Review Addresses Skin Health of Children in Refugee Camps

The prevalence of dermatologic conditions affecting children in refugee camps remains unclear because of the limited data on the topic, a literature review showed. However, likely culprits include infectious diseases with cutaneous manifestations, such as pediculosis, tinea capitis, and scabies.

“Current data indicates that one in two refugees are children,” one of the study investigators, Mehar Maju, MPH, a 4th-year student at of the University of Washington School of Medicine, Seattle, Washington, told this news organization following the annual meeting of the Society for Pediatric Dermatology, where the results were presented during a poster session. “The number of refugees continues to rise to unprecedented levels every year,” and climate change continues to drive increases in migration, “impacting those residing in camps,” she said. “As we continue to think about what this means for best supporting those residing in camps, I think it’s also important to consider how to best support refugees, specifically children, when they arrive in the United States. Part of this is to know what conditions are most prevalent and what type of social support this vulnerable population needs.”

To identify the common dematologic conditions among children living in refugee camps, Maju and fellow 4th-year University of Washington medical student Nadia Siddiqui searched PubMed and Google Scholar for studies that were published in English and reported on the skin disease prevalence and management for refugees who are children. Key search terms used included “refugees,” “children,” “dermatology,” and “skin disease.” Of approximately 105 potential studies identified, 19 underwent analysis. Of these, only five were included in the final review. 

One of the five studies was conducted in rural Nyala, Sudan. The study found that 88.8% of those living in orphanages and refugee camps were reported to have a skin disorder, commonly fungal or bacterial infections and dermatitis. In a separate case series, reasearchers found that cutaneous leishmaniasis was rising among Syrian refugee children. 

A study that looked at morbidity and disease burden in mainland Greece refugee camps found that the skin was the second most common site of communicable diseases among children, behind those of the respiratory tract. In another study that investigated the health of children in Australian immigration detention centers, complaints related to skin conditions were significantly elevated among chldren who were detained offshore compared with those who were detained onshore. 

Finally, in a study of 125 children between the ages of 1 and 15 years at a Sierra Leone–based displacement camp, the prevalence of scabies was 77% among those aged <5 years and peaked to 86% among those aged 5-9 years. 

“It was surprising to see the limited information about dermatologic diseases impacting children in refugee camps,” Maju said. “I expected that there would be more information on the specific proportion of diseases beyond those of infectious etiology. For example, I had believed that we would have more information on the prevalence of atopic dermatitis, vitiligo, and other more chronic skin diseases.” 

She acknowledged certain limitations of the analysis, mainly the lack of published information on the skin health of pediatric refugees. “A study that evaluates the health status and dermatologic prevalence of disease among children residing in camps and those newly arrived in the United States from camps would provide unprecedented insight into this topic,” Maju said. “The results could guide public health efforts in improving care delivery and preparedness in camps and clinicians serving this particular population when they arrive in the United States.”

She and her coauthor Siddiqui reported having no relevant disclosures.