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Background: Compared to the general German population, refugees in Germany are a high-risk group for trauma spectrum disorders. Currently, many barriers exist for the implementation of a screen-and-treat approach for mental disorders as part of the routine health care provision during the early stage of the immigration process. Objective: The aim of the present study was to develop and test a systematic screening approach to identify individual refugees in need of mental health care during the initial immigration phase. Method: 167 newly arrived refugees underwent a screening interview with the Refugee Health Screener (RHS) carried out by Intercultural Therapy Assistants (ITAs). The ITAs were super-vised by psychologists at a reception centre in Bielefeld, Germany. A subsample of 48 persons partici-pated in clinical validation interviews. Results: Findings demonstrated the need for and feasibility of a systematic screening during the initial immigration phase. However, established cut-off values of the RHS had to be adapted and the screening procedure had to be adjusted due to the needs of a significant number of refugees in severe psychological crises. Conclusion: A systematic screening that is applied shortly after arrival facilitates the early identification of refugees at risk of developing mental disorders and may be helpful to prevent chronic symptom development and an aggravation of psychological crises.

Aim: The aim of this cross-sectional study was to identify the immunization rate as well as the refusals of at least one vaccination against measles by asylum seekers in the reception center (EAE) Bielefeld (a town in Germany). The findings represent a baseline for this asylum center before the implementation of mandatory immunizations against measles., Method: This is a cross-sectional study. Lists with routinely collected management data were used to collect and analyze demographic information (age, gender, nationality) and data on vaccinations. Results In this study, data on 4606 asylum seekers based in the reception center (EAE) Bielefeld (01 January 2018-31 December 2018) were analyzed. These showed that 59% were male, 41% were female asylum seekers and 62% of them were under 30 years of age. The top ten countries of origin were: Turkey 15%, Syria 13%, Iraq 9%, Iran 9%, Nigeria 5%, Afghanistan 4%, Guinea 3%, Albania 3%, Somalia 3% and Pakistan 3%. Of the 4606 asylum seekers, 4326 were between 1 and 49 years of age; 3150 of them possessed at least one documented vaccination against measles. Thus, the immunization rate of measles vaccination was 73%. The immunization rate of measles vaccination related to different age cohorts ranged from 67% (1-4 years of age) to 78% (10-14 years of age). The following main reasons for non-vaccination against measles were identified: refusal (21%), being ill (2%), pregnancy (2%), "other" (1%)., Conclusion: In EAE Bielefeld the immunization rate of measles vaccination was 73%. The main reason for non-immunization was refusal to be vaccinated (21% of the eligible asylum seekers). It is a matter of urgency that the immunization rate of EAE Bielefeld be increased. The planned statutory vaccination against measles and internal measures in the reception center will help closing immunization gaps. More studies involving numerous asylum reception centers are required to obtain national figures related to measles immunization of asylum seekers in Germany., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

A young mother presented her 19-month-old boy to the general practitioner (GP) with a 24 h history of reluctance to stand or walk and a slightly raised temperature. The GP arranged an assessment by the paediatrician, who organised an ultrasound of the hips which was normal. Approximately 1 week later the patient became constipated as well, was seen again by another GP but no cause was found. Another week later mother consulted the initial GP again as the boy had not shown any signs of improvement and had become more irritable. The GP arranged a review by the paediatrician and MRI scans of the hips and back were performed. These scans showed normal hips but lumbar spine changes suggestive of a spondylodiscitic event. The patient was treated with intravenous antibiotics, a corset and analgesia and made an excellent recovery.