Neurological Care of Refugees and Other Forcibly Displaced Persons

Abstract

There are more than 100 million forcibly displaced persons (FDPs) in the world today, including a high number of people who experience neurologic symptoms and presentations. This review summarizes the conceptual frameworks for understanding neurological health risks and conditions across the migration journey (premigration, migration journey, and postmigration) and life span, including special attention to pediatric FDPs. The interaction with psychiatric illness is discussed, as well as the available published data on neurologic presentations in FDPs in the medical literature. A social determinant of health lens is used to provide ways in which forcible displacement can influence brain health and neurological outcomes. Priorities and future needs for the neurological care of refugees and other FDPs are suggested.

Keywords

refugees - asylum seekers - forcibly displaced persons - migration - health disparities - social determinants of health

Publikationsverlauf

Artikel online veröffentlicht:
18. März 2024

• References

• 1 Farge E. Global level of forced displacement climbs to record 110 million, UN says. Reuters 2023 . Accessed August 26, 2023 at: https://www.reuters.com/world/global-level-forced-displacement-climbs-record-110-mln-un-2023-06-14/
• 2 UNHCR: The UN Refugee Agency. Figures at a Glance. Accessed 27 December, 2019 at: https://www.unhcr.org/figures-at-a-glance.html
• 3 Mateen FJ, Hanafi I, Birbeck GL. et al; AAN Quality Committee. Neurologic care of forcibly displaced persons: emerging issues in neurology. Neurology 2023; 100 (20) 962-969
• 4 Chynoweth SK, Buscher D, Martin S, Zwi AB. A social ecological approach to understanding service utilization barriers among male survivors of sexual violence in three refugee settings: a qualitative exploratory study. Confl Health 2020; 14: 43
• 5 Scharpf F, Kaltenbach E, Nickerson A, Hecker T. A systematic review of socio-ecological factors contributing to risk and protection of the mental health of refugee children and adolescents. Clin Psychol Rev 2021; 83: 101930
• 6 Li SSY, Liddell BJ, Nickerson A. The relationship between post-migration stress and psychological disorders in refugees and asylum seekers. Curr Psychiatry Rep 2016; 18 (09) 82
• 7 Hossain A, Baten RBA, Sultana ZZ. et al. Predisplacement abuse and postdisplacement factors associated with mental health symptoms after forced migration among Rohingya refugees in Bangladesh. JAMA Netw Open 2021; 4 (03) e211801
• 8 Saadi A, Young M-E, Patler C, Estrada JL, Venters HD. Understanding US immigration detention: reaffirming rights and addressing social-structural determinants of health. Health Hum Rights J 2020; 22 (01) 187-198
• 9 El Hajj Abdallah Y, Beveridge J, Chan M. et al; Union of Medical Care and Relief Organizations. Devastating neurologic injuries in the Syrian war. Neurol Clin Pract 2019; 9 (01) 9-15
• 10 Ameen AA. The management of acute craniocerebral injuries caused by missiles: analysis of 110 consecutive penetrating wounds of the brain from Basrah. Injury 1984; 16 (02) 88-90
• 11 Marcikić M, Melada A, Kovacević R. Management of war penetrating craniocerebral injuries during the war in Croatia. Injury 1998; 29 (08) 613-618
• 12 Mateen FJ, Carone M, Nyce S. et al. Neurological disorders in Iraqi refugees in Jordan: data from the United Nations Refugee Assistance Information System. J Neurol 2012; 259 (04) 694-701
• 13 Sigvardsdotter E, Vaez M, Rydholm Hedman A-M, Saboonchi F. Prevalence of torture and other warrelated traumatic events in forced migrants: a systematic review. Torture 2016; 26 (02) 41-73
• 14 Moreno A, Grodin MA. Torture and its neurological sequelae. Spinal Cord 2002; 40 (05) 213-223
• 15 Saadi A, Williams J, Parvez A, Alegría M, Vranceanu A-MM. Head trauma in refugees and asylum seekers: a systematic review. Neurology 2023; 100 (21) e2155-e2169
• 16 Saleem GT, Champagne M, Haider MN. et al. Prevalence and risk factors for intimate partner physical violence-related acquired brain injury among visitors to justice center in New York. J Head Trauma Rehabil 2022; 37 (01) E10-E19
• 17 O'Neal SE, Townes JM, Wilkins PP. et al. Seroprevalence of antibodies against Taenia solium cysticerci among refugees resettled in United States. Emerg Infect Dis 2012; 18 (03) 431-438
