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PubMed2006

[Patterns of contact with the out-of-hours service and emergency rooms by guest workers with immigrant and refugee background in Copenhagen municipality, 1998].

INTRODUCTION: Outside normal office hours, patients in Denmark with acute conditions are treated by the out-of-hours service connected to general practice and in the emergency rooms of hospitals. Little is known about the contact pattern of immigrants with these services. The purpose of this study was to compare the contact rates for immigrants (guest workers and refugees) and non-immigrants with out-of-hours service and emergency rooms and compare the results with the total number of contacts with general practice (out-of-hours service, daytime contacts) and emergency rooms. MATERIALS AND METHOD: Data from 2,243,633 contacts in Copenhagen 1998 registered in the National Patient Registry and 112,733 visits to emergency units were merged with information about citizenship and place of birth in the Central Office of Civil Registration. The contacts were described by the average number of contacts per person at risk per year. RESULTS: The contact rates with the out-of-hours service were significantly lower for immigrant children than for non-immigrants, whereas the number of visits to emergency rooms did not show any differences. For both sexes aged 19-59, the contact rates for out-of-hours service and emergency rooms were higher for immigrants. The total number of contacts was 31-11% lower for children and those 60+ years of age and 4-20% higher for 19- to 59-year-old immigrants. CONCLUSION: Significant differences in the use of acute services by immigrants and non-immigrants were observed. Whether this is appropriate is questionable.

Adolescent↗

PubMedDate not supplied

Nutritional status of single male government-sponsored refugees from Ethiopia.

Single male Ethiopian refugees living in Ottawa were interviewed to determine their dietary intakes, anthropometric status, and the factors associated with nutritional status. Of 58 eligible subjects, 39 (67%) participated. Dietary intakes, measured by three 24-hour recalls, revealed that protein, iron and Vitamin C generally met or exceeded the Nutrition Recommendations for age. The mean percentages of total energy consumption from protein and fats were 17.2% and 33.4% respectively. The mean energy intake of the group was 81.5% +/- 23.9 of the level recommended. 21% had a body mass index (BMI) below 20, and 55% of arm circumference measurements fell at or below the tenth percentile of the National Center for Health Statistics standards for black males. Participants with higher domestic skill scores, measured by the questionnaire, had significantly higher energy intakes (p less than 0.02). Lack of domestic skill was the dietary problem most commonly identified by participants.

Adult↗

PubMed1991

Pulmonary infections in immigrants and refugees.

Immigrants and refugees are susceptible to a wide array of pulmonary diseases, including familiar infections that are acquired after entry and unusual infections that are imported from abroad. The challenges are great; tuberculosis (TB) is now 13 times more prevalent among immigrants than among the general US population. Melioidosis, paracoccidioidomycosis, and paragonimiasis are often mistaken for TB. Pulmonary disease caused by parasites is uncommon and particularly perplexing unless a peripheral blood eosinophilia suggests helminthic infection. TB, melioidosis, fungal infections, and strongyloidiasis may remain inapparent for years and then produce devastating illness in the setting of immunosuppressive therapy or the acquired immunodeficiency syndrome. Proper health care of immigrants requires an understanding of unusual exposures and infections and should include preventive measures as well.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Prevention of hepatitis B transmission in Indo-Chinese refugees with active and passive immunization.

Hepatitis B is a cause of disability and death worldwide, with high rates of perinatal transmission in third world countries, including those of Indochina. Prevention of transmission by active and passive immunization has been available since 1982. This study looked at the serological response of Indo-Chinese refugees to these products in an outpatient primary care clinic and at the compliance problems found in this setting. The carrier rate of all patients screened was 81/446 (18.5%), with 37/233 (15.8%) of prenatal patients as carriers. Newborns whose mothers were carriers were started on an immunization program. The combination of HBIG and vaccine was more than 90% effective in inducing immunity and preventing the carrier state; only two children of the 26 studied who received both active and passive immunization became carriers. Both failures were in children of HBeAg positive mothers. In contrast, those children exposed who had not received treatment (because of birth prior to 1982) had a 33% carrier rate. This success rate was found despite compliance problems in completing the immunizations on schedule. Only 23% of children received their vaccine within four weeks of the recommended schedule, with a mean delay of 1.3 months. Of the 79 children beginning immunizations, 11 moved before completion. All children remaining in San Diego completed the regimen. Thus, the benefits of giving the passive and active immunization to infants of hepatitis B carriers were clear. However, compliance problems jeopardize the effectiveness of a hepatitis B immunization program in this population.(ABSTRACT TRUNCATED AT 250 WORDS)

Asia, Southeastern↗

PubMedDate not supplied

Intestinal parasites in Cambodians: comparison of diagnostic methods used in screening refugees with implications for treatment of populations with high rates of infestation.

