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At least 19 recordsLinked to original sources
PubMed1989

Psychiatric care of refugees exposed to organized violence. A comparative study of refugees and immigrants in Frederiksborg County, Denmark.

Psychiatry in Scandinavia has a tradition for research and clinical work with people from other countries, especially related to refugees and survivors after the Second World War. In recent years an increasing number of refugees have arrived, especially from the countries of the Middle East. The aim of this study was to evaluate the refugee situation in a Danish county, on the basis of data on 49 refugees treated in the county's psychiatric departments from January 1, 1986 to December 31, 1987 and 44 immigrants seen from January 1, 1983 to December 31, 1987. The clinical data illustrated marked differences between immigrants and refugees with respect to social situation and background, symptom pattern and exposure to organized violence. Both groups terminated treatment after very few contacts, and the psychiatric staff seems to need better training. The general need for psychiatric and psychological treatment of immigrants and refugees is still uncertain and further research is required.

Acculturation↗
PubMed1989

Tuberculin survey among Afghan refugee children. Tuberculosis control programme among Afghan refugees in North West Frontier Province (NWFP) Pakistan.

Since 1982 over 2 million Afghan refugees have settled in the North West Frontier Province (NWFP) of Pakistan. Socio-economical factors, sudden urbanisation and psychological stress may influence the pattern of tuberculosis morbidity and infection among refugees as compared with the original population. In order to study the prevalence of tuberculous infection among Afghan children a tuberculin survey was carried out in April and May 1985 on a cluster sample of male children attending the first two grades of primary schools in refugee camps in the NWFP. The sample size was 4108 male children with an average age of 8 years. 1358 of them, average age of 7.8 years, had not been vaccinated with BCG. An infection prevalence of 13.8% was found when using a transverse diameter of 10 mm induration or more for the tuberculin test as the criterion for infection. The findings were compared with the results of a national sample survey carried out in Afghanistan in 1978: a downward trend of the annual risk of infection (ARI) of 7.8% per year was found in children of the same age group. Thus, Afghan children living in refugee camps in NWFP showed a lower ARI than was observed in their homeland 7 years earlier.

Afghanistan↗
PubMed1989

Baseline health care for refugees in The Netherlands.

In the Netherlands there are some 20,000 refugees from different parts of the world (e.g. Vietnam, Latin America). Most of them have experienced a form of organized violence. The somatic and psychosocial complaints of the refugees are comparable to those of Dutch war victims. They are mostly of an aspecific kind and making a diagnosis can be difficult because of the culturally different presentation of ill being. In order to help general practitioners in making a diagnosis the Refugee Health Centre (CGV) has made a classification of complaints according to whether or not they have a specific cause. It is clear from the literature that there are different opinions about the causes of the somatic complaints. As far as the psychic complaints are concerned it is remarkable that in our pilot study (n = 135) only 6% of the examined refugees suffer from a classical picture of the post-traumatic stress disorder; in a number of cases the picture is limited to some components only. Psychosocial complaints of refugees are subdivided and described. The philosophy of the CGV-treatment is to give assistance as much as possible in the refugee's neighbourhood; so that the clinician(s) will become part of the refugee's new social network. Another very important aspect of the assistance given is preventing medicalization of psychological problems. The basis of help is a recognition of the problems and complaints of the refugee. The structure of the Dutch health care, built up in 'lines', is very often very confusing for a refugee; this confusion can cause communication difficulties between refugee and clinician. To develop methods of treatment, definition and registration of complaints and problems can be a first step.

Health Services Needs and Demand↗
PubMed1989

Changing health beliefs and behaviors of resettled Laotian refugees: ethnic variation in adaptation.

This paper describes traditional and changing health-related beliefs and behaviors of ethnic Lao refugees now resettled in the United States and how these compare with those of other ethnic groups of resettled refugees from Southeast Asia. New data are presented for Southeast Asian refugees resettled in Franklin County, Ohio, including resettlement agency utilization statistics for refugees of each local ethnic group, which reveal that Laotian refugees have the most persistent use of resettlement agency services. The results of in-depth, open ended interviews with members of the Franklin County Lao community are also presented. The interview data pertain to Lao self-perceived health problems and health care options as well as their health beliefs and practices, both traditionally in Laos and as these have changed with refugee flight and resettlement. These data are compared with the results of the limited relevant health-related research on other ethnic groups of Southeast Asian refugees, revealing that Laotian refugees rely to a relatively great extent on the Western biomedical system. It is suggested that the nature of Lao refugee adaptation is due to the continuation of traditional patron-client relationships in the U.S., with Lao patrons referring their refugee clients to the services of agencies and the biomedical establishment.

