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Cruz A, Sequeira-Aymar E, Gonçalves AQ, Camps-Vila L, Monclús-González MM, Revuelta-Muñoz EM, Busquet-Solé N, Sarriegui-Domínguez S, Casellas A, Cuxart-Graell A, Rosa Dalmau Llorca M, Aguilar-Martín C, Requena-Méndez A. Epidemiology of infectious diseases in migrant populations from endemic or high-endemic countries: A multicentric primary care-based study in Spain. Trop Med Int Health 2024; 29:820-832. [PMID: 39031944 DOI: 10.1111/tmi.14036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2024]
Abstract
OBJECTIVES We aimed to evaluate the epidemiology of seven infections (Chagas disease, strongyloidiasis, schistosomiasis, human immunodeficiency virus, hepatitis B and C virus, and active tuberculosis) in migrant populations attended at primary care facilities in Catalonia, Spain. METHODS This is a cross sectional study conducted from March to December 2018 at eight primary care centres in Catalonia, Spain where health professionals were recommended to systematically screen multiple infections in migrants considering the endemicity of the pathogens in their country of birth. Routine health data were retrospectively extracted from electronic health records of the primary care centres. The proportion of cases among individuals tested for each infection was estimated with its 95% confident interval (CI). Mixed-effects logistics regression models were conducted to assess any possible association between the exposure variables and the primary outcome. RESULTS Out of the 15,780 migrants that attended primary care centres, 2410 individuals were tested for at least one infection. Of the 508 (21.1%) migrants diagnosed with at least one condition, a higher proportion originated from Sub-Saharan Africa (207, 40.7%), followed by South-East Europe (117, 23.0%) and Latin-America (88, 17.3%; p value <0.001). The proportion of migrants diagnosed with Chagas disease was 5/122 (4.1%, 95%CI 0.5-7.7), for strongyloidiasis 56/409 (13.7%, 95%CI 10.3-17.0) and for schistosomiasis 2/101 (2.0%, 95%CI 0.0-4.7) with very few cases tested. The estimated proportion for human immunodeficiency virus was 67/1176 (5.7%, 95%CI 4.4-7.0); 377/1478 (25.5%, 95%CI 23.3-27.7) for hepatitis B virus, with 108/1478 (7.3%, 95%CI 6.0-8.6) of them presenting an active infection, while 31/1433 (2.2%, 95%CI 1.4-2.9) were diagnosed with hepatitis C virus. One case of active tuberculosis was diagnosed after testing 172 migrant patients (0.6%, 95%CI 0.0-1.7). CONCLUSIONS We estimated a high proportion of the studied infections in migrants from endemic areas. Country-specific estimations of the burden of infections in migrants are fundamental for the implementation of preventive interventions.
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Affiliation(s)
- Angeline Cruz
- ISGlobal, Barcelona, Spain
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Ethel Sequeira-Aymar
- ISGlobal, Barcelona, Spain
- Consorci d'Atenció Primària de Salut Barcelona Esquerra (CAPSBE) Casanova, Barcelona, Spain
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Alessandra Queiroga Gonçalves
- Unitat de Suport a la Recerca Terres de l'Ebre, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Tarragona, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Barcelona, Spain
| | - Laura Camps-Vila
- Unitat Docent Multiprofessional d'Atenció Familiar i Comunitària Catalunya Central, Institut Català de la Salut Carrer Pica d'Estats, Barcelona, Spain
| | | | - Elisa M Revuelta-Muñoz
- Centre d'Atenció Primària Rambla Ferran, Institut Català de la Salut (ICS), Lleida, Spain
| | - Núria Busquet-Solé
- Centre d'Atenció Primària Sagrada Família, Institut Català de la Salut (ICS), Barcelona, Spain
| | | | | | | | - M Rosa Dalmau Llorca
- Unitat de Suport a la Recerca Terres de l'Ebre, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Tarragona, Spain
- Equip d'Atenció Primària Tortosa Oest, Institut Català de la Salut (ICS), Tarragona, Spain
| | - Carina Aguilar-Martín
- Unitat de Suport a la Recerca Terres de l'Ebre, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Tarragona, Spain
- Unitat d'Avaluació, Direcció d'Atenció Primària Terres de l'Ebre, Institut Català de la Salut, Tarragona, Spain
| | - Ana Requena-Méndez
- ISGlobal, Barcelona, Spain
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- CIBERINFEC, ISCIII-CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Spain
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Boukari Y, Devakumar D. Far-right riots in the UK: the culmination of years of rhetoric and policies. Lancet 2024:S0140-6736(24)01713-6. [PMID: 39217993 DOI: 10.1016/s0140-6736(24)01713-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2024] [Accepted: 08/16/2024] [Indexed: 09/04/2024]
Affiliation(s)
- Yamina Boukari
- Institute of Health Informatics, University College London, London NW1 2DA, UK.
| | - Delan Devakumar
- Institute for Global Health, University College London, London NW1 2DA, UK
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Kenny KS, Wanigaratne S, Merry L, Siddiqi A, Urquia ML. Discrimination and Racial Inequities in Self-reported Mental Health Among Immigrants and Canadian-Born Individuals in a Large, Nationally Representative Canadian Survey. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02128-4. [PMID: 39164490 DOI: 10.1007/s40615-024-02128-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 08/02/2024] [Accepted: 08/06/2024] [Indexed: 08/22/2024]
Abstract
We examined the link between discrimination and self-rated mental health (SRMH) among immigrants and Canadian-born individuals, stratified according to an individual's identification as racialized or white. Using data from Canada's General Social Survey (2014) (weighted N = 27,575,000) with a novel oversample of immigrants, we estimated the association of perceived discrimination with SRMH separately among immigrants and Canadian-born individuals and stratified by racialized status. Among immigrants, we also investigated whether age-at-arrival attenuated or strengthened associations. The prevalence of discrimination was higher among racialized compared to white immigrants (18.9% versus 11.8%), and among racialized compared to white non-immigrants (20.0% versus 10.5%). In the adjusted model with immigrants, where white immigrants not reporting discrimination were the referent group, both white (adjusted prevalence odds ratio [aPOR] 6.11, 95% confidence interval [CI] 3.08, 12.12) and racialized immigrants (aPOR 2.28, 95% CI 1.29, 4.04) who experienced discrimination reported poorer SRMH. The associations were weaker among immigrants who immigrated in adulthood. In the adjusted model with non-immigrants, compared to unexposed white respondents, Canadian-born white respondents who experienced discrimination reported poorer SRMH (aPOR 3.62, 95% CI 2.99, 4.40) while no statistically significant association was detected among racialized respondents (aPOR 2.24, 95% CI 0.90, 5.58). Racialized respondents experienced significant levels of discrimination compared to white respondents irrespective of immigrant status. Discrimination was associated with poor SRMH among all immigrants, with some evidence of a stronger association for white immigrants and immigrants who migrated at a younger age. For Canadian-born individuals, discrimination was associated with poor SRMH among white respondents only.