We performed a retrospective review of screening parasitology examinations on a Cambodian refugee population served by an urban neighborhood health center. Five-hundred twenty of 1084 patients were examined for ova and parasites either by purged stool, which was examined immediately, or preserved stool, examined at a teaching hospital and proprietary laboratories. Overall, 335 (64 percent) of the tested patients had at least one parasite. The prevalence of infection varied by test technique (purged stool examined immediately, 86 percent; preserved stool examined at a hospital, 65 percent; preserved stool sent to a proprietary laboratory, 31 percent, P less than 0.01). In this population where Entamoeba histolytica infection was 44 percent as measured by the purged warm stool technique, the cold preserved stool test had a measured relative sensitivity of 33 percent. Assuming a selectivity of 99 percent, it would take eight negative tests to reach a greater than 95 percent negative predictive value. The high rate of intestinal carriage of pathogenic parasites in this population and the insensitivity of commonly available diagnostic tests make routine presumptive treatment of intestinal parasites an option when the purged stool examination is unavailable.

Adolescent↗

PubMed1990

Obstetric care of a Southeast Asian refugee population in a midwestern community.

The obstetric records of 430 Hmong and other Southeast Asian refugee women were retrospectively reviewed from January 1, 1977 to July 1, 1988. All patients gave birth in two hospitals in a midwestern community, La Crosse, Wisconsin. Lack of medical care for early pregnancy complications, late onset of obstetric care, anemia, and high rates of parasites and hepatitis occurred frequently in pregnancy. Admission in advanced labor, a low operative delivery rate (6%), and a higher prematurity rate characterized intrapartum care. Birthweight data revealed statistically significantly smaller infants after 38 weeks' gestation. Postpartum febrile morbidity and neonatal complications were rare. Cultural differences and their effects on obstetric care are discussed.

Abortion, Spontaneous↗

PubMed1990

Consent problems and the Southeast Asian refugee.

More than 24,000 refugees of Southeast Asian descent live in Wisconsin. These people, of a different cultural background with different methods of treating the sick, on occasion seek medical aid. It is incumbent on the treating physicians to understand the cultural differences and the avenues open to them to render treatment to these people. This paper reviews these concerns.

Asia, Southeastern↗

PubMed1990

Prevention of excess mortality in refugee and displaced populations in developing countries.

More than 30 million refugees and internally displaced persons in developing countries are currently dependent on international relief assistance for their survival. Most of this assistance is provided by Western nations such as the United States. Mortality rates in these populations during the acute phase of displacement have been extremely high, up to 60 times the expected rates. Displaced populations in northern Ethiopia (1985) and southern Sudan (1988) have suffered the highest crude mortality rates. Although mortality rates have risen in all age groups, excess mortality has been the greatest in 1- through 14-year-old children. The major causes of death have been measles, diarrheal diseases, acute respiratory tract infections, and malaria. Case-fatality ratios for these diseases have risen due to the prevalence of both protein-energy malnutrition and certain micronutrient deficiencies. Despite current technical knowledge and resources, several recent relief programs have failed to promptly implement essential public health programs such as provision of adequate food rations, clean water and sanitation, measles immunization, and control of communicable diseases. Basic structural changes in the way international agencies implement and coordinate assistance to displaced populations are urgently needed.

Africa↗

PubMedDate not supplied

Intestinal parasites in refugee claimants: a case study for selective screening?

The medical profiles of 1,967 refugee claimants to Montreal, Quebec, Canada from January 1987 to July 1987 were reviewed to evaluate the importance of imported intestinal parasite infection in this group and to re-examine the screening policy governing these infections. An overall infection rate of 29.3% was obtained for pathogenic parasites, where helminths were four times more frequently found than the protozoa Entamoeba histolytica and Giardia lamblia. Age, sex, years of schooling, country of origin and level of eosinophilia were found to be associated with infection, with country of origin being the strongest predictor of infection. These results document the parasite infection in a select group of immigrants which would not have been identified and treated if a special program of screening were not in operation. We suggest that the present immigration policy of no screening for intestinal parasite infection be at least modified to include a recommendation that new arrivals, who are considered to be at high risk for parasite infection, be informed that an examination for parasites would be beneficial to their personal health.

Adolescent↗

PubMed1990

Counselling survivors of torture and refugee trauma.

A substantial number of refugees arriving in Australia are the victims of torture and other forms of organised violence. In this article, the authors provide an overview of the broad range of physical and emotional disabilities that arise from these experiences, examine the special difficulties in identifying and assessing patients at the primary health care level, and offer an approach to counselling for survivors and their families.

Counseling↗

PubMed1990

Cancer risks and prevention practices among Vietnamese refugees.

Although Vietnamese refugees are the fastest-growing Asian minority in the United States, little is known about their health knowledge and practices, especially regarding cancer prevention. To address this problem, we interviewed a randomly selected sample of 215 Vietnamese adults living in the San Francisco Bay Area. Results indicated that 13% had never heard of cancer, 27% did not know that cigarette smoking can cause cancer, and 28% believed that cancer is contagious. Although hepatitis B-related liver cancer is endemic among Vietnamese, 48% had never heard of hepatitis B. Among men (n = 116), 56% were smokers (versus 32% in the general US population). Male cigarette smoking was significantly associated with incomes below the poverty level (P less than .01), residence in the US for 9 years or less (P less than .05), not knowing that smoking causes cancer (P less than .05), and limited English proficiency (P less than .01). Binge drinking was reported by 35% of men. Young Vietnamese of both sexes reported consuming diets higher in fat and lower in fiber than when they lived in Vietnam. Among eligible women, 32% had never had a Papanicolaou test (versus 9% of US women), 28% had never had a breast examination (versus 16%), and 83% had never had a mammogram (versus 62%). Education about cancer and its risk factors, smoking cessation, and cancer screening are high priorities for this population.

