Published in PLOS One on 2026-09-01, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. HealthSignal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Heribert Stich, Angelika Deisling, Fabian Standl
Source: PLOS One • DOI 10.1371/journal.pone.0354114
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
We examined infectious disease screening in unaccompanied minors because migration-related exposures may increase the risk of communicable diseases and because early detection enables timely treatment and prevention. However, the relationship between migration journey characteristics and infectious disease prevalence in this population remains poorly understood. We therefore examined infectious disease prevalence among unaccompanied minors upon arrival in Germany and explored its association with migration journey characteristics.
We conducted a retrospective cross-sectional study using standardized, case-specific health assessments conducted by the Public Health Service in one Bavarian district. Routine data were collected over thirteen consecutive years (2010–2022). We first described the prevalence of detected infections in the full cohort of 237 unaccompanied minors undergoing legally mandated screening, including tuberculosis, hepatitis A, hepatitis B, hepatitis C, scabies, and intestinal parasitic infections. We then analyzed the subgroup of 129 minors with documented migration journey information to describe socio-epidemiological profiles and explore patterns according to number of transit countries, journey duration, and modes of migration.
In the full cohort, at least one infectious disease was detected in 61.2% of minors. Prevalence patterns were broadly similar in the migration-history subgroup, where 65.1% had at least one detected infectious disease. In the subgroup, most unaccompanied minors were male (79.8%) and aged 13.5 to 16.5 years (55.0%). Tuberculosis prevalence was highest among Sub-Saharan African participants (20.0%, 95% CI 11.2–32.7), while hepatitis B predominated in North African and Southeast European minors. Over half (52.9%) passed through three to four countries, and 72.1% used two different modes of travel. Although confidence intervals were wide, infectious disease positivity was numerically higher among minors with longer documented migration journeys.
Infectious disease positivity was common among unaccompanied minors in this cohort and showed similar overall prevalence patterns in the full cohort and the migration-history subgroup. Migration journey characteristics provided useful descriptive context, but observed differences by journey duration were not supported by clear statistical evidence and should be interpreted cautiously given the limited sample size, wide confidence intervals, and potential confounding. These findings support structured health screening after arrival and careful documentation of migration history during clinical assessment.
Background
Forced migration is a critical public health challenge. Approximately 110 million people worldwide were forcibly displaced in 2023 [1]. A relevant proportion of these were children and adolescents, including unaccompanied minors, that is, individuals younger than 18 years who migrate without parents or legal guardians [2–4]. Unstable living conditions, interrupted healthcare, and migration-related exposures may increase this group’s vulnerability to communicable diseases [5–7]. Although infectious disease prevalence has been documented in broader migrant populations [8–15], the relationship between migration journey characteristics and infection patterns in unaccompanied minors remains poorly characterized. Germany requires standardized health screening for all asylum seekers upon arrival. Depending on age and clinical indication, these examinations include legally required testing for selected infectious diseases such as tuberculosis, hepatitis A, hepatitis B, hepatitis C, and selected parasitic and dermatological infections [16]. We conducted this study over 13 years because relatively few eligible cases presented annually in this region. During the study period, Germany received substantial numbers of asylum seekers, with Bavaria implementing regionally organized reception and health screening structures [17].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider public health desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Heribert Stich, Angelika Deisling, Fabian Standl. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by HealthSignal. The researchers are the authors of the source study, not members of HealthSignal’s staff.
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