Health and socio-demographic background of Ukrainian minors and their families in Germany - challenges for refugee medicine
Authors: Hoffmann Anna Teresa , Kobbe Robin , Denz Robin , Maier Christoph , Toepfner Nicole , Timmesfeld Nina , Petersmann Astrid , Giesbrecht Katharina , Hovardovska Olga , Vehreschild Jörg Janne , Scherer Margarete , de Miranda Susana M. Nunes , Mitrov Lazar , Friedrichs Anette , Caliebe Amke , Skipiol Katarzyna Emilia , Holzwarth Sarah , Kaur Yadwinder , Schlegtendal Anne , Hojenski Leonhard , Ruß Anne-Kathrin ,   NU(M)KRAINE Paed Study Group, Akinina Alena , Dopfer-Jablonka Alexandra , Wauschkuhn Caroline , Liashenko Inna , Almahfoud Maher , Denkinger Claudia Maria , Lücke Thomas , Höppner Jakob , Brandhorst Gunnar , Hamprecht Axel , Sergeev Dmitry , Vehreschild Maria J. G. T. , Brinkmann Folke 
Published: December 2024

Abstract
In 2022, over 1,000,000 people from Ukraine fled to Germany, mostly women and children. The aim of this study was to determine health status and socio-demographic background of Ukrainian refugee minors in Germany and to compare that to German minors. In this study, Ukrainian refugees of all ages, who voluntarily made contact with the study centres via flyers or refugee shelters, were interviewed with the help of trained interpreters from 09–12/2022. We assessed data from minors and their families on socio-economic status, general health perception, current and pre-existing infectious and non-contagious diseases, and vaccination status. The data for the minors were collected by interviewing the accompanying adults. In addition, a physical examination and serological screening for infectious and vaccine-preventable diseases were performed. Overall, 392 minors and accompanying adults (358) were included. Minors’ general and mental health were reported as “at least good" in 83% (316) and 80% (304), respectively. In 16% (63), infectious or other underlying diseases were recorded. Tuberculosis infections (7, 1.8%) and hepatitis C (2, 0.5%) were found through the serological tests. HIV could only be detected in one previously known case. Self-reported vaccinations against measles and varicella, for example, did not match serological findings (protection against measles 304; 84%; varicella 230; 64%).

Conclusion: Accompanying adults often rate the general health and well-being of Ukrainian refugee minors as rather poor. Frequently, self-reported vaccinations and preexisting diseases did not match serology results; therefore, Ukrainian refugee minors without formal vaccination certificate should be offered all recommended vaccinations and be generously screened for hepatitis B, C and HIV in addition to tuberculosis.

What is Known:• Infectious diseases (TB, hepatitis B/C, HIV) are more common among Ukrainian minors and vaccine hesitancy is more widespread than in many host countries and require appropriate medical care.• Displacement and war worsen medical care and have negative impact on mental health..

What is New:• Although intrafamilial spread of infectious diseases was rare (in this cohort), perceived general health of Ukrainian minors is rather poor.• Semi-structured interviews—even with interpreters—are often insufficient to collect valid medical information.