Medicine and Health Sciences Commons^™

Factors In Primary Care Use Among Young Adult Refugees From Burma And Bhutan In Early Resettlement: Findings From Colorado, Sarah Brewer, Jini Puma

Journal of Refugee & Global Health

Background: Young adult refugees have suboptimal primary care use in early resettlement—domains of integration influence primary care engagement during this time.

Methods: Adjusted logistic regression models were used to estimate odds of (1) having a primary care exam and (2) identification of a primary care provider (PCP) as predicted by domains of integration among young adult refugees (n=154) from Burma and Bhutan across four years following resettlement.

Results: Overall integration and predisposing factors, such as language and cultural knowledge, were lower odds of having a primary care provider. Enabling factors such as having insurance and knowing how to make an …

Knowledge And Awareness Of Vitamin D Among Pregnant Or Lactating Iraqi Refugee Women: A Call For Different Approaches In Health Education And Outreach, Someireh Amirfaiz, Ed.D.

Journal of Refugee & Global Health

Vitamin D deficiency during pregnancy and lactation has negative impacts on maternal, fetal, and infant health. Low health literacy and other social determinants of health may increase the risk of deficiency among refugee women. This qualitative study used a survey and in-depth individual interviews to examine knowledge of vitamin D among ten pregnant or breastfeeding Iraqi refugee women in the United States, and sought participants’ recommendations on culture-centered and participatory health promotion strategies. All participants reported having insufficient information and understanding of vitamin D, its health benefits, and the risks of deficiency. The four primary themes that emerged from the …

Comparing The Health And Welfare Of Refugees And Non-Refugees At The Outset Of The Covid-19 Pandemic: The Results Of A Community Needs Assessment., Matthew J. Lyons, Mary Helen O'Connor, Iris Feinberg, Daniel J. Whitaker, Michael Eriksen, Ashli Owen-Smith, Saiza Jivani, Mohammad Tamer, Esther Kim, Ganaro Makor

Journal of Refugee & Global Health

Refugees are a vulnerable population who experience significant health disparities. They may also be at disproportionately high risk of adverse outcomes due to the COVID-19 pandemic. This paper presents the results of a community needs assessment to investigate the impact of the pandemic on health and welfare in a refugee relocation community in the United States. A multilingual data collection team made up of refugees surveyed 179 participants (128 refugees vs. 51 non-refugees). Only 55.9% of refugee respondents said they would be able to provide enough food for their family this week, compared with 84.0% of non-refugees (p < 0.01), and this difference was even greater for food next week …

The Health Of Haitian Schoolchildren: Longitudinal Effect Of Annual Visits On Growth, Jamarie Geller, Mary Starrs, Andrew Bartholomew, Sara Kaliszak, Jeri Kessenich

Journal of Refugee & Global Health

Objectives: Haiti has one of the highest rates of childhood undernutrition in the world, devastating overall health. This study focuses on the growth of children offered longitudinal healthcare by Kids Health for Haiti, using BMI to indicate developmental and nutritional status. Objectives include collecting baseline prevalence data, examining the longitudinal impact of longitudinal interventions, and discussing future investigation and programming areas.

Methods: A retrospective longitudinal observational chart review on 245 students over a six-year period analyzing height, weight, and BMI. All data was collected as part of routine health provision and underwent statistical analysis using a single-subject design.

Results:46.3%, …

A Comparative Analysis Of The Knowledge And Stigmatizing Attitude Of Ghanaians And Nigerians Towards Covid-19 Survivors, Emmanuel Lamptey, Dorcas Serwaa, Maxwell Hubert Antwi, Theckla Ikome Ms, Nkechi Odogwu

Journal of Refugee & Global Health

Introduction: In Africa, COVID-19 associated stigmatization still remains the contextual factor that poses a challenge for the mitigation and suppression of COVID-19 spread, especially among the illiterate populations. This comparative study was therefore conducted to assess the knowledge and willingness of Ghanaians and Nigerians to associate with COVID-19 survivors.

