Medical check-up of newly arrived unaccompanied minors: A dedicated pediatric consultation service in a hospital.


Journal

Archives de pediatrie : organe officiel de la Societe francaise de pediatrie
ISSN: 1769-664X
Titre abrégé: Arch Pediatr
Pays: France
ID NLM: 9421356

Informations de publication

Date de publication:
Nov 2021
Historique:
received: 02 11 2020
revised: 15 03 2021
accepted: 26 09 2021
pubmed: 11 11 2021
medline: 15 12 2021
entrez: 10 11 2021
Statut: ppublish

Résumé

Healthcare for the increasing number of migrants in Europe, and particularly of unaccompanied minors (UMs) seeking asylum, has become a major challenge. We aimed to describe the health issues of UMs managed in a dedicated pediatric consultation service in a care center in Paris. All UMs attending a dedicated migrant medical consultation service in Robert Debré Hospital, Paris, France, were included in a single-center retrospective observational study from September 1, 2017, to September 30, 2018. Out of the 107 UMs who were included, 87% had a health problem (n=93) and 52% had an infectious disease (n=56). The main infectious diagnoses were schistosomiasis (22%), latent tuberculosis (22%), intestinal parasitosis (16%), and chronic hepatitis B (8%). Posttraumatic stress disorder (PTSD) and overweight were common (35% and 20%, respectively). The median age was 15 years old (IQR, 14-16), the male/female ratio was 95/12. Most of the children were from sub-Saharan Africa (n=67), 46% had crossed Libya (n=49) and, when compared to the other migration routes, faced an increasing risk of violence (69%, p=0.04), imprisonment (53%, p=0.03), and forced labor (48%, p=0.02). The median duration of the trip before reaching France was 6 months (IQR, 2-13), the median time to consultation was 2 months (0-5) and was not associated with an increased risk of health problems. A total of 43 UMs were lost to follow-up. Health problems, particularly infectious diseases and PTSD, are common among UMs and should prompt an early medical consultation with psychiatric evaluation. Follow-up is problematic and could be improved by an on-line health book.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
Healthcare for the increasing number of migrants in Europe, and particularly of unaccompanied minors (UMs) seeking asylum, has become a major challenge. We aimed to describe the health issues of UMs managed in a dedicated pediatric consultation service in a care center in Paris.
METHODS METHODS
All UMs attending a dedicated migrant medical consultation service in Robert Debré Hospital, Paris, France, were included in a single-center retrospective observational study from September 1, 2017, to September 30, 2018.
RESULTS RESULTS
Out of the 107 UMs who were included, 87% had a health problem (n=93) and 52% had an infectious disease (n=56). The main infectious diagnoses were schistosomiasis (22%), latent tuberculosis (22%), intestinal parasitosis (16%), and chronic hepatitis B (8%). Posttraumatic stress disorder (PTSD) and overweight were common (35% and 20%, respectively). The median age was 15 years old (IQR, 14-16), the male/female ratio was 95/12. Most of the children were from sub-Saharan Africa (n=67), 46% had crossed Libya (n=49) and, when compared to the other migration routes, faced an increasing risk of violence (69%, p=0.04), imprisonment (53%, p=0.03), and forced labor (48%, p=0.02). The median duration of the trip before reaching France was 6 months (IQR, 2-13), the median time to consultation was 2 months (0-5) and was not associated with an increased risk of health problems. A total of 43 UMs were lost to follow-up.
CONCLUSION CONCLUSIONS
Health problems, particularly infectious diseases and PTSD, are common among UMs and should prompt an early medical consultation with psychiatric evaluation. Follow-up is problematic and could be improved by an on-line health book.

Identifiants

pubmed: 34756657
pii: S0929-693X(21)00161-5
doi: 10.1016/j.arcped.2021.09.012
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

689-695

Informations de copyright

Copyright © 2021 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None.

Auteurs

A Bergevin (A)

General Pediatric Department, Nord Ouest Hospital, Villefranche sur Saône, 69655 France; Pediatric Residents Association, AJP, Paris, 75 France. Electronic address: bergevinalice@yahoo.fr.

M Husain (M)

Pediatric Residents Association, AJP, Paris, 75 France.

M Cruz (M)

Pediatric Residents Association, AJP, Paris, 75 France; APHP, General Pediatric Department Robert Debré Hospital, Paris 75019 France.

C Le Blanc (CL)

Pediatric Residents Association, AJP, Paris, 75 France; APHP, General Pediatric Department Jean Verdier Hospital, Bondy 93140 France.

A Dieme (A)

Pediatric Residents Association, AJP, Paris, 75 France; General Pediatric Department Ambroise Paré, Boulogne-Billancourt 92100 France.

M-L Girardin (ML)

Pediatric Residents Association, AJP, Paris, 75 France; Pediatric Intensive Care Unit, Hautepierre Hospital, Strasbourg 67200 France.

C Toujouse (C)

Pediatric Residents Association, AJP, Paris, 75 France.

R Ben Tkhayat (RB)

Pediatric Residents Association, AJP, Paris, 75 France.

S Slabab (S)

Pediatric Residents Association, AJP, Paris, 75 France.

O Corseri (O)

Pediatric Residents Association, AJP, Paris, 75 France; APHP, General Pediatric Department Robert Debré Hospital, Paris 75019 France.

M Maglorius (M)

Pediatric Residents Association, AJP, Paris, 75 France.

C Vercamer (C)

Pediatric Residents Association, AJP, Paris, 75 France; APHP, General Pediatric Department Jean Verdier Hospital, Bondy 93140 France.

E Eskander (E)

Pediatric Residents Association, AJP, Paris, 75 France.

E Desselas (E)

Pediatric Residents Association, AJP, Paris, 75 France; General Pediatric Department Montpellier Hospital, Paris 34295 France.

N Lachaume (N)

APHP, General Pediatric Department Robert Debré Hospital, Paris 75019 France; APHP, General Pediatric Department Louis Mourier Hospital, Colombes, 92700 France.

A Garraffo (A)

APHP, General Pediatric Department Robert Debré Hospital, Paris 75019 France; Pediatric Department, Villeneuve-Saint-Georges Hospital, Villeneuve-Saint-Georges, 94190 France.

F Sorge (F)

APHP, General Pediatric Department Robert Debré Hospital, Paris 75019 France; APHP, General Pediatric Department Necker Hospital, Paris, 75015 France.

E Le Roux (EL)

Clinical Epidemiology Department Robert Debré Hospital, Paris, 48 boulevard Sérurier 75019 France; Paris Diderot Medical University, 10 avenue de Verdun Paris, 75010 France; ECEVE, INSERM 1123, 10 avenue de Verdun Paris, 75010 France.

J Gaschignard (J)

APHP, General Pediatric Department Robert Debré Hospital, Paris 75019 France.

M Caseris (M)

APHP, General Pediatric Department Robert Debré Hospital, Paris 75019 France.

A Faye (A)

APHP, General Pediatric Department Robert Debré Hospital, Paris 75019 France; Clinical Epidemiology Department Robert Debré Hospital, Paris, 48 boulevard Sérurier 75019 France; Paris Diderot Medical University, 10 avenue de Verdun Paris, 75010 France. Electronic address: albert.faye@aphp.fr.

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