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Affiliation(s)
- Kathleen S Kenny
- Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
| | - Susitha Wanigaratne
- Edwin S.H. Leong Centre for Healthy Children, SickKids Research Institute & the University of Toronto, Toronto, Canada
- ICES, Toronto, Canada
| | - Lisa Merry
- Faculty of Nursing, University of Montreal, Montreal, Canada
- SHERPA University Institute, Montreal, Canada
| | - Arjumand Siddiqi
- Division of Epidemiology, Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, USA
| | - Marcelo L Urquia
- Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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Du L, Li X, Lu X, Guo Y. The synthesis strategies of covalent organic frameworks and advances in their application for adsorption of heavy metal and radionuclide. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 939:173478. [PMID: 38815828 DOI: 10.1016/j.scitotenv.2024.173478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/09/2024] [Accepted: 05/21/2024] [Indexed: 06/01/2024]
Abstract
Covalent organic frameworks (COFs) are a novel type of porous materials, with unique properties, such as large specific surface areas, high porosity, pronounced crystallinity, tunable pore sizes, and easy functionalization, and thus have received considerable attention in recent years. COFs play an essential role in the catalytic degradation, adsorption, and separation of heavy metals, radionuclides. In recent years, considering several outstanding characteristics of COFs, including their good thermal/chemical stability, high crystallinity, and remarkable adsorption capacity, they have been widely used in the removal of various environment pollutants. This review primarily discusses the synthesis strategies of COFs along with their diverse synthesis methods, and provides a comprehensive summary and analysis of recent research advances in the use of COFs for removing heavy metal ions and radionuclides from water bodies. Additionally, the adsorption mechanism of COFs with regard to metal ions was determined by analyzing the structural characteristics of COFs. Finally, the future research directions on COFs adsorb rare earth element was discussed.
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Affiliation(s)
- Lili Du
- Key Laboratory of Chemistry of Northwestern Plant Resources, CAS and Key Laboratory for Natural Medicines of Gansu Province, Lanzhou Institute of Chemical Physics, Chinese Academy of Sciences, Lanzhou 730000, PR China; University of Chinese Academy of Sciences, Beijing 100049, PR China
| | - Xiang Li
- Key Laboratory of Chemistry of Northwestern Plant Resources, CAS and Key Laboratory for Natural Medicines of Gansu Province, Lanzhou Institute of Chemical Physics, Chinese Academy of Sciences, Lanzhou 730000, PR China; University of Chinese Academy of Sciences, Beijing 100049, PR China
| | - Xiaofeng Lu
- Key Laboratory of Chemistry of Northwestern Plant Resources, CAS and Key Laboratory for Natural Medicines of Gansu Province, Lanzhou Institute of Chemical Physics, Chinese Academy of Sciences, Lanzhou 730000, PR China.
| | - Yong Guo
- Key Laboratory of Chemistry of Northwestern Plant Resources, CAS and Key Laboratory for Natural Medicines of Gansu Province, Lanzhou Institute of Chemical Physics, Chinese Academy of Sciences, Lanzhou 730000, PR China.
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Alves YM, Berra TZ, de Jezus SV, Araújo VMS, Pinheiro JDS, de Assis LBDO, Canelonez M, Sacramento DS, Perez F, Maciel ELN, Arcêncio RA. Adherence to Short-Duration Treatment (3HP) for Latent Tuberculosis among International Migrants in Manaus, Amazonas: Evaluation of the Efficacy of Different Treatment Modalities. Microorganisms 2024; 12:1629. [PMID: 39203470 PMCID: PMC11356601 DOI: 10.3390/microorganisms12081629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 07/31/2024] [Accepted: 08/06/2024] [Indexed: 09/03/2024] Open
Abstract
Migration, a multifaceted phenomenon, has a significant impact on health. Migrants perform similar movement patterns within their country of origin, in transit, and in the country of destination, thus making it difficult to monitor TB treatment throughout the journey. The objective was to compare the effectiveness of different treatment modalities in adherence to the short-term regimen for LTBI (3HP) among international migrants and refugees. This is a quasi-experimental study conducted in Manaus-AM. The study population was made up of international migrants. The certification and monitoring of medication intake employed three strategies: self-administration (SA), directly observed conventional therapy (DOT), and Video Telemonitoring System for Tuberculosis Treatment (VDOT). The VDOT group and SA group exhibited the lowest rate of treatment dropout or interruption at 16.1%, followed by the DOT group at 23.1%. The results suggest that the most effective strategy for ensuring adherence among migrants and refugees was VDOT (OR_adj 0.26; CI 0.7-0.94), suggesting that migrants may be more likely to adhere to and complete their treatment. The results show that relying on different treatment strategies, adapted to the individuals' needs and risk factors, is a viable and effective way of providing person-centered TB care.
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Affiliation(s)
- Yan Mathias Alves
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Sao Paulo, Brazil; (Y.M.A.)
- Brazilian Tuberculosis Research Network (REDE-TB), Rio de Janeiro 21941-904, Rio de Janeiro, Brazil
| | - Thaís Zamboni Berra
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Sao Paulo, Brazil; (Y.M.A.)
- Brazilian Tuberculosis Research Network (REDE-TB), Rio de Janeiro 21941-904, Rio de Janeiro, Brazil
| | - Sonia Vivian de Jezus
- Sinop Campus, Federal University of Mato Grosso (UFMT), Sinop 78550-728, Mato Grosso, Brazil
| | - Vânia Maria Silva Araújo
- Brazilian Tuberculosis Research Network (REDE-TB), Rio de Janeiro 21941-904, Rio de Janeiro, Brazil
| | - Jair dos Santos Pinheiro
- State Tuberculosis Control Program of Amazonas, Manaus 69093-018, Amazonas, Brazil; (J.d.S.P.); (L.B.d.O.d.A.)
| | | | - Marvis Canelonez
- State Tuberculosis Control Program of Amazonas, Manaus 69093-018, Amazonas, Brazil; (J.d.S.P.); (L.B.d.O.d.A.)
| | | | - Freddy Perez
- Communicable Diseases Prevention, Control, and Elimination and Environmental Determinants of Health Department, Pan American Health Organization, Washington, DC 20037, USA;
- Department of Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90050-170, Rio Grande do Sul, Brazil
| | - Ethel Leonor Noia Maciel
- Ministry of Health, Secretariat for Health Surveillance and the Environment, Brasília 70058-900, Distrito Federal, Brazil
| | - Ricardo Alexandre Arcêncio
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Sao Paulo, Brazil; (Y.M.A.)