• 18 Mateen FJ, Carone M, Haskew C, Spiegel P. Reportable neurologic diseases in refugee camps in 19 countries. Neurology 2012; 79 (09) 937-940
• 19 Mateen FJ, Carone M, Al-Saedy H. et al. Medical conditions among Iraqi refugees in Jordan: data from the United Nations Refugee Assistance Information System. Bull World Health Organ 2012; 90 (06) 444-451
• 20 Kane JC, Ventevogel P, Spiegel P, Bass JK, van Ommeren M, Tol WA. Mental, neurological, and substance use problems among refugees in primary health care: analysis of the Health Information System in 90 refugee camps. BMC Med 2014; 12: 228
• 21 Fransen S, Werntges A, Hunns A, Sirenko M, Comes T. Refugee settlements are highly exposed to extreme weather conditions. Proc Natl Acad Sci U S A 2023; 120 (00) e2206189120
• 22 Tenorio A, Brandel MG, Produturi GR. et al. The impact of the Mexico-San Diego border wall extension on spine injuries: a retrospective cohort review. J Travel Med 2022; 29 (07) taac112
• 23 Tenorio A, Brandel MG, Produturi GR. et al. Characterizing the frequency, morbidity, and types of traumatic brain injuries after the Mexico-San Diego border wall extension: a retrospective cohort review. J Neurosurg 2023; 139 (03) 848-853
• 24 Ramey WL, Walter CM, Zeller J, Dumont TM, Lemole GM, Hurlbert RJ. Neurotrauma from border wall jumping: 6 years at the Mexican-American border wall. Neurosurgery 2019; 85 (03) E502-E508
• 25 Centers for Disease Control and Prevention (CDC). Vitamin B12 deficiency in resettled Bhutanese refugees–United States, 2008–2011. MMWR Morb Mortal Wkly Rep 2011; 60 (11) 343-346
• 26 Fu Liong H, Santhi DP, Shanthi V, Mohd Hanip R. Myanmarese neuropathy: clinical description of acute peripheral neuropathy detected among Myanmarese refugees in Malaysia. Int Sch Res Notices 2014; 2014: 187823
• 27 Saadi A, Patler C, De Trinidad Young M-E. Cumulative risk of immigration prison conditions on health outcomes among detained immigrants in California. J Racial Ethn Health Disparities 2021; 9 (06) 2518-2532
• 28 Patler C, Saadi A. Risk of poor outcomes with COVID-19 among U.S. detained immigrants: a cross-sectional study. J Immigr Minor Health 2021; 23 (04) 863-866
• 29 Hargreaves S, Rustage K, Nellums LB. et al. Occupational health outcomes among international migrant workers: a systematic review and meta-analysis. Lancet Glob Health 2019; 7 (07) e872-e882
• 30 Kim MH, Foverskov E, Frøslev T. et al. Neighborhood disadvantage and the risk of dementia and mortality among refugees to Denmark: a quasi-experimental study. SSM Popul Health 2022; 21: 101312
• 31 Asgary R, Segar N. Barriers to health care access among refugee asylum seekers. J Health Care Poor Underserved 2011; 22 (02) 506-522
• 32 Altun A, Soh S-E, Brown H, Russell G. The association between chronic pain and pre-and-post migration experiences in resettled humanitarian refugee women residing in Australia. BMC Public Health 2022; 22 (01) 911
• 33 Sun M, Tran D, Bach A. et al. Impact of war and resettlement on Vietnamese families facing dementia: a qualitative study. Clin Gerontol 2022; 45 (04) 798-807
• 34 Al-Rousan T, Awad M, Sideman AB, Moore AA. A qualitative study of older refugees' perception and attitudes towards dementia and dementia risk reduction during the COVID-19 pandemic. Alzheimers Dement 2022; 18: e066710
• 35 Chemali Z, Borba CPC, Johnson K, Khair S, Fricchione GL. Needs assessment with elder Syrian refugees in Lebanon: implications for services and interventions. Glob Public Health 2018; 13 (09) 1216-1228
• 36 Hamrah MS, Bartlett L, Jang S, Roccati E, Vickers JC. Modifiable risk factors for dementia among migrants, refugees and asylum seekers in Australia: a systematic review. J Immigr Minor Health 2023; 25 (03) 692-711
• 37 Al-Rousan T, AlHeresh R, Saadi A. et al. Epidemiology of cardiovascular disease and its risk factors among refugees and asylum seekers: systematic review and meta-analysis. Int J Cardiol Cardiovasc Risk Prev 2022; 12: 200126
• 38 Berkowitz SA, Fabreau GE, Raghavan S. et al. Risk of developing diabetes among refugees and immigrants: a longitudinal analysis. J Community Health 2016; 41 (06) 1274-1281
