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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In recent months Europe has had to contend with the arrival of a large number of displaced persons&#44; most of them from Syria&#46; The United Nations Refugee Agency &#40;UNHCR&#59; in Spain&#44; ACNUR&#41; has warned of the vulnerability of this population and of the higher risk of health problems it presents&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Some of us&#44; as paediatricians&#44; have had occasion to treat Syrian children in our consulting rooms recently&#44; and have been able to observe their health needs&#46; This situation is likely to become more common in the coming months&#46; In a recent document&#44; the Spanish Association of Paediatrics committed itself to taking an active part both in direct health care and in designing and implementing a reception programme for these refugees&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The Spanish Society for Paediatric Infectious Diseases &#40;SEIP&#58; Sociedad Espa&#241;ola de Infectolog&#237;a Pedi&#225;trica&#41; has also felt moved to show its concern through this editorial&#46; In the following paragraphs the members of the Tropical Infections&#44; Tuberculosis and International Cooperation Working Groups&#44; with the endorsement of the board of the SEIP&#44; wish to put on record the magnitude of the problem and draw attention to the health needs most frequently observed in this population&#44; concentrating primarily on infectious diseases&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In 2014&#44; according to the estimates of the United Nations Refugee Agency &#40;UNHCR&#41;&#44; 13&#46;9<span class="elsevierStyleHsp" style=""></span>million people became newly uprooted due to conflicts or persecution&#44; which represents a substantial increase on previous years&#46; This agency estimates that in 2014 there were already 59&#46;5<span class="elsevierStyleHsp" style=""></span>million displaced persons worldwide&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The armed conflict suffered by the Syrian Arab Republic in the last four years is a major cause of this global increase&#46; It is estimated that at least 7&#46;6<span class="elsevierStyleHsp" style=""></span>million Syrians had been internally displaced by the end of 2014&#46; In addition&#44; over 4<span class="elsevierStyleHsp" style=""></span>million people were forced to leave Syria&#44; making it the country that is producing the largest number of refugees in the world&#44; since one in every four new refugees in the world is of Syrian origin&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Approximately half a million people have entered the European Union illegally since January this year&#44; some 258&#44;000 of whom are of Syrian origin&#46; In 2014 714&#44;000 asylum applications were received in Europe&#44; an increase of 45&#37; compared with 2013&#46; According to UNICEF data a quarter of these asylum applications were for children&#44; and the figure is expected to rise in 2015&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">It is important to emphasise that in the analysis of the displaced population of Syrian origin living in the refugee camps in Iraq&#44; Jordan and Lebanon in the first quarter of 2013&#44; 76&#37; were women and children&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> Currently it is estimated that a third of Syrian displaced persons entering Europe through Greece are women and children&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">As regards the most common health problems observed while treating approximately 90&#44;000 displaced Syrians in Lebanon&#44; 47&#37; of patients were suffering from skin diseases&#58; bacterial infections and parasitic infections such as lice&#44; scabies and leishmaniasis&#44; 27&#37; had digestive system diseases&#44; primarily diarrhoea&#44; and 19&#37; had respiratory infections&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">A UNHCR report also highlights the importance of chronic diseases&#44; mainly in the adult population&#44; such as hypertension and other cardiovascular diseases&#44; diabetes