Methods: A cross-sectional study was conducted to collect information from 290 Ghanaian and 220 Nigerian nationals aged 18 years and above between 11th July-30th October 2020. An electronic-based questionnaire was developed to collect information on the public. The data were analyzed with SPSS v 22 and factors influencing knowledge and willingness …

User And Provider Perspectives On Improving Mental Healthcare For Syrian Refugee Women In Winnipeg, Manitoba, Canada, Sanjida Newaz, Natalie Riediger

Journal of Refugee & Global Health

Introduction: Refugees have higher risk of developing mental illness like anxiety, depression and Post-Traumatic Stress Disorder as they flee from violence. Women refugees may have unique mental healthcare needs due to their vulnerability to gender-based violence and abuse during flight from war. The research question of this study was what the health system can do better to address the mental healthcare needs of refugee women in Winnipeg.

Methods: Semi-structured interviews were conducted with 9 Syrian refugee women and 6 service providers/decision makers. The interviews were analyzed using qualitative inductive analysis and coded for themes based on recurring issues.

Results: Limited …

A Community Academic Partnership Approach To Addressing Health Needs Of The Local Refugees: Participants’ Perspectives And Recommendations For Developing New Partnerships, Melissa D. Warne-Griggs, Nicolin Thaler, Kristin Koehn, Kristin Sohl

Journal of Refugee & Global Health

Community-academic partnerships have demonstrated how collaboration can provide academic healthcare workers and non-medical community providers such as educators and social services with a comprehensive view of issues affecting refugee populations. The ICIH (Interagency Council on Immigrant Health) is a physician-community partnership consisting of healthcare professionals, non-medical educators, social workers, early childhood services and other community agencies. It was formed to address the well-being of a local immigrant population, strengthen bonds between the community and healthcare system, and educate and empower pediatricians to provide culturally aware services. The collaboration has been very successful as demonstrated by the production of multiple collaborative …

Supporting Academic Primary Care Teams Serving Refugees: A Qualitative Study, Gabrielle Waclawik Md Mph, Fabiana Kotovicz, Devin Walsh-Felz Md Mph, Savitri Tsering Mssw, Nancy Pandhi Md Mph Phd

Journal of Refugee & Global Health

Introduction: Primary care providers continue to experience significant challenges when caring for refugee patients, yet they are often refugees’ initial point of contact with the U.S. health care system. The purpose of this qualitative study is to expand our understanding of the experiences of academic primary care team members during clinical encounters with refugee patients.

Methods: This multi-perspective, qualitative study included physicians (faculty and residents), nurse practitioners, pharmacists, nurses, and medical assistants (n=10), who have been working with refugee patients for at least one year at two family medicine residency clinics and/or a community health center. Semi-structured in-person interviews were …

From The Democratic Republic Of The Congo To North Carolina: An Examination Of Chronic Disease Risk, Lauren R. Sastre Dr.

Journal of Refugee & Global Health

Refugees from the Democratic Republic of the Congo are one of the largest refugee groups globally and in the US, however, there is limited research with this group. Therefore, objectives of this study were to examine: 1) obesity and hypertension rates, 2) diet and lifestyle behavior changes, and 3) diet, lifestyle and social factors of obesity and hypertension risk of Congolese refugees in the US. This cross-sectional data collection utilized a survey developed specifically for this project. Clinical and anthropometric measures including height, weight and blood pressure were also obtained. Data analysis included descriptive and regression analysis. Participants (n=48, >18 …

Healthcare Barriers For Congolese Refugee Children In Louisville, Ky: Parental Perception And Narratives Through Focus Group Discussions, Zheyi Teoh, Brit Anderson, Annie Rominger

Journal of Refugee & Global Health

Background: There are up to 3500 refugees who resettle in Kentucky annually with 66% of refugee children originating from the Democratic Republic of the Congo. Little is known about the barriers to healthcare perceived by Congolese parents. This information can direct interventions to improve the care of these children.

Methods: Focus group discussions (FGD) were used to allow families to share personal anecdotes, compare experiences, and encourage discussion between group members. Between August 2018 to May 2020, three FGDs were conducted with Congolese parents who have at least one child ≤18 years old. An interpreter was utilized for each session …

Looking Beyond A Rare Presentation Of Betel Nut Use In A North American Patient- An Opportunity For Lessons And Intervention In Global Health And Gender Equity, Muhammad O. Zaman, Thomas M. Park, Vikas Patel, Riley G. Jones

Journal of Refugee & Global Health

Betel nut is estimated to be the fourth most common psychoactive substance used globally behind caffeine, alcohol, and nicotine with 600 million global users. Betel nut use has a strong association with oral cancer and many other systemic effects including oral submucosal fibrosis. Although North American use is rare, its enduring effects may surface long after use posing a diagnostic challenge to practitioners caring for an increasingly global diaspora. Herein, we present a patient with severe trismus due to advanced oral submucosal fibrosis who was unexpectedly found to be importing and using Betel nut for over thirty years after immigrating. …