- Brazilian Tuberculosis Research Network (REDE-TB), Rio de Janeiro 21941-904, Rio de Janeiro, Brazil
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Cherri Z, Lau K, Nellums LB, Himmels J, Deal A, McGuire E, Mounier-Jack S, Norredam M, Crawshaw A, Carter J, Seedat F, Clemente NS, Bouaddi O, Friedland JS, Edelstein M, Hargreaves S. The immune status of migrant populations in Europe and implications for vaccine-preventable disease control: a systematic review and meta-analysis. J Travel Med 2024; 31:taae033. [PMID: 38423523 DOI: 10.1093/jtm/taae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/10/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Ensuring vaccination coverage reaches established herd immunity thresholds (HITs) is the cornerstone of any vaccination programme. Diverse migrant populations in European countries have been associated with cases of vaccine-preventable diseases (VPDs) and outbreaks, yet it is not clear to what extent they are an under-immunized group. METHODS We did a systematic review and meta-analysis to synthesize peer-reviewed published primary research reporting data on the immune status of migrants in EU/EEA countries, the UK and Switzerland, calculating their pooled immunity coverage for measles, mumps, rubella and diphtheria using random-effects models. We searched on Web of Science, Embase, Global Health and MEDLINE (1 January 2000 to 10 June 2022), with no language restrictions. The protocol is registered with PROSPERO (CRD42018103666). FINDINGS Of 1103 abstracts screened, 62 met eligibility criteria, of which 39 were included in the meta-analysis. The meta-analysis included 75 089 migrants, predominantly from outside Europe. Pooled immunity coverage among migrant populations was well below the recommended HIT for diphtheria (n = 7, 57.4% [95% confidence interval (CI): 43.1-71.7%] I2 = 99% vs HIT 83-86%), measles (n = 21, 83.7% [95% CI: 79.2-88.2] I2 = 99% vs HIT 93-95%) and mumps (n = 8, 67.1% [95% CI: 50.6-83.6] I2 = 99% vs HIT 88-93%) and midway for rubella (n = 29, 85.6% [95% CI: 83.1-88.1%] I2 = 99% vs HIT 83-94%), with high heterogeneity across studies. INTERPRETATION Migrants in Europe are an under-immunized group for a range of important VPDs, with this study reinforcing the importance of engaging children, adolescents and adults in 'catch-up' vaccination initiatives on arrival for vaccines, doses and boosters they may have missed in their home countries. Co-designing strategies to strengthen catch-up vaccination across the life course in under-immunized groups is an important next step if we are to meet European and global targets for VPD elimination and control and ensure vaccine equity.
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Affiliation(s)
- Zeinab Cherri
- The Migrant Health Research Group, Institute for Infection and Immunity, St Georges, University of London, London, UK
| | - Karen Lau
- The Migrant Health Research Group, Institute for Infection and Immunity, St Georges, University of London, London, UK
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Lancet Migration European Regional Hub
| | - Laura B Nellums
- Faculty of Medicine and Heath Sciences, University of Nottingham, Nottingham, UK
| | - Jan Himmels
- The Migrant Health Research Group, Institute for Infection and Immunity, St Georges, University of London, London, UK
| | - Anna Deal
- The Migrant Health Research Group, Institute for Infection and Immunity, St Georges, University of London, London, UK
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Emma McGuire
- The Migrant Health Research Group, Institute for Infection and Immunity, St Georges, University of London, London, UK
| | - Sandra Mounier-Jack
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Marie Norredam
- Danish Research Centre for Migration, Ethnicity and Health, Section of Health Services Research, Department of Public Health, University of Copenhagen, Denmark
- Department of Infectious Diseases, Hvidovre Hospital, University of Copenhagen, Denmark
| | - Alison Crawshaw
- The Migrant Health Research Group, Institute for Infection and Immunity, St Georges, University of London, London, UK
| | - Jessica Carter
- The Migrant Health Research Group, Institute for Infection and Immunity, St Georges, University of London, London, UK
| | - Farah Seedat
- The Migrant Health Research Group, Institute for Infection and Immunity, St Georges, University of London, London, UK
| | - Nuria Sanchez Clemente
- The Migrant Health Research Group, Institute for Infection and Immunity, St Georges, University of London, London, UK
| | - Oumnia Bouaddi
- Lancet Migration European Regional Hub
- International School of Public Health, Mohammed VI University of Sciences and Health, Casablanca, Morocco
- Mohammed VI Center for Research and Innovation, Rabat, Morocco
| | - Jon S Friedland
- Institute for Infection and Immunity, St Georges, University of London, London, UK
| | | | - Sally Hargreaves
- The Migrant Health Research Group, Institute for Infection and Immunity, St Georges, University of London, London, UK
- Lancet Migration European Regional Hub
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Douradinha B. Infectious diseases and discrimination: Sicily's Lampedusa migrants. Trends Immunol 2024; 45:577-579. [PMID: 38997890 DOI: 10.1016/j.it.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 06/21/2024] [Accepted: 06/21/2024] [Indexed: 07/14/2024]
Abstract
Lampedusa, a picturesque Italian island in the Mediterranean, serves as a gateway for migrants from Africa and Asia to Europe. Despite populist rhetoric portraying migrants as carriers of disease, epidemiological data reveal very low levels of communicable diseases among migrants, challenging false narratives and xenophobic sentiments propagated by populist governments.
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Affiliation(s)
- Bruno Douradinha
- Independent Researcher; Current address: Vaccine Technology, Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Headington, Oxford OX3 7TY, UK.
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Minopoli M, Noël L, Dagge A, Blayney G, Bhide A, Thilaganathan B. Maternal ethnicity and socioeconomic deprivation: influence on adverse pregnancy outcomes. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2024; 64:187-192. [PMID: 38419266 DOI: 10.1002/uog.27625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 02/17/2024] [Accepted: 02/18/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE To evaluate the relative importance of ethnicity and socioeconomic deprivation in determining the likelihood and prevalence of placentally derived composite of adverse pregnancy outcomes (CAPO) and composite of severe adverse pregnancy outcomes (CAPO-S). METHODS This was a single-center retrospective cohort study of data obtained in a tertiary maternity unit. Data regarding ethnicity and socioeconomic deprivation (as measured with indices of multiple deprivation) were collected for 13 165 singleton pregnancies screened routinely in the first trimester for pre-eclampsia using the Fetal Medicine Foundation combined risk-assessment algorithm. CAPO was defined as the presence of one or more interrelated outcomes associated with placental dysfunction, namely, hypertensive disorders of pregnancy, preterm birth, birth weight ≤ 10th centile and stillbirth. CAPO-S was defined as the presence of one or more of the following: hypertensive disorders of pregnancy at < 37 + 0 weeks, preterm birth at < 34 + 0 weeks, birth weight ≤ 5th centile and stillbirth at < 37 + 0 weeks. RESULTS The prevalence of CAPO was 16.3% in white women, 29.3% in black women and 29.3% in South Asian women. However, half (51.7%) of all CAPO cases occurred in white women. There was a strong interaction between ethnicity and socioeconomic deprivation, with a correlation coefficient of -0.223. Both ethnicity and socioeconomic deprivation influenced the prevalence of CAPO and CAPO-S, with the contribution of ethnicity being the strongest. CONCLUSIONS Black and Asian ethnicity, as well as socioeconomic deprivation, influence the prevalence of placenta-mediated adverse pregnancy outcomes. Despite this, most adverse pregnancy outcomes occur in white women, who represent the majority of the population and are also affected by socioeconomic deprivation. For these reasons, inclusion of socioeconomic deprivation should be considered in early pregnancy risk assessment for placenta-mediated CAPO. © 2024 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- M Minopoli
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
- Department of Medicine and Surgery, Obstetrics and Gynaecology Unit, Università degli Study di Parma, Parma, Italy
