Neglected Children with Cystic Fibrosis due to War (Turkey Profile of Refugee Patients)

Research Square (Research Square)(2023)

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摘要
Abstract Introduction: Since the outbreak of the Syrian civil war in 2011, the population of Arab refugees in Turkey has rapidly increased. While cystic fibrosis (CF) is believed to be rare among Arabs, recent studies suggest it is underdiagnosed. This study aims to present the demographic, clinical, and genetic characteristics of CF patients among Arab refugees in Turkey. Additionally, a comparison is made between the findings in the National CF Registry 2021 in Turkey (NCFRT) and the refugee CF patient group. Materials and Methods: The study included refugee patients between the ages of 0 and 18 years who were diagnosed with CF and received ongoing care at pediatric pulmonology centers from March 2011 to March 2021. The study examined demographic information, age at diagnosis, age of diagnosis of patients through CF newborn screening (NBS), presenting symptoms, CFTR mutation test results, sputum culture results, weight, height, and body mass index (BMI) z score. Their results were compared with the NCFRT results. Results: The study included 14 pediatric pulmonology centers and 87 patients, consisting of 46 (52.9%) boys and 41 (47.1%) girls. All of the patients were Arab refugees, with 80 (92%) being Syrian. The median age at diagnosis of patients was 22.33 (1-258) months. The median age of diagnosis of patients through NBS was 4.2 (1–12) months. Parental consanguinity was observed in 52 (59.7%) patients. The most frequently found mutation (22.2%) was F508del, found in 32 out of 144 alleles. There was a large number of genetic variations. Compared to NCFRT, refugee patients were diagnosed later and long-term follow-up of refugee CF patients had significantly worse nutritional status and pseudomonas colonization. Discussion: Although refugee CF patients have equal access to NBS programs and CF medications as well as Turkish patients, the median age at diagnosis of patients, the median age of diagnosis of patients through NBS, their nutritional status, and Pseudomonas colonization were significantly worse than Turkish patients, which may be related to the difficulties of living in another country and poor living conditions. The high genetic heterogeneity and rare mutations detected in the refugee patient group compared to Turkish patients. Well-programmed NBS programs, thorough genetic studies, and the enhancement of living conditions for refugee patients in the countries they relocate to can have several advantages such as early detection and improved prognosis.
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cystic fibrosis,refugee patients,children,turkey
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