Gaining A “Foothold” On The Diagnosis Of Leishmaniasis, Brent M. Troy, Rebecca Hart, Navjyot Vidwan, Bethany Hodge

Journal of Refugee & Global Health

Pediatric refugees and immigrants may present with unusual diagnoses due to their extensive migration and potential harsh conditions in travel. Trauma and family separation add to the difficulty of obtaining a history of exposures. We report a case of one of the more commonly neglected tropical diseases, Leishmaniasis. A 15-year-old male refugee patient presented to the hospital with ulcerative lesions to his legs. His migration history was extensive, starting in Central Africa with travel to South America, followed by migration through Central America to Texas. The patient developed ulcerative lesions on his legs, and he was brought to the children’s …

Letter From The Editor-In-Chief: Journal Of Refugee & Global Health Volume 2, Issue 2, Ruth Carrico

Journal of Refugee & Global Health

No abstract provided.

Treatment Of Podoconiosis With Complicating Polyinfections Within Rural African Villages: A Case Study, Amanda R. Beering, Abigail R. Florence, Soon Bahrami Md

Journal of Refugee & Global Health

This case study aims to provide a treatment plan for the treatment of podoconiosis with complicating polyinfections in a resource poor setting. A second objective is to help healthcare providers teach preventive measures to villagers in affected regions.

Implementing A Clinical Research Program In Long Term Care Facilities: Experiences From The University Of Louisville Center Excellence For Research In Infectious Diseases [Cerid], Ruth Carrico, Dawn Balcom, Kuldeep Ghosh, Bilal Abaid, Vidyulata Salunkhe, Bibodh Jung Karki, Simra Kiran, Stephen Furmanek, Senen Pena, Julio A. Ramirez

Journal of Refugee & Global Health

Background: According to the US Census Bureau International Report, in 2015, almost nine percent of the world’s population was aged 65 and over. As the worldwide population ages, there is a need to understand how to best care for those individuals. Developing clinical research programs focusing on long term care (LTC) will be critical to defining best practice.

Objectives: The objectives of this manuscript are to: 1) outline the challenges identified in performing clinical research in long term care facilities (LTCF), and 2) offer solutions for future clinical research in the LTC environment based upon our experiences.

Methods: A research …

An Overview Of The Health Profile Of Syrian Refugees Arriving In Kentucky From 2012-2017, Camila Calderon, Annie Rominger

Journal of Refugee & Global Health

Background:

The civil unrest in Syria has led to millions of displaced Syrians. The United States has relocated over 15,000 Syrian refugees, mostly arriving since 2015. Little is known about the health of Syrian refugees entering the United States.

Methods:

Syrian refugees in Kentucky who had a medical screening and documented RHA from October 2012 to September 2017 were included in the study. The information is collected and stored in the Arriving Refugee Informatics Surveillance and Epidemiology (ARIVE) database. This study is a retrospective review of the ARIVE database to describe the general health of the Syrian refugees …

Applying The Plan-Do-Study-Act (Pdsa) Approach To Community Health Worker Job Satisfaction: Local And Global Perspectives, Wendy R. Thal, Rosalinda Jimenez

Journal of Refugee & Global Health

Community Health Workers (CHW) have been a continuing presence in the world health care arena for several decades. While the work they do is diverse, all abide by local social and cultural “norms” and are stakeholders within the population they serve. [1] While much literature is available on the importance of community health workers in the provision of care in regions with limited access to health care, there is little known on what inspires someone to engage in the role. The World Health Organization purports that building value for these lay health care providers within their community via training, support, …

International Infection Control Training Partnerships: Experiences From The Egypt-University Of Louisville Collaboration, Amr Aboelnasr, Mohammad Tahboub, Dawn Balcom, Lynn Roser, Morgan Stanley, Stephen P. Furmanek, Ruth Carrico

Journal of Refugee & Global Health

Background: Healthcare-associated infection (HAI) is a global challenge that represent opportunities for international collaboration. Both the United States and Egypt prioritize HAI reduction as activities of public health importance. These shared priorities provide a foundation for interactive education and training.