| | - L Noël
- Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - A Dagge
- Department of Obstetrics, Gynecology and Reproductive Medicine, Northern Lisbon University Hospital, Lisbon, Portugal
| | - G Blayney
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
- Department of Fetal Medicine, Royal Jubilee Maternity Service, Belfast Health and Social Care Trust, Belfast, UK
| | - A Bhide
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | - B Thilaganathan
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
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Borschmann R, Kinner SA, Hedrick K. Setting the standards for safeguarding health and wellbeing in US Immigration and Customs Enforcement detention facilities. LANCET REGIONAL HEALTH. AMERICAS 2024; 36:100851. [PMID: 39184237 PMCID: PMC11343729 DOI: 10.1016/j.lana.2024.100851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 07/18/2024] [Accepted: 07/19/2024] [Indexed: 08/27/2024]
Affiliation(s)
- Rohan Borschmann
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
- Medical Sciences Division, Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxfordshire, UK
- Justice Health Group, enAble Institute, Curtin University, Perth, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Stuart A. Kinner
- Justice Health Group, enAble Institute, Curtin University, Perth, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Kyli Hedrick
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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McGranahan M, Augarde E, Schoenaker D, Duncan H, Mann S, Bick D, Boardman F, Oyebode O. Preconception health among migrant women in England: A cross-sectional analysis of maternity services data 2018-2019. J Migr Health 2024; 10:100250. [PMID: 39156886 PMCID: PMC11327935 DOI: 10.1016/j.jmh.2024.100250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 05/17/2024] [Accepted: 07/18/2024] [Indexed: 08/20/2024] Open
Abstract
Background Perinatal outcomes are poor among migrant women in vulnerable situations, but little is known about their health preconception. We investigated preconception health inequalities between migrant women in vulnerable situations and non-migrant women. Methods This national cross-sectional study used data from the NHS Maternity Services Data Set (MSDS) version 1.5, incorporating NHS maternity services in England. All 652,880 women with an antenatal booking appointment between 1/4/2018 and 31/3/2019 were included. Migration category data were available for 66.2 % (n = 432,022). Odds ratios were calculated comparing preconception indicators among probable migrants in vulnerable situations (English not their first language with complex social factors (CSF)), probable migrants not in vulnerable situations (English not their first language without CSF), probable non-migrants in vulnerable situations (English their first language with CSF) and probable non-migrants not in vulnerable situations (English their first language without CSF). CSF include recent migrants, asylum seekers, refugees, difficulty reading/speaking English; alcohol and/or drugs misuse; aged under 20; and/or experiencing domestic abuse. Findings We identified 3.8 % (25,070 women) of the study population as probable migrants in vulnerable situations, 10.2 % (66,783 women) as probable migrants not in vulnerable situations, 5.6 % (36,433 women) as probable non-migrants in vulnerable situations, 46.5 % (303,737 women) as probable non-migrants not in vulnerable situations, and 33.8 % as having missing migration category data. Probable migrants in vulnerable situations (n = 25,070) had over twice the odds of not taking folic acid preconception compared to probable non-migrants not in vulnerable situations (odds ratio 2.15, 95 % confidence interval 2.06-2.25). They had increased odds of previous obstetric complications and being underweight, but lower odds of physical and mental health conditions (apart from diabetes and hepatitis b), smoking and overweight or obesity. Interpretation Inequalities exist across many preconception indicators, highlighting opportunities to improve preconception health in this population to reduce health inequalities and improve perinatal and neonatal outcomes. Funding Medical Research Council.
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Affiliation(s)
- Majel McGranahan
- University of Warwick Medical School, Medical School Building, Coventry CV4 7HL, UK
| | - Elizabeth Augarde
- Office for Health Improvement and Disparities (OHID), 39 Victoria Street, Westminster, London SW1H 0EU, UK
| | - Danielle Schoenaker
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Tremona Road SO16 6YD, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, SO16 6YD, Southampton, UK
| | - Helen Duncan
- Office for Health Improvement and Disparities (OHID), 39 Victoria Street, Westminster, London SW1H 0EU, UK
| | - Sue Mann
- NHS England and Improvement, Wellington House, London SE1 8UG, UK
| | - Debra Bick
- Warwick Clinical Trials Unit, University of Warwick, Gibbet Hill Road, Coventry CV4 7AL, UK
| | - Felicity Boardman
- University of Warwick Medical School, Medical School Building, Coventry CV4 7HL, UK
| | - Oyinlola Oyebode
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, EC1M 6BQ, UK
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11
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Seedat F, Evangelidou S, Abdellatifi M, Bouaddi O, Cuxart-Graell A, Edries H, Elafef E, Maatoug T, Ouahchi A, Mathilde Pampiri L, Deal A, Arias S, Abdelkhalek A, Arisha AH, Assarag B, Bani IA, Chaoui A, Chemao-Elfihri W, Hassouni K, Hilali M, Khalis M, Mansour W, Mtiraoui A, Wickramage K, Zenner D, Requena-Mendez A, Hargreaves S, Migrant Health Working Group MENA, Abdelkhalek A, Adam A, Aissa ABH, Agyemang C, Altyib S, Ardalan A, Belgacem HB, Belkhammar I, Calvot T, Casamitjana N, Ceretti L, Chavassieux N, Chrifi H, Douagi M, Elnil A, Fanjul G, Fouad FM, Hamed A, Ito C, Khelifi A, Makhlouf L, Mokni M, Olchini D, Oufkir T, Park N, Raffa G, Saidi W, Santafé S, Sironi A, Temimi F, Turki Z. Defining indicators for disease burden, health outcomes, policies and barriers and facilitators to health services for migrant populations in the Middle East and North African region: a protocol for a suite of systematic reviews. BMJ Open 2024; 14:e083813. [PMID: 39002961 PMCID: PMC11255408 DOI: 10.1136/bmjopen-2023-083813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 06/11/2024] [Indexed: 07/15/2024] Open
Abstract
INTRODUCTION The Middle East and North African (MENA) region is characterised by high and complex migration flows, yet little is known about the health of migrant populations, their levels of underimmunisation and access to healthcare provision. Data are needed to support regional elimination and control targets for key diseases and the design and delivery of programmes to improve health outcomes in these groups. This protocol describes a suite of seven systematic reviews that aim to identify, appraise and synthesise the available evidence on the burden and health outcomes, policies and access (barriers and facilitators) related to these mobile populations in the region. METHODS Seven systematic reviews will cover three questions to explore the: (1) burden and health outcomes, (2) policies and (3) healthcare barriers and facilitators for the following seven disease areas in migrants in the MENA region: tuberculosis, HIV and hepatitis B and C, malaria and neglected tropical diseases, diabetes, mental health, maternal and neonatal health, and vaccine-preventable diseases. We will search electronic databases for studies in any language (year 2000-2023), reference-check relevant publications and cross-check included studies with experts. We will search for grey literature by hand searching key databases and websites (including regional organisations and MoH websites) for country-specific guidelines and talking to our network of experts for local and regional reports and key datasets. We will assess the studies and policies for their quality using appropriate tools. We will meta-analyse the data by disease outcome if they are of sufficient volume and similarity. Where meta-analysis is not possible and where data are on policy or access, we will narratively synthesise the evidence using summary tables, figures and text. DISSEMINATION We anticipate disseminating the findings through peer-reviewed publications, conferences and other formats relevant to all stakeholders. We are following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and protocols will be registered on International Prospective Register of Systematic Reviews.