• 39 Atallah SM, Al-Jaghbir MT, Zayed AA. The prevalence of diabetic peripheral neuropathy among diabetic Palestinian refugees in the Nuzha area, Jordan: a cross-sectional study. Lancet 2021; 398 (Suppl. 01) S15
• 40 Olsen DR, Montgomery E, Bøjholm S, Foldspang A. Prevalence of pain in the head, back and feet in refugees previously exposed to torture: a ten-year follow-up study. Disabil Rehabil 2007; 29 (02) 163-171
• 41 Nissen A, Hynek KA, Scales D, Hilden PK, Straiton M. Chronic pain, mental health and functional impairment in adult refugees from Syria resettled in Norway: a cross-sectional study. BMC Psychiatry 2022; 22 (01) 571
• 42 Keatley E, dʼAlfonso A, Abeare C, Keller A, Bertelsen NS. Health outcomes of traumatic brain injury among refugee survivors of torture. J Head Trauma Rehabil 2015; 30 (06) E1-E8
• 43 McMurry H, Tsang D, Lin N, Symes S, Dong C, Monteith T. Head injuries, traumas, and neuropsychiatric sequela in asylum seekers. DRYAD 2020 Accessed March 01, 2024 at: https://doi.org/10.5061/DRYAD.BVQ83BK5H
• 44 Baskaran A, Marogi E, Bitar R, Attarian H, Saadi A. Improving sleep health among refugees: a systematic review. Neurol Clin Pract 2023; 13 (02) e200139
• 45 Kizilhan JI, Steger F, Noll-Hussong M. Shame, dissociative seizures and their correlation among traumatised female Yazidi with experience of sexual violence. Br J Psychiatry 2020; 216 (03) 138-143
• 46 Brinckmann MP, van Noort BM, Leithner C, Ploner CJ. Neurological emergencies in refugees. Front Neurol 2018; 9: 1088
• 47 Senadim S, Uygun E, Erdogan M, Koksal A, Soysal A, Atakli D. Profile of Syrian asylum-seekers from neurological clinic in a tertiary center. Eur Neurol 2018; 80 (5–6): 249-253
• 48 Fazzi E, Korff C, Bernabe Gelot A. et al. Neurodevelopmental problems of unaccompanied refugee and migrant children: a new challenge for pediatric neurologists. Dev Med Child Neurol 2019; 61 (11) 1348
• 49 Schiergens KA, Staudigl M, Borggraefe I, Maier EM. Neurological sequelae due to inborn metabolic diseases in pediatric refugees: challenges in treating the untreated. Neuropediatrics 2018; 49 (06) 363-368
• 50 Yayan EH, Düken ME, Özdemir AA, Çelebioğlu A. Mental health problems of syrian refugee children: post-traumatic stress, depression and anxiety. J Pediatr Nurs 2020; 51: e27-e32
• 51 Ulintz A, Anderson K, Shah I, Khan M, Weinstein E, Peterson R. Pediatric emergency department use by Afghan refugees at a temporary housing facility. J Am Coll Emerg Physicians Open 2023; 4 (02) e12947
• 52 Sangalang CC, Vang C. Intergenerational trauma in refugee families: a systematic review. J Immigr Minor Health 2017; 19 (03) 745-754
• 53 East PL, Gahagan S, Al-Delaimy WK. The impact of refugee mothers' trauma, posttraumatic stress, and depression on their children's adjustment. J Immigr Minor Health 2018; 20 (02) 271-282
• 54 Palosaari E, Punamäki R-L, Qouta S, Diab M. Intergenerational effects of war trauma among Palestinian families mediated via psychological maltreatment. Child Abuse Negl 2013; 37 (11) 955-968
• 55 Nelson CA, Scott RD, Bhutta ZA, Harris NB, Danese A, Samara M. Adversity in childhood is linked to mental and physical health throughout life. BMJ 2020; 371: m3048
• 56 Saadi A, Hampton K, de Assis MV, Mishori R, Habbach H, Haar RJ. Associations between memory loss and trauma in US asylum seekers: A retrospective review of medico-legal affidavits. PLoS ONE 2021; 16 (03) e0247033
• 57 Westergaard ML, Jensen RH, Carlsson J. Headache comorbidity in refugees and migrants with post-traumatic stress disorder. Cephalalgia 2023; 43 (03) 33 31024221147502
• 58 Strømme EM, Igland J, Haj-Younes J. et al. Chronic pain and mental health problems among Syrian refugees: associations, predictors and use of medication over time: a prospective cohort study. BMJ Open 2021; 11 (09) e046454
• 59 Parvez A, Percac-Lima S, Saadi A. The presence and profile of neurological conditions and associated psychiatric comorbidities in U.S. resettled refugees: a retrospective single center study. J Immigr Minor Health 2023; 25 (02) 365-373
• 60 Yamout B, Itani S, Hourany R, Sibaii AM, Yaghi S. The effect of war stress on multiple sclerosis exacerbations and radiological disease activity. J Neurol Sci 2010; 288 (1-2): 42-44
• 61 Bryant RA, Nickerson A, Morina N, Liddell B. Posttraumatic stress disorder in refugees. Annu Rev Clin Psychol 2023; 19: 413-436