Objective: In the fall 2018, The United States Agency for International Development (USAID) sought a US training site where a delegation of physicians and nurses from Egypt could receive experiential training regarding HAI and prevention. The objectives of this review are to: 1) outline the training components used for the US-Egypt collaboration held at the University of Louisville …

Factors Associated With Full Immunization Coverage Among Children Up To 12 Months, Kakuma Mission Hospital, Turkana County, Kenya, Kevin Lomuria, Naomi Nyakio, Elvis Oyugi, James A. Ransom

Journal of Refugee & Global Health

The 2014 Kenya Demographic Health Survey showed that only 56.7% of children in Turkana County had received all recommended vaccines by 12 months of age, which is 12% below national and 24% below World Health Organization global coverage rates. This study aimed to identify factors that influence full immunization coverage (FIC) by 12 months of age in Kakuma Mission Hospital (KMH), Turkana County, in 2015. Kakuma is the site of a UNHCR refugee camp, established in 1969. Administration of vitamin A by 6 months of age and administration of measles-containing vaccine by 9 months of age were predictive of FIC.

Barriers To Health Among Idps In Kabul, Afghanistan: A Qualitative Study, Yagana Parwak, Madhavi Dandu, Rohini J. Haar

Journal of Refugee & Global Health

Background: Forced displacement is a significant problem for regions experiencing prolonged humanitarian crises due to armed conflict. Afghanistan, having experienced over four decades of conflict, has an estimated 1.2 million internally displaced persons (IDPs), a majority of which are concentrated in urban centers. IDPs have limited resources and face challenges accessing health services through traditional channels, leading to a disproportionate burden of morbidity and mortality. Health care facilities created for and existing within IDP camps also face numerous challenges. We aim to understand the structural factors that negatively impact health and the specific barriers to healthcare access for IDPs using …

Infertility In Muslim Refugees: A Review Of The Literature, Simone N. Reaves, Fern R. Hauck

Journal of Refugee & Global Health

Many couples worldwide are affected by infertility, which is defined as an inability to conceive after at least one year of regular unprotected sexual intercourse. Many Muslim and Middle Eastern societies place a high societal value on having children and therefore, couples who are unable to conceive for various reasons often find themselves feeling stigmatized and socially isolated. Muslim refugees living in the United States face additional challenges and barriers to care due to their refugee status. This review is a synthesis of existing literature that 1) identifies Islamic viewpoints on infertility and assistive reproductive technology (ART), 2) explores the …

Health-Seeking Behavioral Patterns Among Refugee Groups – A Case-Study In South-Central Kentucky, Chika Ejike, Grace Lartey, Randy Capps, David Ciochetty

Journal of Refugee & Global Health

Each year, thousands of people get displaced from their homes due to genocide, famine, civil wars and other crises in their countries. The United States has traditionally been receptive to resettling refugees. These refugees view resettlement as an opportunity to obtain proper health care. Due to the diverse cultural identities of refugee populations, it is essential to research complex culturally dependent healthcare utilization patterns. A purposeful sample of four refugees from the Burmese, Congolese and Iraqi refugee communities in south-central Kentucky- completed interviews. They shared experiences and insights from their cultural points of view. Results showed demographic factors directly impacted …

Refugee Women's Needs: The Athens Case, Melissa J. Diamond

Journal of Refugee & Global Health

Medicins sans Frontiers estimates that twenty-five per cent of new asylum-seeking arrivals in Athens in 2016 were women [1]. Despite the sizable number of women asylum seekers arriving in Athens, women’s voices are often excluded from research on refugee needs. This research sought to understand the needs of women asylum seekers in Athens through the collection of qualitative data on their needs and experiences upon arriving in Athens. Twelve women from Syria, Afghanistan and other countries (background withheld for confidentiality) participated. The sampled women demonstrated an acute understanding of their own needs and the needs of their communities. While many …

Designing The Arriving Refugee Informatics Surveillance And Epidemiology (Arive) System: A Web-Based Electronic Database For Epidemiological Surveillance, William A. Mattingly, Ruth M. Carrico, Timothy L. Wiemken, Robert R. Kelley, Rebecca A. Ford, Rahel Bosson, Kimberley A. Buckner, Julio A. Ramirez

Journal of Refugee & Global Health

Objectives: We design and implement the Arriving Refugee Informatics surVeillance and Epidemiology (ARIVE) system to improve the health of refugees undergoing resettlement and enhance existing health surveillance networks.