and chronic obstructive pulmonary disease&#46; Approximately 15&#37; of patients were suffering from mental illnesses that have been linked to displacement&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">The studies carried out in Jordanian refugee camps show prevalences of severe acute malnutrition of less than 5&#37;&#44; although the prevalences of anaemia in women and children were close to 50&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">In October 2013 the first cases of poliomyelitis were declared in Syria&#44; 15 years after the eradication of the disease in that country&#46; The low rates of vaccination coverage of around 45&#37; observed in some regions following the outbreak of the conflict and the difficulties in achieving adequate treatment of drinking and washing water have been linked to the reappearance of poliovirus&#46; In response&#44; an immunisation campaign has been conducted with oral polio vaccine&#44; which has enabled 2&#46;7<span class="elsevierStyleHsp" style=""></span>million children to be vaccinated in the country and 23<span class="elsevierStyleHsp" style=""></span>million in neighbouring regions&#46; In spite of this&#44; international agencies recognise that polio is a threat in the region&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> In addition&#44; an increase has been observed in cases of other vaccine-preventable diseases&#44; such as measles&#44; not only in Syria but also in the refugee camps in adjoining countries&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">A greater prevalence of tuberculosis&#44; as much as 40&#37; higher&#44; has also been observed in displaced Syrians compared with the prevalence observed in the host population&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Cutaneous leishmaniasis caused by <span class="elsevierStyleItalic">Leishmania tropica</span> and also by <span class="elsevierStyleItalic">Leishmania major</span> has been endemic in Syria for decades&#44; mainly in Aleppo&#46; In the last few years the incidence of this disease has increased in the country&#44; and also in neighbouring regions&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">In addition&#44; outbreaks of other diseases such as typhoid and hepatitis A have been described in the last few years in people of Syrian origin&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">For all these reasons&#44; we in the SEIP associate ourselves with the wish expressed by the AEP to ensure protection and health care for all refugee children&#44; and particularly at the present time for Syrian children&#44; whose right to be protected is enshrined in Article 22 of the Convention of the Rights of the Child adopted by the General Assembly of the United Nations in 1989&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p></span>"
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Editorial
For the health protection of refugee children
Por la protección de la salud de los niños refugiados
L.M. Prietoa,
Corresponding author
lmprieto.hugf@salud.madrid.org

Corresponding author.
, M. García López Hortelanob, M.J. Mellado Peña on behalf of Grupo de Infecciones Tropicales , Grupo de Tuberculosis and Grupo de Cooperación Internacional de la Sociedad Española de Infectología Pediátrica
a Servicio de Pediatría, Hospital Universitario de Getafe, Getafe, Madrid, Spain
b Servicio de Pediatría Hospitalaria y Enfermedades Infecciosas y Tropicales Pediátricas, Hospital Universitario Infantil La Paz, Madrid, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In recent months Europe has had to contend with the arrival of a large number of displaced persons&#44; most of them from Syria&#46; The United Nations Refugee Agency &#40;UNHCR&#59; in Spain&#44; ACNUR&#41; has warned of the vulnerability of this population and of the higher risk of health problems it presents&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Some of us&#44; as paediatricians&#44; have had occasion to treat Syrian children in our consulting rooms recently&#44; and have been able to observe their health needs&#46; This situation is likely to become more common in the coming months&#46; In a recent document&#44; the