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Affiliation(s)
- Farah Seedat
- St George's University of London Institute for Infection and Immunity, London, UK
| | | | - Moudrick Abdellatifi
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
| | - Oumnia Bouaddi
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
| | | | - Hassan Edries
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
| | - Eman Elafef
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
| | | | | | | | - Anna Deal
- St George's University of London Institute for Infection and Immunity, London, UK
- London School of Hygiene & Tropical Medicine, London, UK
| | - Sara Arias
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
| | | | | | | | | | | | | | - Kenza Hassouni
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
| | - Mahmoud Hilali
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
| | - Mohamed Khalis
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
| | | | | | | | | | - Ana Requena-Mendez
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Karolinska Institute, Stockholm, Sweden
| | - Sally Hargreaves
- St George's University of London Institute for Infection and Immunity, London, UK
| | | | - MENA Migrant Health Working Group
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Adel Abdelkhalek
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Asad Adam
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Adnene Ben Haj Aissa
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Charles Agyemang
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Salma Altyib
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Ali Ardalan
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Hanen Ben Belgacem
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Imane Belkhammar
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Thomas Calvot
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Nuria Casamitjana
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Luciana Ceretti
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Nelly Chavassieux
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Hassan Chrifi
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Mohamed Douagi
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Algdail Elnil
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Gonzalo Fanjul
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Fouad M Fouad
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Ahmed Hamed
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Chiaki Ito
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Abdedayem Khelifi
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Lora Makhlouf
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Maissa Mokni
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Davide Olchini
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Tarik Oufkir
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Nasong Park
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Giuseppe Raffa
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Wafa Saidi
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Sandra Santafé
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Alice Sironi
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Fatma Temimi
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Zeineb Turki
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
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12
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Lokotola CL, Mash R, Sethlare V, Shabani J, Temitope I, Baldwin-Ragaven L. Migration and primary healthcare in sub-Saharan Africa: A scoping review. Afr J Prim Health Care Fam Med 2024; 16:e1-e10. [PMID: 39099278 PMCID: PMC11304195 DOI: 10.4102/phcfm.v16i1.4507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND Migration in Africa is increasing and driven by a variety of inter-related socio-economic, conflict and climate-related causes. Primary healthcare (PHC) migration on PHC service will be in the forefront of responding to the associated health issues. AIM This study aimed to review the literature on the effect of migration on PHC service delivery in Africa and the challenges facing migrants in accessing PHC. METHOD A systematic approach (Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews) was applied across six databases and grey literature from African universities (2010 to 2021). Data were extracted and analysed quantitatively and qualitatively. RESULTS A total of 3628 studies were identified and 50 were included. Most studies were descriptive or used mixed methods. Publications came from 25 countries, with 52% of studies from South Africa, Uganda and Kenya. Most migrants originated from Zimbabwe, the Democratic Republic of Congo and Somalia. Population health management for migrant communities was challenging. Migration impacted PHC services through an increase in infectious diseases, mental health disorders, reproductive health issues and malnutrition. Primary healthcare services were poorly prepared for handling displaced populations in disaster situations. Access to PHC services was compromised by factors related to migrants, health services and healthcare workers. CONCLUSION Several countries in Africa need to better prepare their PHC services and providers to handle the increasing number of migrants in the African context.Contribution: The review points to the need for a focus on policy, reducing barriers to access and upskilling primary care providers to handle diversity and complexity.
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Affiliation(s)
- Christian Lueme Lokotola
- Department of Family and Emergency Medicine, Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town.
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13
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Saracci R. Displaced People Health, a Challenge for Epidemiology and Public Health. Int J Public Health 2024; 69:1607580. [PMID: 39056060 PMCID: PMC11269613 DOI: 10.3389/ijph.2024.1607580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 05/30/2024] [Indexed: 07/28/2024] Open
Affiliation(s)
- Rodolfo Saracci
- European Educational Programme in Epidemiology, Florence, Italy
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14
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Regmi P, Aryal N, van Teijlingen E, KC RK, Gautam M, Maharjan S. A Qualitative Insight into Pre-Departure Orientation Training for Aspiring Nepalese Migrant Workers. Trop Med Infect Dis 2024; 9:150. [PMID: 39058192 PMCID: PMC11281639 DOI: 10.3390/tropicalmed9070150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/26/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024] Open
Abstract
Pre-departure orientation training (PDOT) can help equip aspiring migrant workers with skills and knowledge to mitigate vulnerabilities throughout their migration journey, including health. In Nepal, PDOT has been mandatory since 2004 for migrant workers awaiting labour permits. The current PDOT programme includes country-specific information as well as health and well-being advice. However, the views of trainees and trainers on PDOT are largely unknown. This qualitative study aims to explore perceptions of migrant workers and relevant stakeholders on the content and delivery of PDOT. Six focus group discussions and six in-depth interviews were conducted with migrants, and eight interviews with key stakeholders were conducted. Thematic analysis resulted in five themes: (a) PDOT structure, accessibility, and implementation; (b) role of stakeholders in labour migration process; (c) coordination and governance; (d) curriculum development and relevance; and (e) capacity of trainers and effectiveness of training. Our findings emphasise the need for a more tailored curriculum with relevant information, education, and communication resources, possibly with input from former migrant workers. Regular updates of training topics and resources, as well as continued engagement with migrants after their employment, are essential for meeting the dynamic demands of the global employment market.
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Affiliation(s)
- Pramod Regmi
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK
| | - Nirmal Aryal
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK
| | - Edwin van Teijlingen
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK
| | - Radheshyam Krishna KC
- Migration Health Division, International Organization for Migration, Tripoli P.O. Box 6748, Libya
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15
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Maia AC, Marques MJ, Goes AR, Gama A, Osborne R, Dias S. Health literacy strengths and needs among migrant communities from Portuguese-speaking African countries in Portugal: a cross-sectional study. Front Public Health 2024; 12:1415588. [PMID: 39022410 PMCID: PMC11253791 DOI: 10.3389/fpubh.2024.1415588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 06/17/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction Health literacy among migrants is a matter of public health and social justice. Migrants from diverse backgrounds encounter challenges such as linguistic barriers, cultural disparities, restricted access to health services, and heterogeneous migration statuses. Addressing these challenges requires careful consideration of their unique experiences and needs to promote equitable health outcomes. This can hinder their ability to navigate the healthcare system, understand health information, and engage in health-promoting behaviours. However, there is still a significant gap in our understanding of health literacy within migrant communities. This study has a dual aim: to identify health literacy strengths and needs among migrants from Portuguese-speaking African Countries (PALOP) countries in the Lisbon Metropolitan Area and to examine associations between demographic, socioeconomic, migration and health condition characteristics and the health literacy domains. Methods A cross-sectional survey was conducted. Data were collected from 506 PALOP migrants using the Health Literacy Questionnaire (HLQ). We also collected demographic, socioeconomic, migration, and health condition data. We employed multiple linear regression to understand the relationship between the HLQ nine domains and these characteristics. Results The HLQ scores revealed distinct patterns of health literacy between the groups. Health literacy needs were particularly evident in the domains related to feeling understood and supported by healthcare providers and navigating the healthcare system. Conversely, higher scores and potential strengths were observed in actively managing one's health and understanding enough health information to make informed decisions. However, in these, the average scores suggest that a high proportion of people recognised difficulties. 'The results also indicated that a higher educational level was associated with increased health literacy. In contrast, low self-perceived health status, living alone, shorter duration of residence in Portugal, and being either undocumented or in the process of obtaining legal status were associated with lower health literacy. Conclusion Our study highlights the importance of migration-related variables and self-reported health status in understanding health literacy among migrant communities. Factors such as length of stay and low self-perceived health status are associated with potentially disadvantageous levels of health literacy, which could exacerbate health inequalities. Assessing these variables is critical to identify gaps in health literacy and develop tailored interventions to reduce health inequalities.
