Medical care and initial health status of French children returnees from Jihadist Group Operation Areas: a cross-sectional study from 2017 to 2020 in one referral French hospital.

Introduction: The return of foreign fighters's children whose parents joined the so called « islamic state » in the Iraq-Syrian area, had been a very controversial topic. Since 2017, a national procedure in France has been designed to coordinate their care, including a systematic pediatric medical assessment.

Methods: The aim of this cross-sectional study was to assess the prevalence rate of diseases diagnosed at their arrival in France. Demographic characteristics and clinical assessment of all the children included in this procedure in one paediatric center between 2017 and 2020 were retrospectively collected.

Findings: We included 70 children (44M, 26F ; mean age : 4.9 years old (±3.8)). In average, they crossed two countries, mainly Syria (n=55), Turkey (n=53) and Iraq (n=18). At least one parent was deceased or incarcerated in respectively 25 (36%) and 50 cases (71%). Main pathologies were infectious diseases (n=14, 20%), including one lymph node tuberculosis. Mild nutritional impairment (n=55, 78%-95%), stunting (n=13, 19%- 95%), psychomotor troubles (n=18, 26%) and psychological or behavior troubles (n=36, 51%) were also reported. Nutritional impairment was associated with a longer stay abroad (aOR 4.34, 95% CI [1.21-18.24], p=0.03) whereas no significant association was found between the other diseases and age, birth country or length of stay abroad.

Conclusions: Nutritional impairment and psychomotor or behaviour troubles were more frequent than other diseases in our cohort. These results emphasize the importance of considering the developmental aspects of these young children who experimented multiple potentially psychic traumatic events.