Spanish Association of Paediatrics committed itself to taking an active part both in direct health care and in designing and implementing a reception programme for these refugees&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The Spanish Society for Paediatric Infectious Diseases &#40;SEIP&#58; Sociedad Espa&#241;ola de Infectolog&#237;a Pedi&#225;trica&#41; has also felt moved to show its concern through this editorial&#46; In the following paragraphs the members of the Tropical Infections&#44; Tuberculosis and International Cooperation Working Groups&#44; with the endorsement of the board of the SEIP&#44; wish to put on record the magnitude of the problem and draw attention to the health needs most frequently observed in this population&#44; concentrating primarily on infectious diseases&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In 2014&#44; according to the estimates of the United Nations Refugee Agency &#40;UNHCR&#41;&#44; 13&#46;9<span class="elsevierStyleHsp" style=""></span>million people became newly uprooted due to conflicts or persecution&#44; which represents a substantial increase on previous years&#46; This agency estimates that in 2014 there were already 59&#46;5<span class="elsevierStyleHsp" style=""></span>million displaced persons worldwide&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The armed conflict suffered by the Syrian Arab Republic in the last four years is a major cause of this global increase&#46; It is estimated that at least 7&#46;6<span class="elsevierStyleHsp" style=""></span>million Syrians had been internally displaced by the end of 2014&#46; In addition&#44; over 4<span class="elsevierStyleHsp" style=""></span>million people were forced to leave Syria&#44; making it the country that is producing the largest number of refugees in the world&#44; since one in every four new refugees in the world is of Syrian origin&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Approximately half a million people have entered the European Union illegally since January this year&#44; some 258&#44;000 of whom are of Syrian origin&#46; In 2014 714&#44;000 asylum applications were received in Europe&#44; an increase of 45&#37; compared with 2013&#46; According to UNICEF data a quarter of these asylum applications were for children&#44; and the figure is expected to rise in 2015&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">It is important to emphasise that in the analysis of the displaced population of Syrian origin living in the refugee camps in Iraq&#44; Jordan and Lebanon in the first quarter of 2013&#44; 76&#37; were women and children&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> Currently it is estimated that a third of Syrian displaced persons entering Europe through Greece are women and children&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">As regards the most common health problems observed while treating approximately 90&#44;000 displaced Syrians in Lebanon&#44; 47&#37; of patients were suffering from skin diseases&#58; bacterial infections and parasitic infections such as lice&#44; scabies and leishmaniasis&#44; 27&#37; had digestive system diseases&#44; primarily diarrhoea&#44; and 19&#37; had respiratory infections&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">A UNHCR report also highlights the importance of chronic diseases&#44; mainly in the adult population&#44; such as hypertension and other cardiovascular diseases&#44; diabetes and chronic obstructive pulmonary disease&#46; Approximately 15&#37; of patients were suffering from mental illnesses that have been linked to displacement&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">The studies carried out in Jordanian refugee camps show prevalences of severe acute malnutrition of less than 5&#37;&#44; although the prevalences of anaemia in women and children were close to 50&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">In October 2013 the first cases of poliomyelitis were declared in Syria&#44; 15 years after the eradication of the disease in that country&#46; The low rates of vaccination coverage of around 45&#37; observed in some regions following the outbreak of the conflict and the difficulties