Search

Purpose: Syrian refugees (SRs) have had difficulties in the diagnosis, treatment, and follow-up of chronic diseases, such as cancer, because of the conflict in the region. The cancer diagnosis and treatment process of SR are also a matter of curiosity. We aimed to compare the demographic characteristics and survival outcome data of SRs and Turkish citizens (TCs), and colorectal cancer (CRC) is one of the most common cancer types seen with similar frequency globally., Materials and Methods: A total of 421 patients with CRC were included. Overall survival (OS) was estimated using the Kaplan-Meier method, and the log-rank test was used for comparison. Patient demographic data were compared using the Pearson Chi-square test and independent t test., Results: In total, 421 patients (282 TCs and 139 SRs) were included in this study. The mean age was 52.9 ± 14.3 years for the entire population: 55.3 ± 14.1 years for TCs and 47.9 ± 13.4 years for SRs. Forty (29%) SRs and 60 (21.4%) TCs had de novo metastatic disease ( P = .08). The median OS in the general population was 57.9 months (95% CI, 40.1 to 75.7), whereas it was 80.9 months (95% CI, 56.5 to 97.2) in TCs and 42.2 months in SRs (95% CI, 27.0 to 57.4; P = .006). In the nonmetastatic group, the median OS did not reach (NR) in TCs, and it was 52.6 months (95% CI, 43.7 to 61.5) in SRs ( P = .02). In the metastatic group, the median OS was 21 months (95% CI, 8.5 to 29.2) in TCs, and it was 18.9 months in SRs (95% CI, 16.3 to 25.7; P = .93)., Conclusion: The survival rate was lower in the SR group. Since CRC is also common among refugees, developing and implementing methods to improve the welfare of vulnerable populations is necessary.

Introduction: This study examines the health problems and healthcare needs of refugee and asylum-seeker children and aims to develop strategies for improvement., Methods: Based on quantitative data from 448 refugee and asylum-seeker children and 222 non-refugee local children, this study was conducted at Düzce University, Department of Paediatrics, between 2010 and 2021. The refugee children originated from three countries: Iraq (n = 304), Syria (n = 101) and Afghanistan (n = 43). The data were analysed using the SPSS data analysis program. Ethical clearance was obtained from the Ethics Committee of Düzce Üniversity., Results: The results suggest that refugee and asylum-seeker children have significantly higher rates of acute illness or infection, malnutrition (p < 0.001) and anaemia (p < 0.001) than local children as a result of living in overcrowded families (p = 0.017) and unhealthy conditions. Adolescent pregnancy (p = 0.049) emerges as an important social problem as a result of child marriage among refugee children, mostly in the form of consanguineous marriages (p < 0.001). The rate of having at least two adolescent pregnancies (under 18) was highest among Syrian refugee girls (p = 0.01). Although refugee and asylum-seeker children have higher rates of health insurance (between 74% and 95%), they have lower rates of insurance compared to local children. This research also compares the data from three nationalities, including Syria, Afghanistan and Iraq children; Iraqi and Afghan children under the international protection (IP) system with limited social support and rights had worse health conditions compared to other groups. Although Iraqi children had the highest rates of health insurance on admission (p < 0.001), they also had higher rates of chronic diseases (p = 0.001), infections (p = 0.004), allergic rhinitis (p = 0.001) and malnutrition (p < 0.001). The youngest age of admission (p = 0.006) and the shortest length of stay (p = 0.004) were for Afghan children who also had higher rates of upper respiratory infections (p = 0.021)., Conclusions: This study highlights the urgent need for improved screening programmes and the importance of collaborative efforts to address the specific health needs of these populations. Addressing the health status of child refugees is a complex and multifaceted task that requires the active participation of healthcare professionals, policymakers and researchers, each of whom has a crucial role to play., (© 2024 John Wiley & Sons Ltd.)

