gms | German Medical Science

Introduction: The surge in global migration has given rise to significant healthcare challenges for migrants throughout European countries, particularly in children. As Germany emerges as the second most prominent destination for migrants worldwide, the optimization of health assessments for refugee children remains a pressing and formidable challenge.

In Munich, as in many other cities across the country, the initial contact for minors with the health authorities occurs through the public health department as part of tuberculosis (TB) screening. In recent years, public health authorities encountered challenges in referring children for additional TB assessments. The unique characteristics of these pediatric patients posed difficulties for medical personnel in providing quality assessments due to the absence of structures to adapt services to their specific situations and backgrounds. Consequently, significant delays in the treatment of TB cases occurred. These challenges underscore the imperative to enhance the quality of care for children with a migration background, especially those who have been exposed to or infected with TB.

Methods: The PMPH was launched in March 2023 as a pilot project, representing an innovative collaboration between the Public Health Department of Munich and the pediatric infectious disease department of the Dr. von Haunerschen Children’s Hospital. This initiative has established a dedicated medical team providing specialized consultations for children with a migration background.

Results: Since the project’s launch until January 2024, the PMPH has provided care for more than 120 children from over 25 different countries of origin. The implementation of the new clinic ensures timely care for the children, supports the establishment of a pediatric TB cohort, and takes new approaches towards holistic care. This includes Therapeutic Drug Monitoring (TDM) for children undergoing therapy for medication adjustment and ensuring therapy adherence. In addition to TB care, the center also implements general and infectious disease screening. Simultaneously, collaboration with specialized institutes for mental health in the context of migration is established to address underlying disorders. Collaboration with social and interpreter services is also part of the program to create a culturally sensitive atmosphere. We present the first results of the PMPH from March 2023 to March 2024.

Discussion: The PMPH project has already contributed successfully to improving the care of migrated children with TB. Additionally, the project provides a valuable framework for clinical and healthcare research in the field of pediatric TB and migrant child health.