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Affiliation(s)
- Ana Catarina Maia
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center (CHRC), NOVA University Lisbon, Lisbon, Portugal
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Maria João Marques
- NOVA National School of Public Health, Public Health Research Centre, CHRC, REAL, NOVA University Lisbon, Lisbon, Portugal
| | - Ana Rita Goes
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center (CHRC), NOVA University Lisbon, Lisbon, Portugal
| | - Ana Gama
- NOVA National School of Public Health, Public Health Research Centre, CHRC, REAL, NOVA University Lisbon, Lisbon, Portugal
| | - Richard Osborne
- Centre of Global Health and Equity, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Sónia Dias
- NOVA National School of Public Health, Public Health Research Centre, CHRC, REAL, NOVA University Lisbon, Lisbon, Portugal
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Tsoh JY, Takubo Y, Fukui E, Suzuki A, Iwai M, Saito H, Tsujino N, Uchino T, Katagiri N, Nemoto T. Exploring early discontinuation of mental health outpatient treatment: language, demographics and clinical characteristics among migrant populations in Japan. BMJ MENTAL HEALTH 2024; 27:e301059. [PMID: 38960880 PMCID: PMC11227775 DOI: 10.1136/bmjment-2024-301059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/30/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND The fast-growing migrant population in Japan and globally poses challenges in mental healthcare, yet research addressing migrants' mental health treatment engagement remains limited. OBJECTIVE This study examined language proficiency, demographic and clinical characteristics as predictors of early treatment discontinuation among migrants. METHODS Electronic health record data from 196 adult migrants, identified from 14 511 patients who received mental health outpatient treatment during 2016 and 2019 at three central hospitals in the Tokyo-Yokohama metropolitan region of Japan, were used. We conducted multivariable regression models to identify predictors of early discontinuation within 3 months. FINDINGS The study cohort (65% women, age range: 18-90 years, from 29 countries or regions) included 23% non-Japanese speakers. Japanese and non-Japanese speakers had similar discontinuation rates (26% vs 22%). Multivariable models revealed younger age (OR=0.97; 95% CI: 0.95, 0.99; p=0.016) and those with a primary diagnosis other than a schizophrenia spectrum disorder (OR=3.99; 95% CI: 1.36, 11.77; p=0.012) or a neurotic, stress-related and somatoform disorder (OR=2.79; 95% CI: 1.14, 6.84; p=0.025) had higher odds of early discontinuation. These effects were more pronounced among the Japanese speakers with significant language-by-age and language-by-diagnoses interactions. CONCLUSION Younger age and having a primary diagnosis other than a schizophrenia spectrum disorder or a neurotic, stress-related and somatoform disorder increased vulnerability for discontinuing mental health treatment early in Japanese-speaking migrants but not for migrants with limited Japanese proficiency. CLINICAL IMPLICATIONS Understanding language needs within a context of mental health treatment should go beyond assumed or observed fluency. Unmet language needs might increase vulnerability for treatment disengagement among migrants. Targeted clinical efforts are crucial for enhancing early treatment engagement and informing health practices in Japan and countries with growing migrant populations.
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Affiliation(s)
- Janice Y Tsoh
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco School of Medicine, San Francisco, California, USA
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota-ku, Tokyo, Japan
- Department of Psychiatry and Implementation Science, Toho University Faculty of Medicine, Ota-ku, Tokyo, Japan
| | - Youji Takubo
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota-ku, Tokyo, Japan
- Department of Psychiatry and Implementation Science, Toho University Faculty of Medicine, Ota-ku, Tokyo, Japan
| | - Eriko Fukui
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota-ku, Tokyo, Japan
- Department of Psychiatry and Implementation Science, Toho University Faculty of Medicine, Ota-ku, Tokyo, Japan
| | - Ayaka Suzuki
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota-ku, Tokyo, Japan
| | - Momoko Iwai
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota-ku, Tokyo, Japan
| | - Hisaaki Saito
- Department of Neuropsychiatry, Kawasaki Municipal Hospital, Kawasaki, Kanagawa, Japan
| | - Naohisa Tsujino
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota-ku, Tokyo, Japan
- Department of Psychiatry, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Kanagawa, Japan
| | - Takashi Uchino
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota-ku, Tokyo, Japan
- Department of Psychiatry and Implementation Science, Toho University Faculty of Medicine, Ota-ku, Tokyo, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota-ku, Tokyo, Japan
- Department of Psychiatry and Implementation Science, Toho University Faculty of Medicine, Ota-ku, Tokyo, Japan
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota-ku, Tokyo, Japan
- Department of Psychiatry and Implementation Science, Toho University Faculty of Medicine, Ota-ku, Tokyo, Japan
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Eick F, Vallersnes OM, Fjeld HE, Sørbye IK, Valberg M, Dahl C. Perinatal mortality among pregnant undocumented migrants in Norway 1999-2020: A register-based population study. Soc Sci Med 2024; 353:117055. [PMID: 38897075 DOI: 10.1016/j.socscimed.2024.117055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/11/2024] [Accepted: 06/13/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Irregular legal status is a recognized health risk factor in the context of migration. However, undocumented migrants are rarely included in health surveys and register studies. Adverse perinatal outcomes are especially important because they have long-term consequences and societal risk factors are modifiable. In this study, we compare perinatal outcomes in undocumented migrants to foreign-born and Norwegian-born residents, using a population-based register. METHODS We included women 18-49 years old giving birth to singletons as registered in the Medical Birth Registry of Norway from 1999 to 2020. Women were categorized as 'undocumented migrants' (without an identity number), 'documented migrants' (with an identity number and born abroad), and 'non-migrants' (with an identity number and born in Norway). The main outcome was perinatal mortality, i.e., death of a foetus ≥ gestational week 22, or neonate up to seven days after birth. We used log-binominal regression to estimate the association between legal status and perinatal mortality, adjusting for several maternal pre-gestational and gestational factors. Direct standardization was used to adjust for maternal region of origin. ETHICAL APPROVAL Regional Ethical Committee (REK South East, case number 68329). RESULTS We retrieved information on 5856 undocumented migrant women who gave birth during the study period representing 0.5% of the 1 247 537 births in Norway. Undocumented migrants had a relative risk of 6.17 (95% confidence interval 5.29 ̶7.20) of perinatal mortality compared to non-migrants and a relative risk of 4.17 (95% confidence interval 3.51 ̶4.93) compared to documented migrants. Adjusting for maternal region of origin attenuated the results slightly. CONCLUSION Being undocumented is strongly associated with perinatal mortality in the offspring. Disparities were not explained by maternal origin or maternal health factors, indicating that social determinants of health through delays in receiving adequate care and factors negatively influencing gestational length may be of importance.