Background: The perinatal and neonatal outcomes of Syrian refugees during the coronavirus disease 2019 (COVID-19) pandemic are unknown. Therefore, in this study, we aimed to evaluate these outcomes., Methods: Turkish (n = 303) and Syrian refugees (n = 303) who delivered in our hospital between June 1, 2020 and December 31, 2020 were included in the study. Demographic, perinatal, and neonatal data were obtained by retrospectively evaluating hospital records., Results: Adolescent pregnancy was more common in Syrian refugees (p < 0.001). The rates of antenatal visits, performed combined test, triple test, quadruple test, fetal anatomy ultrasound, and glucose tolerance test were lower in all refugees (p < 0.01). Furthermore, there was no difference in the mode of delivery, Hb after delivery, gestational age, birth weight, Apgar score, stillbirth, and fetal anomaly (p > 0.05 for all)., Conclusion: Despite poorer antenatal care during the COVID-19 pandemic, Syrian refugee pregnant women had similar perinatal and neonatal outcomes compared with the Turkish pregnant population., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Cancer is a significant health problem for refugees and host countries. Breast cancer is the most common cancer among refugees. The subject of our study is to examine the clinical and pathological features of Syrian refugees with breast cancer and compare them with Turkish patients with breast cancer., Methods: Data of patients with breast cancer between January 2018 and December 2020 were retrospectively reviewed. The clinical and histological features, treatment modalities and overall survival were collected and analyzed., Results: A total number of 338 women with breast cancer were included in this study. Ninety-nine of the 338 (29.3%) patients were Syrian refugees and 239 patients (70.7%) were Turkish. The median follow-up time was significantly lower in Syrian patients ( P <0.001). Median OS was 146 months in Turkish and 116 months in Syrian group ( P =0.022). Independent risk factors associated with long survival were receiving adjuvant chemotherapy (HR 0.465; 95% CI 0.234-0.926; P =0.029), adjuvant radiotherapy (HR 0.372 95% CI 0.182-0.758; P =0.007), and adjuvant hormonotherapy (HR 0.367; 95% CI 0.201-0.669; P =0.001). The rates of receiving adjuvant chemotherapy, adjuvant radiotherapy, and adjuvant hormonal therapy were significantly lower in the Syrian group ( P =0.023, P =0.005, P =0.002, respectively)., Conclusion: Syrian refugees with breast cancer are more likely to receive suboptimal treatments. They have inferior survival compared to local patients. Our findings highlight the need for the provision of cancer therapy in such vulnerable populations. We suggest that more attention should be paid to breast cancer, as it is the most common cancer among refugees., (© 2023 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Background: As a result of the Syrian civil war, > 5 million Syrian citizens have fled to neighbouring countries, particularly Turkey, under refugee status., Aims: To analyse the cost and justification for surgery of Syrian refugees treated in a secondary care hospital in Sanliurfa, Southeastern Turkey, close to the Syrian border., Methods: We enrolled 1458 Syrian refugees who were operated upon between 2012 and 2015. The data were obtained through a retrospective search of the hospital information system. Patients were divided into traumatic and nontraumatic cases. Injured body regions, anaesthetic technique, duration of operation, length of hospital stay, sociodemographic features and treatment cost were recorded and analysed., Results: Length of the hospital stay was 7.66 (0.31) days for all 1458 patients. The most common operations were orthopaedic, urological and cranial surgery. The total healthcare costs while patients stayed in hospital was ~US$ 2 million, and cost per patient was US$ 1400., Conclusions: The number of trauma operations performed has declined between 2012 and 2015. Health spending on refugees is an indicator of the economic burden on the country., (Copyright © World Health Organization (WHO) 2021. Open Access. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).)

The objective of this study; is to find out the sensitivity, the concern that are created by the Covid-19 pandemic on the Syrian refugees, who live in Kilis province of Turkey and have different life standards and status and to find out their possibilities and attitudes of prevention from and combating the pandemic. The data of the study were collected between 12-16 April 2020 by applying a questionnaire on 414 refugees. According to the study results, it has been discovered that the refugees have concerns about Covid-19 and their insensitivity levels are low. It has been seen that there is a group who are not aware of the seriousness of the pandemic, who do not have enough information about the pandemic and cannot reach personal protective equipment (such as masks, gloves). In general, in the fight against pandemic; the levels of refugees' following the rules and their finding the decisions taken and implemented proper, can be defined as close to each other and good.

