Screening for infectious diseases and vaccination status in Ukrainian paediatric refugees: a retrospective cohort
Nina Vaezipour1,2, Sarah Depallens3, Noémie Wagner4,5
1Paediatric Infectious Diseases and Vaccinology, University Children's Hospital Basel, Basel, Switzerland. nina.vaezipour@ukbb.ch.
Insights
Paediatric refugees show low uptake of infectious disease screenings, but catch-up vaccinations are successful. Addressing vaccine hesitancy is key for improving refugee child health.
Area of Science:
- Public Health
- Infectious Diseases
- Pediatrics
Background:
- Paediatric refugees face significant health challenges, yet data for evidence-based care guidelines is scarce.
- Real-world data on the health status and healthcare needs of paediatric Ukrainian refugees is limited.
- Developing effective healthcare strategies for this vulnerable population requires robust data collection.
Purpose of the Study:
- To evaluate healthcare data and adherence to national guidelines for paediatric Ukrainian refugees in Switzerland.
- To assess infectious disease screening rates and vaccination status in this cohort.
- To identify challenges and opportunities for improving healthcare delivery to refugee children.
Main Methods:
- Demographic and health data were collected from 517 paediatric Ukrainian refugees arriving in Switzerland (Feb-Oct 2022).
- Infectious disease screening test results (HIV, Hepatitis B/C, Tuberculosis) and vaccination status were extracted from a REDCap database.
- Adherence to national guidelines for refugee paediatric care was assessed, alongside screening refusal rates.
Main Results:
- Low intention-to-test rates were observed for HIV screening due to high refusal rates.
- Positivity rates for screened infectious diseases were low: HIV (2.7%), Hepatitis B (1.6%), Hepatitis C (0.7%), Tuberculosis (1.0%).
- Initial vaccination coverage varied (71-82%), with vaccine hesitancy as a primary reason for incomplete status; however, 98% completed catch-up programs after arrival and counselling.
Conclusions:
- Challenges exist in the uptake of recommended infectious disease screenings among paediatric refugees, necessitating culturally sensitive strategies.
- Observed infectious disease positivity rates can inform and refine current screening recommendations.
- Counselling effectively addresses vaccine hesitancy, leading to significantly improved vaccination coverage in refugee populations.
Abstract:
Paediatric refugees face heightened health risks. At the same time, lack of real-world data hampers the development of evidence-based guidelines for their health care providers. The aim of the study was to assess health-care data and guideline adherence regarding paediatric Ukrainian refugees. Demographic and health-related data were collected from paediatric Ukrainian refugees who arrived in Switzerland between 24 February and 31 October 2022. Data was obtained from five participating centres. Information on infectious disease screening tests and vaccination status was extracted from a REDCap database. Adherence to national guidelines for the care of Ukrainian paediatric refugees was assessed. Of 517 children enrolled, test positivity rates were 2.7% (2/74) for HIV, 1.6% (2/125) for hepatitis B, 0.7% (2/307) for hepatitis C, and 1.0% (3/308) for tuberculosis screening. A high rate of refusal of HIV screening was observed, substantially reducing the intention-to-test rate (0.38-1.25%). Age-appropriate vaccination status was documented in 71-82% of children for measles-mumps-rubella, diphtheria-tetanus-pertussis, poliomyelitis, and Haemophilus influenzae type b. Main reason for incomplete vaccination status was vaccine hesitancy. Following arrival in Switzerland, 98% (509/517) of participants completed catch-up vaccination programmes.Conclusion: Our findings highlight challenges in the uptake of recommended infectious disease screening among paediatric refugees, underscoring the need for targeted and culturally sensitive screening strategies. The observed positivity rates provide important data to refine current screening recommendations. Moreover, the marked improvement in vaccination coverage after counselling highlights the effectiveness of addressing vaccine hesitancy in refugee populations.