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Affiliation(s)
- Frode Eick
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Postboks 1130 Blindern, 0318, Oslo, Norway.
| | - Odd Martin Vallersnes
- Department of General Practice, Institute of Health and Society, University of Oslo, Norway; Oslo Accident and Emergency Outpatient Clinic, Department of Emergency General Practice, City of Oslo Health Agency, Norway
| | - Heidi E Fjeld
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Postboks 1130 Blindern, 0318, Oslo, Norway
| | - Ingvil K Sørbye
- Department of Obstetrics, Division of Obstetrics and Gynaecology, Oslo University Hospital, Norway
| | - Morten Valberg
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Postboks 1130 Blindern, 0318, Oslo, Norway; Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Norway
| | - Cecilie Dahl
- Department of Public Health Science, Institute of Health and Society, University of Oslo, Norway
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Mirzaei Damabi N, Begum M, Avery JC, Padhani ZA, Lassi ZS. Unveiling silenced narratives: a scoping review on sexual function challenges in migrant and refugee women. Sex Med Rev 2024; 12:288-298. [PMID: 38462747 DOI: 10.1093/sxmrev/qeae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 01/17/2024] [Accepted: 01/26/2024] [Indexed: 03/12/2024]
Abstract
INTRODUCTION Of the approximately 281 million international migrants and 35.3 million refugees around the world, almost half are women. These individuals experience significant stress due to language barriers, financial difficulties, poor living and working conditions, and discrimination. Consequently, concerns related to sexuality may receive lower priority despite their significant impact on overall well-being. OBJECTIVES This scoping review aims to review the sexual function of migrant and refugee women and identify any knowledge gaps in the field. METHODS We conducted a scoping review following the PRISMA-ScR guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews). We searched online databases-Medline, Embase, Emcare, PsycINFO, CINAHL, Scopus, Web of Science, and Cochrane-and gray literature, with no restrictions on year of publication, language, or study design. Utilizing Covidence software, 2 authors screened and extracted data from studies based on predetermined eligibility criteria. A thematic analysis was executed, and findings were reported descriptively. RESULTS Initially, we identified 5615 studies; after screening titles, abstracts, and full texts, we ultimately included 12 studies. The review identified a limited body of research with various unvalidated tools. Moreover, these studies yielded heterogeneous results: migrant women reported less sexual knowledge, experience, and liberal attitudes, resulting in lower rates of desire and arousal as compared with nonmigrants. Some studies showed lower sexual function in migrants, while others found no significant differences between migrants and nonmigrants. The assimilation into Western cultures may influence migrants' sexual attitudes and behaviors. Factors such as education and gender role ideology can also significantly affect sexual function among migrant populations. CONCLUSION This review underscores the limitations in previous sexual function research, emphasizing the need for a more inclusive approach. It also offers valuable insights for codesigning programs to address sexual dysfunction among migrant and refugee women, improving their well-being. Future research should prioritize neglected populations and create culturally sensitive interventions to reduce sexual health disparities in migrants.
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Affiliation(s)
- Negin Mirzaei Damabi
- Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5006, Australia
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5000, Australia
| | - Mumtaz Begum
- Life Course and Intergenerational Health Research Group, Faculty of Health and Medical Science, University of Adelaide, Adelaide 5005, Australia
| | - Jodie C Avery
- Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5006, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5000, Australia
| | - Zahra Ali Padhani
- Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5006, Australia
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5000, Australia
| | - Zohra S Lassi
- Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5006, Australia
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5000, Australia
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19
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Lundborg L, Ananth CV, Joseph KS, Cnattingius S, Razaz N. Changes in the prevalence of maternal chronic conditions during pregnancy: A nationwide age-period-cohort analysis. BJOG 2024. [PMID: 38899437 DOI: 10.1111/1471-0528.17885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 05/13/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVE To estimate temporal changes in the prevalence of pre-existing chronic conditions among pregnant women in Sweden and evaluate the extent to which secular changes in maternal age, birth cohorts and obesity are associated with these trends. DESIGN Population-based cross-sectional study. SETTING Sweden, 2002-2019. POPULATION All women (aged 15-49 years) who delivered in Sweden (2002-2019). METHODS An age-period-cohort analysis was used to evaluate the effects of age, calendar periods, and birth cohorts on the observed temporal trends. MAIN OUTCOME MEASURES Pre-existing chronic conditions, including 17 disease categories of physical and psychiatric health conditions recorded within 5 years before childbirth, presented as prevalence rates and rate ratios (RRs) with 95% confidence intervals (CIs). Temporal trends were also adjusted for pre-pregnancy body mass index (BMI) and the mother's country of birth. RESULTS The overall prevalence of at least one pre-existing chronic condition was 8.7% (147 458 of 1 703 731 women). The rates of pre-existing chronic conditions in pregnancy increased threefold between 2002-2006 and 2016-2019 (RR 2.82, 95% CI 2.77-2.87). Rates of psychiatric (RR 3.80, 95% CI 3.71-3.89), circulatory/metabolic (RR 1.62, 95% CI 1.55-1.71), autoimmune/neurological (RR 1.69, 95% CI 1.61-1.78) and other (RR 2.10, 95% CI 1.99-2.22) conditions increased substantially from 2002-2006 to 2016-2019. However, these increasing rates were less pronounced between 2012-2015 and 2016-2019. No birth cohort effect was evident for any of the pre-existing chronic conditions. Adjusting for secular changes in obesity and the mother's country of birth did not affect these associations. CONCLUSIONS The burden of pre-existing chronic conditions in pregnancy in Sweden increased from 2002 to 2019. This increase may be associated with the improved reporting of diagnoses and advancements in chronic condition treatment among women, potentially enhancing their fecundity.
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Affiliation(s)
- Louise Lundborg
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Cande V Ananth
- Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
- Cardiovascular Institute of New Jersey, New Brunswick, New Jersey, USA
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey, USA
- Environmental and Occupational Health Sciences Institute, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - K S Joseph
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada
- British Columbia Children's Hospital Research Institute, Vancouver, Canada
| | - Sven Cnattingius
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Neda Razaz
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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Hüning BM, Jaekel J, Jaekel N, Göpel W, Herting E, Felderhoff-Müser U, Spiegler J, Härtel C. Perinatal Outcomes of Immigrant Mothers and Their Infants Born Very Preterm across Germany. Healthcare (Basel) 2024; 12:1211. [PMID: 38921324 PMCID: PMC11204027 DOI: 10.3390/healthcare12121211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 06/10/2024] [Accepted: 06/14/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND In Germany, more than 40% of infants are born to immigrant parents. Increased survival rates of very preterm (below 32 weeks gestation at birth; VP) infants have not resulted in equally improved life chances and quality of life. More information on perinatal variations in outcomes according to social inequalities, migration background, and language barriers is needed. We tested whether mothers' immigrant status and language barriers are associated with perinatal health and short-term neonatal outcomes. METHODS The data are from the national multi-centre German Neonatal Network (GNN) cohort, including VP births from 2009 onwards. In total, 3606 (n = 1738 female) children were assessed, and 919 (n = 449 female) of these children had immigrant backgrounds. Immigrant status was operationalised as a binary variable based on the children's mothers' countries of birth (born in Germany vs. foreign-born). Self-reported home language (L1) was used to calculate the average linguistic distance to German as one continuous variable. RESULTS Mixed-effects models showed that two out of fourteen effects of interest survived the adjustment for known confounders and accounting for the nestedness of data within birth hospitals. Linguistic distance from mothers' L1s to German was independently associated with diagnoses of preeclampsia (OR = 1.01, 95% CI = [1.00, 1.01]). Infants of foreign-born mothers had higher odds for amniotic infection syndrome (AIS; OR = 1.45 [1.13, 1.86]) than infants of German mothers. CONCLUSIONS Our findings from this large multi-centre longitudinal cohort of VP-born children indicate that maternal immigrant status and language barriers have limited impact on perinatal health and severe neonatal outcomes. This suggests that, regardless of background or language skills, there may be few inequalities in the perinatal health of pregnant women and their newborn preterm infants.