Background: The goal of this retrospective study was to clarify the effect of using temporary vascular shunt (TVS) as a previous intervention., Methods: A total of 96 cases with war-related lower extremity arterial injury and surgically treated between October 2013 and March 2016 were included in the study. The patients were divided into two groups: those in which TVS was performed as a previous intervention on admission (TVS group, n=24) and those in which compression, tourniquet, and ligation/clampage were performed as a previous intervention on admission (non-TVS group, n=72)., Results: In comparing injury pattern, there was no difference between the two groups. In addition, mean hematocrit level, mean systolic blood pressure, the incidence of concomitant vein injury, nerve injury, soft tissue damage, and bone injury were similar in both groups. The overall amputation rate was 19%. There were a total of 18 amputations, with 1 (4%) in the TVS group and 17 (24%) in the non-TVS group. The difference on amputation rate was statistically significant. The mean values of the mangled extremity severity score (MESS) were 6.45 in the TVS group and 7.44 in the non-TVS group. The overall mean MESS was 7.1. The duration of ischemia (DoI) was 4.84+-1.84 h in the TVS group and 5.95+-1.92 h in the non-TVS group. These differences in MESS and DoI were statistically significant., Conclusion: We think that it may be beneficial for patients to consider a TVS to reduce DoI and gain time for surgical revascularization. As a result, the present study demonstrates that the use of TVS may successfully serve as a bridge between initial injury and definitive repair with a reduction in amputation rates.

Purpose: Turkey hosts around 3 million Syrian refugees which is more than any other country in the world. Along with some other adaptation issues like cultural, language, and economic difficulties, significant problems in managing medical problems, chronic diseases like cancer in particular, have to be fixed. However, there are few studies which explore main patient and clinicopathological characteristics in Syrian refugees with cancer. The purpose of this study was to highlight the aforementioned characteristics along with management issues after cancer diagnosis of these patients., Methods: This study was designed as a hospital-based retrospective observational case-series study of 134 Syrian refugees cancer patients between 2015 and 2017., Results: The patient median age was 47.5 years (range 18- 80). Out of the 134, 102 (76.1%) were female. The most common cancer types were breast (n=57, 42.5%) and gynecological cancers (n=14, 10.4%). The majority of patients were diagnosed at advanced stage (n=60, 44.8%). There were 91 (67.9%) and 43 (32.1%) patients admitted to our center from refugee camps and staying in a house, respectively. The median follow-up was 14 months (range 1-111) and 11 (8.2%) patients died. One and two-year survival rate of the whole group were 93% and 86%, respectively. There were 12 (9%) patients with grade 3-4 hematological and non-hematological toxicities. Neutropenia was the most common grade 3-4 toxicity (n=8, 6%). The patients staying in refugee camp (n-91) or in a house (n=43) finished all planned cycles of chemotherapy with a rate of 71% (n=65) and 79% (n=34), respectively. Statistical analysis failed to show significant relationship between the staying site (either camp or house), chemotherapy compliance rate, grade 3-4 toxicities with p=0.347 and p=0.09, respectively., Conclusion: Our results revealed that breast cancer and gynecological cancers were the most common cancer types which are good candidates for cancer screening. Unfortunately, the majority of patients had cancer diagnosed at advanced stage. However, after diagnosis they could reach all health facilities including surgical operation, radiotherapy, and systemic chemotherapy similar to Turkish cancer patients. Therefore, our results suggested that major problem for the Syrian refugees adapting them into national screening program which may resulted that cancer diagnosis at earlier stage with high cure rate.

New Delhi metallo-β-lactamase-1 (NDM-1), an acquired class B carbapenemase, is a significant clinical threat owing to the extended hydrolysis of β-lactams including carbapenems. Here, to the best of our knowledge we describe for the first time in Turkey two NDM-1-producing Acinetobacter baumannii isolates recovered from intensive care unit patients. The presence of blaNDM-1 was detected by PCR and confirmed by sequencing. The clonal relationship was assessed by PFGE and multilocus sequence typing. Both isolates were positive for blaNDM-1 and were attributed with the sequence type 85. One isolate was from a Syrian refugee, whereas the second was from a patient who had never travelled outside Turkey. Our findings confirmed that the rapid spread of NDM-1-producing Gram-negative organisms could become a major challenge for the treatment and control of healthcare-associated infections in our geographical area. They suggest also that NDM-1-producing strains and/or their genetic determinants are probably being imported from Syria to neighbouring countries.