<P> Refugees are often more susceptible to illness for several reasons, including a lack of immunity to local strains of malaria and other diseases . Displacement of a people can create favorable conditions for disease transmission . Refugee camps are typically heavily populated with poor sanitary conditions . The removal of vegetation for space, building materials or firewood also deprives mosquitoes of their natural habitats, leading them to more closely interact with humans . In the 1970s, Afghani refugees that were relocated to Pakistan were going from a country with an effective malaria control strategy, to a country with a less effective system . </P> <P> The refugee camps were built near rivers or irrigation sites had higher malaria prevalence than refugee camps built on dry lands . The location of the camps lent themselves to better breeding grounds for mosquitoes, and thus a higher likelihood of malaria transmission . Children aged 1--15 were the most susceptible to malaria infection, which is a significant cause of mortality in children younger than 5 . Malaria was the cause of 16% of the deaths in refugee children younger than 5 years of age . Malaria is one of the most commonly reported causes of death in refugees and displaced persons . Since 2014, reports of malaria cases in Germany had doubled compared to previous years, with the majority of cases found in refugees from Eritrea . </P> <P> The World Health Organization recommends that all people in areas that are endemic for malaria use long - lasting insecticide nets . A cohort study found that within refugee camps in Pakistan, insecticide treated bed nets were very useful in reducing malaria cases . A single treatment of the nets with the insecticide permethrin remained protective throughout the 6 month transmission season . </P> <P> Access to services depends on many factors, including whether a refugee has received official status, is situated within a refugee camp, or is in the process of third country resettlement . The UNHCR recommends integrating access to primary care and emergency health services with the host country in as equitable a manner as possible . Prioritized services include areas of maternal and child health, immunizations, tuberculosis screening and treatment, and HIV / AIDS - related services . Despite inclusive stated policies for refugee access to health care on the international levels, potential barriers to that access include language, cultural preferences, high financial costs, administrative hurdles, and physical distance . Specific barriers and policies related to health service access also emerge based on the host country context . For example, primaquine, an often recommended malaria treatment is not currently licensed for use in Germany and must be ordered from outside the country . </P>

Where have refugees come from in the past