Health and illness in migrants and refugees arriving in Europe: analysis of the electronic Personal Health Record system

Author/s: Dominik Zenner, Ana Requena Méndez, Steffen Schillinger, Elena Val, Kolitha Wickramage
Year:
Language: English
Publication Type: Scientific report (Journal)(External)

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Migration Health Research Podcast No. 11 (Migration Health Research Bulletin #24) 
Dr. Ana Requena-Méndez, Assistant Research Professor at the Department of Medicine Solna, Karolinska Institutet, Sweden and Barcelona Institute for Global Health, Spain speaks about a health information system that registers health data on newly arriving migrants and what they found out about the health status of migrants.

 

Description

Abstract

Background
The electronic Personal Health Record (ePHR) is a health information system that registers health data on newly arriving migrants and was implemented in eight European countries (Bulgaria, Croatia, Cyprus, Greece, Italy, Romania, Serbia and Slovenia). This is a cross-sectional study aimed to describe the health problems and health status of all migrants attended at health clinics as part of the health assessment program established in the reception centres (2016–2019).

Methods
Data were collected on demographics, clinical and laboratory findings and diagnostics performed, including medical records. We classified all diseases using pre-specified algorithms according to information on pre-specified variables from the ePHR questionnaire, ICD-10 codes, positive laboratory findings or review of medical records. Crude proportions were calculated and odds ratios (OR) estimated using logistic regression modelling.

Results
The ePHR dataset contained a total of 19 564 clinical episodes in 14 436 individuals, recorded between January 2016 and October 2019. Most individuals (75%) were refugees or asylum seekers (22%) from 92 different nationalities. There were 2531/19 564 (12.9%) infectious diseases episodes reported during the study period, being 1283/2531 (50.7%) of them pharyngo-tonsillitis, 529 (20.9%) scabies, 158 (6.2%) viral hepatitis and 156(6.1%) lower respiratory infections. There were 2462 (17.1%) individuals with non-communicable diseases reported; including 821 (5.7%) cardiovascular diseases, 1183 (8.2%) neurological condition, 644 (4.5%) Diabetes mellitus and 212 (1.5%) kidney disease cases. Having Diabetes Mellitus (adjusted OR, aOR 3.3, [95% confidence interval, CI 2.7–4.1], P < 0.001), and neurological disorders (aOR 1.8, [95% CI 1.4–2.2], P < 0.001) were associated with cardiovascular disorders in the multivariable logistic regression model.

Mental health problems were reported in 641/14 436 (4.4%) individuals and were associated with increasing age. Furthermore, 610 episodes of acute injuries were reported among 585/14 436 (4.1%) people, 517 (88.4%) of them in men (P < 0.001).

Conclusions
The ePHR is a valuable tool to efficiently collect health-related data to better address migrant health issues. We described a mostly healthy population with many acute infectious disease episodes particularly in children, but also with significant number of chronic conditions and less frequent injuries or mental health problems.

Publisher
Journal of Travel Medicine