Prevalence of infectious diseases, immunity to vaccine-preventable diseases and chronic medical conditions among Ukrainian refugees in Germany - A cross sectional study from the German Network University Medicine (NUM).

Infections Infectious diseases Severe Acute Respiratory Syndrome Coronavirus-2 Ukraine refugees

Journal

Journal of infection and public health
ISSN: 1876-035X
Titre abrégé: J Infect Public Health
Pays: England
ID NLM: 101487384

Informations de publication

Date de publication:
16 Feb 2024
Historique:
received: 21 08 2023
revised: 26 01 2024
accepted: 05 02 2024
medline: 9 3 2024
pubmed: 9 3 2024
entrez: 8 3 2024
Statut: aheadofprint

Résumé

Vulnerability to infectious diseases in refugees is dependent on country of origin, flight routes, and conditions. Information on specific medical needs of different groups of refugees is lacking. We assessed the prevalence of infectious diseases, immunity to vaccine-preventable diseases, and chronic medical conditions in children, adolescents, and adult refugees from Ukraine who arrived in Germany in 2022. Using different media, we recruited Ukrainian refugees at 13 sites between 9-12/2022. An antigen test for acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection, serologies for a range of vaccine-preventable diseases, as well as interferon gamma release assays (IGRAs) for tuberculosis (TB), and SARS-CoV-2 were performed. We assessed personal and family history of chronic medical conditions, infectious diseases, vaccination status, and conditions during migration. Overall, 1793 refugees (1401 adults and 392 children/adolescents) were included. Most participants were females (n = 1307; 72·3%) and from Eastern or Southern Ukraine. TB IGRA was positive in 13% (n = 184) of the adults and in 2% (n = 7) of the children. Serology-based immunological response was insufficient in approximately 21% (360/1793) of the participants for measles, 32% (572/1793) for diphtheria, and 74% (1289/1793) for hepatitis B. We show evidence of low serological response to vaccine-preventable infections and increased LTBI prevalence in Ukrainian refugees. These findings should be integrated into guidelines for screening and treatment of infectious diseases in migrants and refugees in Germany and Europe. Furthermore, low immunity for vaccine-preventable diseases in Ukrainians independent of their refugee status, calls for tailor-made communication efforts.

Sections du résumé

BACKGROUND BACKGROUND
Vulnerability to infectious diseases in refugees is dependent on country of origin, flight routes, and conditions. Information on specific medical needs of different groups of refugees is lacking. We assessed the prevalence of infectious diseases, immunity to vaccine-preventable diseases, and chronic medical conditions in children, adolescents, and adult refugees from Ukraine who arrived in Germany in 2022.
METHODS METHODS
Using different media, we recruited Ukrainian refugees at 13 sites between 9-12/2022. An antigen test for acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection, serologies for a range of vaccine-preventable diseases, as well as interferon gamma release assays (IGRAs) for tuberculosis (TB), and SARS-CoV-2 were performed. We assessed personal and family history of chronic medical conditions, infectious diseases, vaccination status, and conditions during migration.
RESULTS RESULTS
Overall, 1793 refugees (1401 adults and 392 children/adolescents) were included. Most participants were females (n = 1307; 72·3%) and from Eastern or Southern Ukraine. TB IGRA was positive in 13% (n = 184) of the adults and in 2% (n = 7) of the children. Serology-based immunological response was insufficient in approximately 21% (360/1793) of the participants for measles, 32% (572/1793) for diphtheria, and 74% (1289/1793) for hepatitis B.
CONCLUSIONS CONCLUSIONS
We show evidence of low serological response to vaccine-preventable infections and increased LTBI prevalence in Ukrainian refugees. These findings should be integrated into guidelines for screening and treatment of infectious diseases in migrants and refugees in Germany and Europe. Furthermore, low immunity for vaccine-preventable diseases in Ukrainians independent of their refugee status, calls for tailor-made communication efforts.

Identifiants

DOI: 10.1016/j.jiph.2024.02.003 PMID: 38458134
pubmed: 38458134
pii: S1876-0341(24)00029-7
doi: 10.1016/j.jiph.2024.02.003
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

642-649

Informations de copyright

Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors have no conflicts of interest.