in achieving adequate treatment of drinking and washing water have been linked to the reappearance of poliovirus&#46; In response&#44; an immunisation campaign has been conducted with oral polio vaccine&#44; which has enabled 2&#46;7<span class="elsevierStyleHsp" style=""></span>million children to be vaccinated in the country and 23<span class="elsevierStyleHsp" style=""></span>million in neighbouring regions&#46; In spite of this&#44; international agencies recognise that polio is a threat in the region&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> In addition&#44; an increase has been observed in cases of other vaccine-preventable diseases&#44; such as measles&#44; not only in Syria but also in the refugee camps in adjoining countries&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">A greater prevalence of tuberculosis&#44; as much as 40&#37; higher&#44; has also been observed in displaced Syrians compared with the prevalence observed in the host population&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Cutaneous leishmaniasis caused by <span class="elsevierStyleItalic">Leishmania tropica</span> and also by <span class="elsevierStyleItalic">Leishmania major</span> has been endemic in Syria for decades&#44; mainly in Aleppo&#46; In the last few years the incidence of this disease has increased in the country&#44; and also in neighbouring regions&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">In addition&#44; outbreaks of other diseases such as typhoid and hepatitis A have been described in the last few years in people of Syrian origin&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">For all these reasons&#44; we in the SEIP associate ourselves with the wish expressed by the AEP to ensure protection and health care for all refugee children&#44; and particularly at the present time for Syrian children&#44; whose right to be protected is enshrined in Article 22 of the Convention of the Rights of the Child adopted by the General Assembly of the United Nations in 1989&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Prieto LM&#44; Garc&#237;a L&#243;pez Hortelano M&#44; M&#46;J&#46; Mellado Pe&#241;a on behalf of Grupo de Infecciones Tropicales&#44; Grupo de Tuberculosis&#44; Grupo de Cooperaci&#243;n Internacional de la Sociedad Espa&#241;ola de Infectolog&#237;a Pedi&#225;trica&#46; Por la protecci&#243;n de la salud de los ni&#241;os refugiados&#46; An Pediatr &#40;Barc&#41;&#46; 2016&#59;84&#58;67&#8211;69&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">The members of the Tropical Infections Group&#44; the Tuberculosis Group and the International Cooperation Group of the Spanish Society for Paediatric Infectious Diseases are listed in <a class="elsevierStyleCrossRef" href="#sec0005">Appendix 1</a>&#46;</p>"
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            "titulo" => "Membership of the Working Groups"
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                "apendice" => "<p id="par0080" class="elsevierStylePara elsevierViewall">Daniel Bl&#225;zquez Gomero &#40;Hospital Universitario 12 de Octubre&#44; Madrid&#41;&#44; Cristina Calvo Rey &#40;Hospital Universitario La Paz&#44; Madrid&#41;&#44; Mar&#237;a Jos&#233; Cilleruelo Ortega &#40;Hospital Universitario Puerta de Hierro Majadahonda&#44; Madrid&#41;&#44; &#193;lvaro D&#237;az Conrado &#40;Hospital del Nem&#44; Gerona&#41;&#44; Victoria Fumad&#243; &#40;Hospital San Juan de D&#232;u&#44; Barcelona&#41;&#44; Ra&#250;l Gonz&#225;lez &#40;Panamerican Health Association&#41;&#44; Jos&#233; Tom&#225;s Ramos Amador &#40;Hospital Universitario Cl&#237;nico San Carlos&#44; Madrid&#41;&#44; Ignacio Gonz&#225;lez &#40;Hospital Universitario 12 de Octubre&#44; Madrid&#41;&#44; Maria Isabel Gonz&#225;lez Tom&#233; &#40;Hospital Universitario 12 de Octubre&#44; Madrid&#41;&#44; Sara Guill&#233;n &#40;Hospital Universitario de Getafe&#44; Madrid&#41;&#44; Andrea Mart&#237;n &#40;Hospital Vall d&#8217;Hebr&#243;n&#44; Barcelona&#41;&#44; Leticia Mart&#237;nez Campos &#40;Hospital La Inmaculada&#44; Huercal-Overa&#44; Almeria&#41;&#44; Antonio Medina Claros &#40;Hospital de la Axarqu&#237;a de V&#233;lez-M&#225;laga&#44; Malaga&#41;&#44; Mar&#237;a