PTSD was due in part to symptom overlap. CONCLUSIONS: Children living in war zones are at high risk of suffering from PTSD and depressive disorders. Exposure to trauma was not found to have a unique association with PTSD. The relationship between PTSD and depressive symptomatology requires further investigation.

Adolescent↗
PubMed1991

A framework for community assessment: designing and conducting a survey in a Hispanic immigrant and refugee community.

This article introduces a framework for the study of access to medical care that has been used extensively in national and local surveys, and demonstrates its application to an assessment of health and health care needs in a Hispanic immigrant and refugee community. The presentation of the framework, study design, findings, and implications for research and planning points out the utility of this framework for organizing systematic community assessment data-gathering activities; demonstrates how such an assessment could be incorporated into a public health nursing curriculum or readily adopted by public health nurse professionals in their communities; illustrates the potential for effective partnerships between public health practitioners and academics in conducting and disseminating the findings; and provides a broader conceptual, empirical, and policy-oriented context in which to view local community-assessment activities and their relevance for health policy and program development.

Adolescent↗
PubMed1999

Stories of growing up amid violence by refugee children of war and children of battered women living in Canada.

PURPOSE: To explore how two groups of children who grew up amid violence "make sense" of their experience. As violence has become a common element of some societies, growing numbers of children have been forced to live in dangerous environments. Although considerable research has been conducted with children who are abused or neglected, the needs of those who witness violence have been largely overlooked. DESIGN: Critical narrative and descriptive. Data were collected, 1995-1996, in Canada from a convenience sample of 16 refugee children of war and 16 children of battered women. METHODS: Participants were asked open-ended questions about the violence in their lives, their feelings about what occurred, their thoughts about the reasons for violence, and their ways of surviving and growing. Common themes were identified and validated. FINDINGS: Despite differences in the children's stories, many parallels were evident. Both groups of youngsters endured pain, suffering, and feelings of betrayal. Both used creative strategies to survive. The way the children endured growing up amid violence was mediated by social, political, and cultural constructions of violence. Because these meanings were unique, violence was experienced in several ways. CONCLUSIONS: Although the children showed remarkable strength and insight, they face many challenges. Despite a common perception that children are unable to talk about deeply troubling experiences, this research demonstrated that children not only want to discuss their experience, but also welcome the opportunity to do so.

Adolescent↗
PubMed1993

Ethnicity as a risk factor for mental illness. A population-based study of 338 Latin American refugees and 996 age-, sex- and education-matched Swedish controls.

This article shows the influence of ethnicity on mental health compared with material factors and lifestyle, which are well-known risk factors for mental illness. The study was designed as a case-control study, with 338 Latin American refugees aged 16-74 years (response rate = 81.8%) in Lund, and a random sample of 996 age-, sex- and education-matched Swedish controls. The data were analysed unmatched with logistic regression in main effect models. The strongest independent risk mediator for mental illness was ethnicity, with an estimated odds ratio of 4.11 (2.31-6.92). Low material standard was associated with mental illness, with an odds ratio of 2.13 (1.07-4.11). Individuals who did not feel secure in daily life were at risk of mental illness, as were those with poor leisure opportunities. The combination of ethnicity, age over 44, and not feeling secure in daily life increased the odds ratio of mental illness to 26.62. Ethnicity, a low material standard, not feeling secure in daily life and poor leisure opportunities were significant risk factors for mental illness.

Adult↗
PubMed1983

Southeast Asian refugees and school health personnel.

This paper describes methodological and demographic limitations of attempts to generalize how traditional Southeast Asian cultural beliefs may affect attitudes of refugee children to the health services and style of education in American schools. It presents brief overviews of the diverse cultural influences upon Vietnam, Cambodia and Laos and then discusses some of the psychological consequents of cultural change observed with uprooted children. Finally, it describes the role of school health personnel as a cultural bridge carrying out three functions: (1) Direct Services; (2) Indirect Services; and (3) Research.

Asia, Southeastern↗
PubMed1983

Spirits, shamans, and nightmare death: survivor stress in a Hmong refugee.

The interaction of war, flight, relocation, and survivor stress are examined in a case study of a Hmong refugee. The need for culturally appropriate treatments for non-Western clients is highlighted, and a possible link is suggested between the circumstances of the case study and sudden death syndrome.

Adult↗
PubMed1987

Depression and academic achievement among Indochinese refugee unaccompanied minors in ethnic and nonethnic placements.

Unaccompanied Indochinese refugee adolescents resettled in the United States with ethnic foster families were significantly less depressed and had higher grade-point averages than those in foster care with Caucasian families or in group homes. The ongoing presence of an adult of similar ethnicity to the adolescent appeared to mitigate against the stress of adaptation to a new country.

Acculturation↗
PubMed1972

Chemical spraying as reported by refugees from South Vietnam.

Ninety-eight refugees who had been exposed to chemical sprays in South Vietnam were interviewed in Hanoi. Most reported effects on eyes and skin and gastrointestinal upsets. Ninety-two percent suffered fatigue, prolonged or indefinite in 17 percent of cases. Reports of abortions and monstrous births in sprayed humans and animals and of substantial numbers of deaths among fish, fowl, and pigs were also given.

Abnormalities, Drug-Induced↗
PubMed1980

Nutritional status of Laotian refugee children in Ubon camp, Thailand.

A survey carried out in May 1979 of the nutritional status of 2152 children aged 1-5 living in Ubon Refugee Camp, Thailand, showed that 165 (7.5%) probably suffered from malnutrition, using arm circumference as an index. This index was validated by comparisons with weight for age and with morbidity in 'malnourished' and normal groups. Arm circumference appeared to be a valid index of nutritional status and a useful screening test with a false positive ratio of about 1 : 5. It was then applied to children attending feeding centres within the camp, and it was thus possible to show that the centres were not attended by as many malnourished children as expected. A feeding centre in a highly impoverished area of the camp was shown to be more likely to have a higher percentage of malnourished children attending.

Anthropometry↗