Adolescent↗
PubMed1988

Malaria in Afghan refugees in Pakistan.

Prevalence of malaria in Afghan refugees in Pakistan is higher than in the local population. Malaria control officials in Pakistan hypothesized that Afghan refugees have brought a heavy load of malaria infections with them from Afghanistan, causing a serious setback to the malaria control programme in Pakistan. The purpose of this study was to test this hypothesis, because it is important regarding the selection of appropriate strategy for malaria control. The proposed hypothesis is rejected because of the following evidence against it: (i) a comparison of age-specific parasite rates of malaria in Afghan refugees and a nearby local population at Karachi indicated that Afghan refugees were susceptible to malaria even in later age-groups, while infections in the local population were limited to younger age-groups; (ii) a comparison of epidemiological trends of malaria in Afghan refugees and the local population in the North-West Frontier Province from 1979 to 1986 demonstrated that the rate of increase in the prevalence of malaria over the years was much higher in Afghan refugees than in the local population, a manifestation of low herd immunity in Afghan refugees. The most plausible alternate hypothesis is that Afghan refugees, being more susceptible, were at high risk of malaria infection in Pakistan rather than that they brought a high infection load with them from Afghanistan. Therefore, malaria control in Afghan refugee camps in Pakistan should be primarily based on preventive, rather than curative, measures.

Adolescent↗
PubMed1990

Tuberculosis morbidity and infection in Vietnamese in Southeast Asian refugee camps.

During the last decade, the refugee population in less-developed countries has undergone unprecedented growth. High tuberculosis rates have been documented in refugees, particularly among those from Asia and Africa, generating interest in tuberculosis control efforts. To assess the tuberculosis burden among Vietnamese refugees, we screened refugees within 1 or 2 days after arrival in camps in Thailand and in the Philippines. Refugees in camps in Thailand were screened with chest radiographs. Persons with radiographic findings consistent with tuberculosis received microscopic and culture examination of sputum specimens. The prevalence of bacteriologically confirmed pulmonary tuberculosis was 5.8 per 1,000 refugees. Males had a higher risk than females (relative risk RR = 1.7, 95% confidence interval CI = 1.2 to 2.4). Refugees in the Philippines were given a tuberculin skin test. An annual risk of infection of 2.2% was calculated for this group. Males had a higher risk of infection (RR = 1.9, 95% CI = 1.5 to 2.4) than females. The age-specific prevalence of tuberculosis and the tuberculous infection increased with age. A high proportion of refugees (85%) with positive tuberculin skin tests were eligible for preventive therapy. Special efforts may be necessary to target Vietnamese refugees, as well as other persons originating from countries of high tuberculosis prevalence, for enhanced diagnostic and preventive intervention against tuberculosis to achieve the national goal of tuberculosis elimination by the year 2010.

Adult↗
PubMed1987

A review of refugee medical screening in New South Wales.

Public health concern in relation to refugees arriving in New South Wales is due to the high prevalence of tuberculosis, syphilis and hepatitis B infection in some refugee groups. Other infectious diseases (with the exception of malaria in the Northern Territory and Queensland) do not pose a significant threat to public health owing to their low prevalence (which may result from overseas screening and treatment) and/or low infectivity in Australian conditions. Because of overseas screening by the Commonwealth Government before the departure of the refugees, it was uncommon in 1984 for previously undetected tuberculosis to be detected when refugees were screened on arrival in Sydney (found in only one in 800 refugees who underwent screening). However, of the refugees in Sydney who had positive results of serological tests for syphilis, a substantial proportion (at times in excess of 50%) had had a negative result at the overseas screening; subsequent follow-up of those with positive serological results indicated inactive disease in almost all cases. There is a need to monitor the infectious disease prevalence and the effectiveness of overseas screening of refugees by on-arrival screening; decisions about screening procedures and the selection of particular incoming refugee groups for screening should be based on sound epidemiological and clinical analysis.