Materials and Methods: Using the REDCap electronic data capture software as a basis we create a refugee health database incorporating data from the Center for Disease Control and Prevention’s Electronic Disease Notification (EDN) system and domestic screening data from refugee health care providers.

Results: Domestic screening and EDN refugee health data have been integrated for 13,824 refugees resettled from 35 different countries into the state of Kentucky from the years 2013-2016.

Discussion: …

Transmissible Dermatological Diseases Affecting Syrian Refugees In Lebanon, Nisrine Kawa, Edith Hanna, Abdul Rahman Bizri

Journal of Refugee & Global Health

The Syrian war led many to seek shelter in Lebanon, creating a major refugee crisis. Displaced populations in crowded unequipped settlements are vulnerable to infectious diseases. The burden and incidence of various transmissible skin conditions affecting Syrian refugees in Lebanon and their impact on the Lebanese public health system were evaluated. Literature regarding these conditions among Syrian refugees in host countries, and epidemiological data from the Lebanese Ministry of Public Health Surveillance Unit and primary health-care network were reviewed. Lebanon has witnessed skin disorder outbreaks associated with the Refugee crisis, mainly leishmaniasis, scabies and lice infestations with little data about …

Perceptions Of Health Practices And Interactions With The Us Healthcare System Among Bhutanese Refugees: A Qualitative Approach, Amy E. Szajna

Journal of Refugee & Global Health

Purpose

The aim of this pilot study was to explore health practices of Bhutanese refugees and their interactions with the US healthcare system and providers.

Methodology

Researchers conducted 12 in-depth interviews and 7 patient-provider observation units as part of this descriptive qualitative study.

Results

Participants identified individual definitions of health and behaviors they value to maintain health. They identified significant trust and faith in their healthcare provider and valued provider-directed suggestions. Participants cited concerns with patient-provider communication resulting from limited English proficiency and frequent changes in primary care providers.

Discussion

This study is useful to inform further research and potential …

Vitamin Deficiencies Among Resettled Refugees In Buffalo, Ny, Tyler B. Evans, Myron Glick Md

Journal of Refugee & Global Health

Background

Vitamin deficiency in the developing world is a considerable public health issue that is often overlooked. Refugees are some of the most vulnerable populations, since they rely almost exclusively on the nutrition provided by refugee camps. Buffalo, NY resettles the fourth largest number of refugees per capita among cities in the United States (US).

Objective

We examined the prevalence of vitamin A, B2, B12, and D deficiencies among refugees who had been recently resettled to Buffalo, NY and referred to our practice for assessment. Our exploratory objective was to examine potential differences in the prevalence of vitamin deficiencies among …

"We Didn't Know": An Examination Of Health And Nutrition Knowledge, Behaviors And Clinical Risk Factors To Guide A Pilot Health Education Intervention For Refugees From Burma, Elizabeth B. Smith, Lauren R. Sastre

Journal of Refugee & Global Health

No abstract provided.

Treating Latent Tuberculosis Infection In Newly Arriving Refugees: An Advanced Practice Nurse Initiative At The University Of Louisville Global Health Center, Linda Goss, Dawn Balcom, Karen Mutsch, Ruth Carrico, Rahel Bosson

Journal of Refugee & Global Health

Background: A review of newly arriving refugees referred to the local health department for latent tuberculosis infection (LTBI) treatment during 2013-2015 revealed a treatment gap of 73%, supporting the need to identify new approaches to treat vulnerable populations and mirrored results in the literature.

Objectives: 1) Describe an advanced practice registered nurse (APRN) led alternative approach to LTBI treatment in the refugee population; and 2) evaluate the impact of a 12-week regimen for LTBI on treatment acceptance, adherence and completion.

Methods: During the initial health screening visit, treatment options were provided for those identified with LTBI consisting of either a …

Reasons For Vaccine Declination In Healthy Individuals Attending An International Vaccine And Travel Clinic, Timothy L. Wiemken, Julio A. Ramirez, Ruth M. Carrico

Journal of Refugee & Global Health

Little is known about the vaccine-related health behaviors of healthy individuals. We surveyed healthy individuals attending a vaccine center to define the reasons behind vaccine declination when the vaccine is warranted under current guidance. Declination due to perceived risks of the vaccines were by far the most common rationale, suggesting continued need for public health educational campaigns.