Adult↗

PubMedDate not supplied

Health care needs of Central American refugees.

Public health nurses working with undocumented refugees from Central America encounter afflictions ranging from parasitic infection, emotional trauma, and homelessness. Helping this population requires the skills of a diplomat, advocate, and public health professional--as the experience of one Los Angeles public health nurse demonstrates.

Central America↗

PubMed1989

Dental health knowledge in a group of Latin American refugees in Sweden.

Sixty-nine Latin American refugees with a mean age of 31 years participated in this study. The knowledge about dental health before and after reading a self-instructional manual in Spanish was tested by questionnaires. The test persons were also interviewed about their dietary habits. The results showed an improvement of 30% of right answers after reading the manual and that a frequent sugar consumption was common. This indicates that a self-instructional manual can be of value in oral health prevention in a similar group of non-resident immigrants.

Adult↗

PubMed1989

[Psychosocial problems among refugees in Norway].

172 patients were examined and treated by the Psychosocial Team for Refugees in Norway from 1 January 1986 to 15 November 1988. The patients came from 21 countries, the majority from Iran, Chile and Vietnam. Various reactive conditions dominated the clinical picture, and 53 patients had posttraumatic stress disorder, which was the most frequently occurring single diagnosis. The patient group had been exposed to a number of overwhelming experiences and at least half had been tortured. The therapists identified separation and loss, traumatic experiences and social isolation in exile as the factors of greatest importance for the development of the patients' conditions. 46% of the patients were found to have improved at the end of the treatment.

Adult↗

PubMed1989

Fertility, menstrual characteristics, and contraceptive practices among white, black, and Southeast Asian refugee adolescents.

This study compares fertility and menstrual characteristics and contraceptive practices of white, black, and Southeast Asian refugee adolescents participating in the Minneapolis Health Department's Maternal and Infant Care Program between 1980 and 1982. Mean ages were similar among all racial groups; however, half the Hmong adolescents had a live birth as compared to less than 25% of the other racial groups. More than 75% of the Hmong and other Southeast Asian adolescents were married as compared to 11% of the whites and 8% of the blacks. Menarche was significantly later (2 years) for Hmong and other Southeast Asians, and the interval between menarche and first pregnancy was significantly shorter for the Hmong. While more than half of the whites and blacks previously used contraception, 14% of the Hmong and 29% of the other Southeast Asians had used contraception. Oral contraceptives were the most frequently used method for whites, blacks, and Southeast Asians; the Hmong were equally likely to choose oral contraceptives or barrier methods. The Hmong were less likely to choose contraception postpartum than were the other groups.

Adolescent↗

PubMed1988

[Tuberculin reactors among refugee status claimants newly arrived in Canada].

A large number of new cases of tuberculosis are reported among immigrants to Canada every year. For public health purposes immigration policy requires that all immigrants undergo chest radiography and that those found to be infectious receive treatment and follow-up. Since 1984 the clinique Santé-Accueil of the département de Santé communautaire, hôpital Saint-Luc, Montreal, has participated in the screening of immigrants arriving in Quebec who claim refugee status. We undertook a descriptive study to determine the prevalence of tuberculous infection in this population. Of 865 tuberculin tests administered and read, 329 (38%) produced reactions 10 mm or more in diameter. The proportion of positive reactions was higher among older immigrants and varied by country of origin, from 30% for people from El Salvador to 61% for those from Haiti. A history of vaccination with bacille Calmette-Guérin or the presence of a scar was not associated with a positive reaction. Three cases of pulmonary tuberculosis were identified, for a rate of 118/100,000. Our findings underline the importance of systematically screening immigrants for tuberculous infection with the tuberculin test.

Adolescent↗

PubMed1987

Depression in Southeast Asian refugees.

Depressive illness is common among Southeast Asian refugees. Classic vegetative symptoms seem to cross cultural boundaries and have been found in all ethnic groups studied. A migration history is important for eliciting information about the flight experience and the current living situation. Symptomatic treatment, combined with an abbreviated form of psychotherapy, is effective for many patients.

Antidepressive Agents↗

PubMed1985

A rapid appraisal of the nutritional status of Irian Jaya refugees and Papua New Guineans undergoing severe food shortage in the North Fly region.

A survey of nutritional status of recent border crossers from Irian Jaya undergoing severe food shortages was carried out. The two camps visited were those considered to have the most serious problems at the height of the crisis. Komopkin Camp had the highest levels of malnutrition in all age groups and in all categories, including 52% of children aged 1 to 5 years with signs of kwashiorkor. No kwashiorkor, however, was found in the other camp. Papua New Guinea villagers living alongside the refugees in Komopkin were also suffering from malnutrition, though of lesser severity and shorter duration.

Acute Disease↗