Australia↗
PubMed1987

Prevention of mental disorder among Hmong refugees in the U.S.: lessons from the period 1976-1986.

Scientifically valid, well controlled studies on the prevention of mental disorders are sparse. Nonetheless, much quasi-experimental and descriptive work does exist. Published findings permit an evaluation of the mental health effects of policies, procedures and programs designed for refugees. The federal government assigns legal status to refugees and is paramount in matters of refugee relocation and readjustment within its borders. In matters of social adjustment and prevention of mental disorder, agents of the federal government must consider the accumulation and distribution of knowledge, skill and expertise on refugee social and mental health issues; policies and procedures for relocation; premigration education, training, assessment, and orientation; postmigration support and acculturation; and the development of treatment resources to meet the mental health needs. Once refugees arrive in the United States of America, much of the actual implementation of policy and procedures has been left to state governments. At this level there have been neither the resources nor the expertise to develop programs for the mental health of refugees. Limited resources have been wasted and the mental health of refugees has been neglected or made worse by some state initiated programs.

Adolescent↗
PubMed1991

From post-traumatic stress disorder to cultural bereavement: diagnosis of Southeast Asian refugees.

There are pitfalls in the singular application of western categories in diagnosing psychiatric disorders and distress among refugees. Based on my research with Cambodian refugees I argue that cultural bereavement, by mapping the subjective experience of refugees, gives meaning to the refugee's distress, clarifies the 'structure' of the person's reactions to loss, frames psychiatric disorder in some refugees, and complements the psychiatric diagnostic categories. Cultural bereavement includes the refugees' picture--what the trauma meant to them; their cultural recipes for signalling their distress; and their cultural strategies for overcoming it--and the cultural interpretation of symptoms commonly found among refugees that resemble post-traumatic stress disorder. Cultural bereavement may identify those people who have post-traumatic stress disorder on the Diagnostic and Statistical Manual (DSM) criteria but whose 'condition' is a sign of normal, even constructive, rehabilitation from devastatingly traumatic experiences. Cultural bereavement should be given appropriate status in the nosology.

Adolescent↗
PubMed1990

Mortality trends among refugees in Honduras, 1984-1987.

Mortality data collected from 1984 to 1987 through a routine standardized health information system in the five main refugee populations of Honduras were reviewed. The direct standardized mean annual death rate for all refugees was 5.5 per 1000 population (Honduras population as reference; Honduras mortality rate: 10.1 per 1000). Mortality decreased or remained stable among Salvadoran refugees from 1984 to 1987, but increased among Nicaraguan refugees after 1985. The highest neonatal (56.1 per 1000 livebirths), infant (126.1 per 1000 livebirths) and under-five-year-olds (35.7 per 1000 child less than five years of age) mortality rates were observed in the two Nicaraguan camps. These two camps had the highest rate of newly arriving refugees. Deaths in infants and under-five-year-olds accounted for 42 and 54.1% of all deaths respectively. Of all deaths under five years of age, respiratory infections, diarrhoeal diseases and measles accounted for 21.4%, 22.1% and 4.7%, respectively. Mortality rates, particularly among under-five-year-olds and infants increased when the rate of newly arriving refugees was higher. The importance of adapted health surveillance in refugee settlements is discussed.

Adolescent↗
PubMed1991

An alternative to 'two-step' tuberculin skin testing for Southeast Asian refugees.

Previous studies report that Southeast Asian refugees demonstrate very high incidences of positive reactions to two-step tuberculin testing. In spite of these findings, fiscal restraints have limited the use of two-step testing in some of the centers that screen large numbers of these refugees. In this study, 101 Southeast Asian refugees were studied for their antigenic response to the tuberculin skin test. Forty-nine had positive reactions when the tuberculin skin test was read at 48 hours. Of the 52 refugees who showed a negative reaction at 48 hours, 22 had positive reactions when read a second time, three to five days later. The 28 refugees with negative reactions at both 48 hours and at five to seven days underwent two-step tuberculin testing. Only two of the 28 demonstrated positive reactions with two-step testing. Of the refugees with positive reactions at 48 hours, all but one continued to show positive reactions when the skin test was read a second time, at five to seven days. These findings suggest that a single tuberculin skin test, read at five to seven days, may provide a cost-effective alternative to two-step tuberculin testing for Southeast Asian refugees.

Adolescent↗