Eur J Pediatr Surg 2018; 28(01): 060-066
DOI: 10.1055/s-0037-1604398
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Surgical Health Needs of Minor Refugees in Germany: A Cross-Sectional Study

Marios Loucas
1  Department of Pediatric Surgery, University Medicine Mainz, Mainz, RP, Germany
Rafael Loucas
1  Department of Pediatric Surgery, University Medicine Mainz, Mainz, RP, Germany
Oliver J. Muensterer
1  Department of Pediatric Surgery, University Medicine Mainz, Mainz, RP, Germany
› Author Affiliations
Further Information

Publication History

18 April 2017

06 June 2017

Publication Date:
18 July 2017 (eFirst)


Introduction There has been a substantial rise in refugees entering Germany over the past years, of which approximately one-third are underaged. Many end up in pediatric surgical care, and little is known about the health of these individuals. Our study was designed to assess the surgical-related health status of underage refugees based on a large sample cohort.

Materials and Methods After ethics board approval, we used a structured questionnaire to collect demographic information and surgical health-related elements in three large refugee accommodation centers.

Results A total of 461 minor refugees were included. The majority were boys (54.5%) with an average age of 8 years. Out of the eight recorded countries of origin, most children came from Syria (33.6%) followed by Afghanistan (23.2%). Previous operative interventions were recorded in 42.2% of participants. Among girls, 11% suffered genital mutilation. Trauma was common and the most common mechanism was a fall from bicycle (38%) followed by burn injuries (7.4%). Up to 20% of them experienced physical violence during the flight or in the accommodation facility. Vaccination rates varied widely according to origin. Of the participants, only 63% were vaccinated according to schedule. Chronic diseases were found in only 13% of the study cohort, anemia being most prevalent at 4%.

Conclusion Minor refugees have specific health-related problems that must be considered to ensure appropriate medical care. Many refugee children were victims of physical violence and many girls suffered genital mutilation. Vaccination status is unreliable; therefore, tetanus vaccination should always be considered when these patients seek pediatric surgical care. Tailored anticipatory guidance should be provided to this patient population.

Complying with Ethics of Experimentation

No experiments were conducted on humans or animals by the authors of this article. All data were collected as part of routine examinations and completely anonymous before evaluation. Approval by the local ethics committee was obtained (No. 837.001.16 [10320]).