Health profile of pediatric Special Immigrant Visa holders arriving from Iraq and Afghanistan to the United States, 2009–2017: A cross-sectional analysis


Autoři: Simone S. Wien aff001;  Gayathri S. Kumar aff001;  Oleg O. Bilukha aff003;  Walid Slim aff004;  Heather M. Burke aff001;  Emily S. Jentes aff001
Působiště autorů: Immigrant, Refugee, and Migrant Health Branch, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America aff001;  Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, United States of America aff002;  Emergency Response and Recovery Branch, Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America aff003;  Migration Health Division, International Organization for Migration, Erbil, Iraq aff004;  Migration Health Division, International Organization for Migration, Amman, Jordan aff005
Vyšlo v časopise: Health profile of pediatric Special Immigrant Visa holders arriving from Iraq and Afghanistan to the United States, 2009–2017: A cross-sectional analysis. PLoS Med 17(3): e32767. doi:10.1371/journal.pmed.1003069
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pmed.1003069

Souhrn

Background

The United States has admitted over 80,000 Special Immigrant Visa holders (SIVH), which include children. Despite the increase in the proportion of SIVH admissions to the US over recent years, little is known about health conditions in SIV children. We report the frequency of selected diseases identified overseas and assess differences in selected conditions between SIV children from Iraq and Afghanistan.

Methods and findings

We analyzed 15,729 overseas medical exam data in Centers for Disease Control and Prevention’s Electronic Disease Notification system (EDN) for children less than 18 years of age from Iraq (29.1%) and Afghanistan (70.9%) who were admitted to the US from April 2009 through December 2017 in a cross-sectional analysis. Variables included age, sex, native language, measured height and weight, and results of the overseas medical examination. From our analysis, less than 1% of SIV children (Iraqi: 0.1%; Afghan: 0.12%) were reported to have abnormal tuberculosis test findings, less than 1% (Iraqi: 0.3%; Afghan: 0.7%) had hearing abnormalities, and about 4% (Iraqi: 6.0% Afghan: 2.9%) had vision abnormalities, with a greater prevalence of vision abnormalities noted in Iraqis (OR: 1.9, 95% CI 1.6–2.2, p <0.001). Seizure disorders were noted in 46 (0.3%) children, with Iraqis more likely to have a seizure disorder (OR: 7.6, 95% CI 3.8–15.0, p < 0.001). On average, children from Afghanistan had a lower mean height-for-age z-score (Iraqi: −0.28; Afghan: −0.68). Only the data quality assessment for height for age for children ≥5 years fell within WHO recommendations. Limitations included the inability to obtain all SIVH records and self-reported medical history of noncommunicable diseases.

Conclusion

In this investigation, we found that less than 1% of SIV children were reported to have abnormal tuberculosis test findings and 4% of SIV children had reported vision abnormalities. Domestic providers caring for SIVH should follow the US Centers for Disease Control and Prevention (CDC) Guidelines for the US Domestic Medical Examination for Newly Arriving Refugees, including an evaluation for malnutrition. Measurement techniques and anthropometric equipment used in panel site clinics should be assessed, and additional training in measurement techniques should be considered. Future analyses could further explore the health of SIV children after resettlement in the US.

Klíčová slova:

Anthropometry – Children – Language – Malnutrition – Pediatrics – SIV – Tuberculosis – United States


Zdroje

1. Refugee Processing Center, Bureau of Population, Refugees, and Migration, Office of Admissions, US Department of State. Admissions and Arrivals [cited 2019 Mar 26]. Available from: https://www.wrapsnet.org/admissions-and-arrivals/.

2. Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, US Department of Health and Human Services. Medical Examination of Immigrants and Refugees. 2012 [cited 2019 Mar 26]. Available from: http://www.cdc.gov/immigrantrefugeehealth/exams/medical-examination.html.

3. Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, US Department of Health and Human Services. CDC Immigration Requirements: Technical Instructions for Other Physical or Mental Abnormality, Disease, or Disability. 2012 [cited 2020 Jan 12]. Available from: https://www.cdc.gov/immigrantrefugeehealth/exams/ti/panel/technical-instructions/panel-physicians/other-physical-mental.html.

4. Lee D, Philen R, Wang Z, McSpadden P, Posey D, Ortega L, et al. Disease surveillance among newly arriving refugees and immigrants—Electronic Disease Notification System, United States, 2009. Morbidity and Mortality Weekly Report: Surveillance Summaries. 2013; 62(7): 1–20.

5. World Health Organization. World Health Organization Anthro for personal computers, version 3.2.2, 2011: Software for assessing growth and development of the world’s children. Geneva: World Health Organization; 2011 [cited 2019 Mar 26]. Available from: http://www.who.int/childgrowth/software/en/.

6. World Health Organization. World Health Organization Growth Reference, 5–19 Years, BMI-for-age. Geneva: World Health Organization; 2007 [cited 2019 Mar 26]. Available from: https://www.who.int/growthref/who2007_bmi_for_age/en/.

7. World Health Organization. World Health Organization Global Database on Child Growth and Malnutrition. Geneva: World Health Organization; 1997 [cited 2019 Mar 26]. Available from: https://www.who.int/nutgrowthdb/about/introduction/en/index5.html.

8. Bennet R, Eriksson M. Tuberculosis infection and disease in the 2015 cohort of unaccompanied minors seeking asylum in Northern Stockholm, Sweden. Infectious Diseases. 2017; 49(7): 501–6. doi: 10.1080/23744235.2017.1292540 28276801

9. Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, US Department of Health and Human Services. Tuberculosis Technical Instructions for Panel Physicians. 2019 [cited 2019 Apr 7]. Available from: https://www.cdc.gov/immigrantrefugeehealth/exams/ti/panel/tuberculosis-panel-technical-instructions.html.

10. Schwartzman K, Oxlade O, Barr G, Grimard F, Acosta I, Baez J, et al. Domestic returns from investment in the control of tuberculosis in other countries. New England Journal of Medicine. 2005; 353(10): 1008–20. doi: 10.1056/NEJMsa043194 16148286

11. Posey D, Naughton M, Willacy E, Russell M, Olson C, Godwin C, et al. Implementation of new TB screening requirements for US-bound immigrants and refugees—2007–2014. Morbidity and Mortality Weekly Report. Morbidity and Mortality Weekly Report. 2014; 63(11): 234. 24647399

12. Wingate L, Coleman M, Posey P, Zhou W, Olson C, Maskery B, et al. Cost-effectiveness of screening and treating foreign-born students for tuberculosis before entering the United States. PLoS ONE. 2015; 10(4).

13. Maskery B, Posey D, Coleman M, Asis R, Zhou W, Painter J, et al. Economic analysis of CDC's culture-and smear-based tuberculosis instructions for Filipino immigrants. International Journal of Tuberculosis and Lung Disease. 2018; 22(4): 429–36. doi: 10.5588/ijtld.17.0453 29562992

14. Afghanistan Ministry of Public Health, UNICEF. National Nutrition Survey Afghanistan (2013). 2013 [cited 2019 Mar 26]. Available from: https://reliefweb.int/report/afghanistan/national-nutrition-survey-afghanistan-2013 NNS Afghanistan 2013 (July 26–14).pdf.

15. World Health Organization, Department of Nutrition for Health and Development. Nutrition Landscape Information System. Geneva: World Health Organization [cited 2019 Mar 26]. Available from: https://www.who.int/nutrition/nlis/en/.

16. Dawson-Hahn E, Pak-Gorstein S, Hoopes A, Matheson J. Comparison of the nutritional status of overseas refugee children with low income children in Washington State. PLoS ONE. 2016; 11(1).

17. Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, US Department of Health and Human Services. Guidelines for the US Domestic Medical Examination for Newly Arriving Refugees. 2019 [cited 2019 Mar 26]. Available from: https://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/domestic-guidelines.html.


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