Disease spectrum and medical complaints among migrants: a study from three outpatient clinics for asylum seekers in Berlin, Germany.

Introduction: In 2015, over 20 million people were compelled to flee due to armed conflict and natural disasters. More than one million arrived in Germany, around 55,000 in Berlin. This study examines health issues among asylum seekers and refugees (ASR) in three newly established outpatient clinics in Berlin's refugee shelters. Methods: In a cross-sectional study, patient data recorded between 10 September 2015 and 9 March 2016 were extracted retrospectively, entered into an anonymized database, and analyzed. The International Classification of Diseases (ICD10) was used to code diagnoses retrospectively. Stata15/17 was used for data analysis. Results: A total of 11,894 consultations were included. Of these, 34% (3,774 out of 11,233 consultations for which patient age data was available) were children under five (1,998). Most adults (64%, 4,786/7,459) were aged 21-40. Information on patients' sex was available for 10,898 consultations, 60% (6,556/10,898) were male. Fifty-two countries of origin were represented, Syria (42.6%, 4,263/10,898) and Afghanistan (22.6 %, 2,260/10,898) were the most common. A total of 13,902 diagnoses were documented, 8,818 (67.1%, 8,818/13,135, age-specific data available) were assigned to adults. Infectious diseases made up 46.8% (6,502) of all diagnoses, while 53.2% (7,400) were non-communicable. They were the main diagnoses among children (72%, 3,129/4,317 age-specific data available). Most common for adults and children were respiratory tract infections (75.7%, 4,987). Digestive and circulatory diseases were most frequent in adults (575, 24.1% and 444, 18.6%, respectively). Children suffered most of dermatological conditions and digestive disorders (23.5%, 135/578 and 23%, 132/578, respectively). Orthopedic conditions were the third most common (7.05%, 980/13,902), affecting more adults (9.3%, 820/8,818) and more males. Conclusion: This study shows a high demand for easily accessible primary healthcare for ASR, upon arrival and during stay in shared accommodation. Most reported diseases corresponded to a ubiquitous general medical spectrum and could be treated in outpatient clinics. The broad range of diseases and complaints demonstrates the interdisciplinary nature of refugee healthcare. Although this study showed a snapshot of the situation, study population size and the consistency of the findings with other studies suggest that the data can be applied to similar situations or settings.