Auteurs

Folke Brinkmann (F)

University Children's Hospital, Katholisches Klinikum Bochum, Ruhr-University Bochum, Bochum, Germany.

Anette Friedrichs (A)

Department of Internal Medicine I, Infectious Diseases, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.

Georg Mn Behrens (GM)

Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany; German Center for Infection Research, Site Hannover-Braunschweig, Hannover, Germany.

Pia Behrens (P)

Goethe University Frankfurt, University Hospital Frankfurt, Department of Internal Medicine, Infectious Diseases, Frankfurt am Main, Germany.

Reinhard Berner (R)

Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany.

Amke Caliebe (A)

Institute of Medical Informatics and Statistics, Kiel University and University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.

Claudia M Denkinger (CM)

Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany; German Centre for Infection Research, partner site Heidelberg, Germany.

Katharina Giesbrecht (K)

Goethe University Frankfurt, University Hospital Frankfurt, Department of Internal Medicine, Infectious Diseases, Frankfurt am Main, Germany.

Alexander Gussew (A)

Clinic and Policlinic of Radiology, University Medical Clinic Halle, Halle (Saale), Germany.

Anna Theresa Hoffmann (AT)

University Children's Hospital, Katholisches Klinikum Bochum, Ruhr-University Bochum, Bochum, Germany.

Leonhard Hojenski (L)

Department of Internal Medicine I, Infectious Diseases, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.

Olga Hovardovska (O)

Department of Epidemiology, Helmholtz Centre for Infection Research Braunschweig, Germany; German Centre for Infection Research, TI BBD, Helmholtz Centre for Infection Research, Braunschweig, Germany.

Alexandra Dopfer-Jablonka (A)

Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany; German Center for Infection Research, Site Hannover-Braunschweig, Hannover, Germany.

Achim J Kaasch (AJ)

Institute of Medical Microbiology and Hospital Hygiene, Faculty of Medicine, Otto-von-Guericke-University Magdeburg.

Robin Kobbe (R)

Institute for Infection Research and Vaccine Development (IIRVD), University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.

Monika Kraus (M)

Institute of Epidemiology, Helmholtz Zentrum München, Munich, Germany.

Andreas Lindner (A)

Charité - Universitätsmedizin Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany.

Christoph Maier (C)

University Children's Hospital, Katholisches Klinikum Bochum, Ruhr-University Bochum, Bochum, Germany.

Lazar Mitrov (L)

University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Germany.

Matthias Nauck (M)

Institute of Clinical Chemistry and Laboratory Medicine, University Medicine of Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovacsular Research), Partner Site Greifswald, University Medicine, Greifswald, Germany.

Susana Nunes de Miranda (SN)

University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Germany.

Margarete Scherer (M)

Goethe University Frankfurt, University Hospital Frankfurt, Department II of Internal Medicine, Hematology/Oncology, Frankfurt am Main, Germany.

Yvonne Schmiedel (Y)

Department of Internal Medicine I, Infectious Diseases, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.

Dana Stahl (D)

Trusted Third Party of the University Medicine Greifswald, Greifswald, Germany.

Nina Timmesfeld (N)

Department of Medical Informatics, Biometry and Epidemiology, Ruhr University Bochum, Germany.

Nicole Toepfner (N)

Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany.

Janne Vehreschild (J)

DZHK (German Centre for Cardiovacsular Research), Partner Site Greifswald, University Medicine, Greifswald, Germany.

Walter A Wohlgemuth (WA)

Clinic and Policlinic of Radiology, University Medical Clinic Halle, Halle (Saale), Germany.

Astrid Petersmann (A)

Institute of Clinical Chemistry and Laboratory Medicine, University Medicine of Greifswald, Greifswald, Germany; Institute for Clinical Chemistry and Laboratory Medicine, University Medicine Oldenburg, Oldenburg, Germany.

Maria J G T Vehreschild (MJGT)

Goethe University Frankfurt, University Hospital Frankfurt, Department of Internal Medicine, Infectious Diseases, Frankfurt am Main, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany. Electronic address: vehreschild@med.uni-frankfurt.de.

Classifications MeSH