Jos&#233; Mellado Pe&#241;a &#40;Hospital Universitario La Paz-Carlos III&#44; Madrid&#41;&#44; Mar&#237;a Jes&#250;s M&#233;ndez Hern&#225;ndez &#40;Hospital Germans Trias i Pujol&#44; Barcelona&#41;&#44; Esmeralda N&#250;&#241;ez Cuadros &#40;Hospital Carlos Haya&#44; Malaga&#41;&#44; Roi Pi&#241;eiro P&#233;rez &#40;Hospital General de Villalba&#41;&#44; Mercedes Rivera &#40;Area de Gesti&#243;n Sanitaria Este M&#225;laga-Axarqu&#237;a&#44; Malaga&#41;&#44; Pablo Rojo Conejo &#40;Hospital Universitario 12 de Octubre&#44; Madrid&#41;&#44; Maria Del Mar Santos Sebasti&#225;n &#40;Hospital General Universitario Gregorio Mara&#241;&#243;n&#44; Madrid&#41;&#44; Raquel Angulo Gonz&#225;lez de Lara &#40;Hospital de Poniente&#44; Almeria&#41;&#44; Maria Jos&#233; Mu&#241;oz Vilches &#40;Hospital Infanta Luisa&#44; Seville&#41;&#44; Milagros Garc&#237;a L&#243;pez Hortelano &#40;Hospital Universitario La Paz-Carlos III&#44; Madrid&#41;&#46;</p>"
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                "titulo" => "SEIP Tropical Infections Working Group"
                "identificador" => "sec0010"
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                "apendice" => "<p id="par0085" class="elsevierStylePara elsevierViewall">Katie Badillo Navarro &#40;Hospital de Torrej&#243;n&#44; Madrid&#41;&#44; Mar&#237;a Espiau Guarner &#40;Hospital Vall d&#8217;Hebron&#44; Barcelona&#41;&#44; Marta Garc&#237;a Ascaso &#40;Hospital Puerta de Hierro Majadahonda&#44; Madrid&#41;&#44; Andrea Mart&#237;n Nalda &#40;Hospital Vall d&#8217;Hebron&#44; Barcelona&#41;&#44; Antonio Medina Claros &#40;Hospital de la Axarqu&#237;a de V&#233;lez-M&#225;laga&#44; Malaga&#41;&#44; Mar&#237;a Montero Mart&#237;n &#40;Hospital Comarcal de Melilla&#44; Melilla&#41;&#44; Mar&#237;a Jos&#233; Mu&#241;oz Vilches &#40;Hospital Infanta Luisa&#44; Seville&#41;&#44; Mercedes Rivera Cuello &#40;Hospital de la Axarqu&#237;a de V&#233;lez-M&#225;laga&#44; Malaga&#41;&#44; Pascual Caballero &#40;M&#233;decins Sans Fronti&#232;res&#44; India&#41;&#44; Helena Navarro Gonz&#225;lez &#40;Pablo Horstmann Hospital&#44; Lamu&#44; Kenya&#41;&#44; Pablo Rojo Conejo &#40;Hospital Universitario 12 de Octubre&#44; Madrid&#41; y Luis Manuel Prieto Tato &#40;Hospital Universitario de Getafe&#44; Madrid&#41;&#46;</p>"
                "etiqueta" => "A&#46;2"
                "titulo" => "SEIP International Cooperation Working Group"
                "identificador" => "sec0015"
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                "apendice" => "<p id="par0090" class="elsevierStylePara elsevierViewall">Mar&#237;a Jos&#233; Mellado Pe&#241;a &#40;Hospital Carlos III&#44; Madrid&#41;&#44; Fernando &#193;lvez Gonz&#225;lez &#40;Hospital Cl&#237;nico de Santiago de Compostela&#44; A Coru&#241;a&#41;&#44; Fernando Baquero-Artigao &#40;Hospital Universitario La Paz&#44; Madrid&#41;&#44; Teresa Hern&#225;ndez-Sampelayo Matos &#40;Hospital General Universitario Gregorio Mara&#241;&#243;n&#44; Madrid&#41;&#44; Leticia Mart&#237;nez Campos &#40;Hospital La Inmaculada de Huercal Overa&#44; Almeria&#41;&#44; David Moreno P&#233;rez &#40;Hospital Materno-Infantil Carlos Haya&#44; Malaga&#41;&#44; Esmeralda N&#250;&#241;ez Cuadros &#40;Hospital Materno-Infantil Carlos Haya&#44; Malaga&#41;&#44; Carlos Rodrigo Gonzalo de Liria &#40;Hospital Germans Trias i Pujol&#44; Barcelona&#41;&#44; Antoni Noguera de Juli&#225;n &#40;Hospital San Joan de Deu&#44; Barcelona&#41;&#44; Ana M&#233;ndez Echevarr&#237;a &#40;Hospital Universitario La Paz&#44; Madrid&#41;&#44; Roi Pi&#241;eiro P&#233;rez &#40;Hospital General de Villalba&#41;&#44; Bego&#241;a Santiago Garc&#237;a &#40;Hospital General Universitario Gregorio Mara&#241;&#243;n&#44; Madrid&#41;&#44; Mar&#237;a Luisa Navarro &#40;Hospital General Universitario Gregorio Mara&#241;&#243;n&#44; Madrid&#41;&#46;</p>"
                "etiqueta" => "A&#46;3"
                "titulo" => "SEIP Tuberculosis and Other Mycobacterial Infections Working Group"
                "identificador" => "sec0020"
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ISSN: 23412879
Original language: English
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