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Affiliation(s)
- Britta M. Hüning
- Department of Paediatrics I, Neonatology, Paediatric Intensive Care, Paediatric Neurology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (B.M.H.); (U.F.-M.)
- Center of Translational Neuro- and Behavioural Sciences, C-TNBS, Faculty of Medicine, University of Duisburg-Essen, 45147 Essen, Germany
| | - Julia Jaekel
- Department of Paediatrics I, Neonatology, Paediatric Intensive Care, Paediatric Neurology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (B.M.H.); (U.F.-M.)
- Faculty of Education and Psychology, University of Oulu, 90570 Oulu, Finland;
- Department of Psychology, University of Warwick, Coventry CV4 7AL, UK;
- Public Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland
- Department of Psychology, University of Copenhagen, DK-1165 Copenhagen, Denmark
| | - Nils Jaekel
- Faculty of Education and Psychology, University of Oulu, 90570 Oulu, Finland;
- Public Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland
- Department of English, German and Romance Studies, Faculty of Humanities, University of Copenhagen, DK-2300 Copenhagen, Denmark
| | - Wolfgang Göpel
- Department of Pediatrics, University Hospital Lübeck, 23538 Lübeck, Germany; (W.G.); (E.H.)
| | - Egbert Herting
- Department of Pediatrics, University Hospital Lübeck, 23538 Lübeck, Germany; (W.G.); (E.H.)
| | - Ursula Felderhoff-Müser
- Department of Paediatrics I, Neonatology, Paediatric Intensive Care, Paediatric Neurology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (B.M.H.); (U.F.-M.)
- Center of Translational Neuro- and Behavioural Sciences, C-TNBS, Faculty of Medicine, University of Duisburg-Essen, 45147 Essen, Germany
| | - Juliane Spiegler
- Department of Psychology, University of Warwick, Coventry CV4 7AL, UK;
- Department of Pediatrics, University Hospital Würzburg, 97080 Würzburg, Germany;
| | - Christoph Härtel
- Department of Pediatrics, University Hospital Würzburg, 97080 Würzburg, Germany;
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21
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Videholm S, Silfverdal SA, Gustafsson PE. Intersectional inequalities in paediatric infectious diseases: a national cohort study in Sweden. J Epidemiol Community Health 2024; 78:417-423. [PMID: 38589219 PMCID: PMC11187361 DOI: 10.1136/jech-2023-220593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 03/26/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND It is well known that socially deprived children are more likely to be hospitalised for infections. Less is known about how different social disadvantages interact. Therefore, we examine intersectional inequalities in overall, upper respiratory, lower respiratory, enteric and genitourinary infections in the first 5 years of life. METHODS We conducted a population-based retrospective cohort study of Swedish children born between 1998 and 2015. Inequalities were examined using analysis of individual heterogeneity and discriminatory accuracy as the analytical framework. A variable with 60 intersectional strata was created by combining information on maternal education, household income, sex/gender and maternal migration status. We estimated the incidence rates of infectious disease hospitalisation for each intersectional strata and the associations between intersectional strata and infectious disease hospitalisations using logistic regression models. We furthermore quantified the discriminatory ability of the intersectional strata with respect to infectious disease hospitalisation. RESULTS The study included 1785 588 children and 318 080 hospital admissions. The highest overall incidence of hospitalisations for infections was found in boys born to low-educated mothers who lived in families with the lowest household income. The overall incidence of infections was unrelated to household income in children born to highly educated mothers. The ability of the intersectional strata to discriminate between children with and without infections was poor. CONCLUSION We found that inequalities in paediatric infectious diseases were shaped by the intersections of different social disadvantages. These inequalities should be addressed by public health policies that reach all children.
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Affiliation(s)
- Samuel Videholm
- Department of Clinical Sciences, Pediatrics, Umea Universitet, Umea, Sweden
| | | | - Per E Gustafsson
- Department of Epidemiology and Global Health, Umeå Universitet Medicinska fakulteten, Umea, Sweden
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22
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Abubakar I, Langella R, Meda N. Europe's anti-migration policies: the need to reverse a trajectory towards death, despair, and destitution. Lancet 2024; 403:2465-2467. [PMID: 38754455 DOI: 10.1016/s0140-6736(24)00922-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 05/01/2024] [Indexed: 05/18/2024]
Affiliation(s)
| | | | - Nicolas Meda
- UFR Sciences de la Santé, Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
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23
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Byrne-Davis L, Carr N, Roy T, Chowdhury S, Omer U, Nawaz S, Advani D, Byrne O, Hart J. Challenges and opportunities for competency-based health professional education in Bangladesh: an interview, observation and mapping study. BMC MEDICAL EDUCATION 2024; 24:629. [PMID: 38844893 PMCID: PMC11155113 DOI: 10.1186/s12909-024-05558-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/15/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Bangladesh has a shortfall of health professionals. The World Health Organization states that improving education will increase recruitment and retention of health workers. Traditional learning approaches, in medical education particularly, focus on didactic teaching, teaching of subjects and knowledge testing. These approaches have been superseded in some programmes, with a greater focus on active learning, integrated teaching and learning of knowledge, application, skills and attitudes or values and associated testing of competencies as educational outcomes. In addition, some regions do not have continuous professional development or clinical placements for health worker students, contributing to difficulties in retention of health workers. This study aims to explore the experiences of health professional education in Bangladesh, focusing on what is through observation of health professional education sessions and experiences of educators. METHODS This mixed method study included 22 observations of teaching sessions in clinical and educational settings, detailed analysis of 8 national curricula documents mapped to Global Competency and Outcomes Framework for Universal Health Coverage and 15 interviews of professionals responsible for health education. An observational checklist was created based on previous literature which assessed training of within dimensions of basic clinical skills; diagnosis and management; professionalism; professional development; and effective communication. Interviews explored current practices within health education in Bangladesh, as well as barriers and facilitators to incorporating different approaches to learning. RESULTS Observations revealed a variety of approaches and frameworks followed across institutions. Only one observation included all sub-competencies of the checklist. National curricula documents varied in their coverage of the Global Competency and Outcomes Framework domains. Three key themes were generated from a thematic analysis of interview transcripts: (1) education across the career span; (2) challenges for health professional education; (3) contextual factors and health professional education. Opportunities for progression and development post qualification are limited and certain professions are favoured over others. CONCLUSION Traditional approaches seem to predominate but there is some enthusiasm for a more clinical focus to education and for more competency based approaches to teaching, learning and assessment.
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Affiliation(s)
- Lucie Byrne-Davis
- Division of Medical Education, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
| | - Natalie Carr
- Division of Medical Education, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
| | - Tapash Roy
- Interactive Research and Development (IRD), Florida Castle, Dhaka, Bangladesh
| | | | - Usmaan Omer
- Division of Medical Education, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
| | - Saher Nawaz
- Division of Medical Education, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
| | - Dolce Advani
- Division of Medical Education, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
| | - Olivia Byrne
- Division of Medical Education, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
| | - Jo Hart
- Division of Medical Education, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK.
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24
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Ng SH, Kaur S, Cheah PY, Ong ZL, Lim J, Voo TC. Migration health ethics in Southeast Asia: a scoping review. Wellcome Open Res 2024; 8:391. [PMID: 38595706 PMCID: PMC11002524 DOI: 10.12688/wellcomeopenres.19572.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2024] [Indexed: 04/11/2024] Open
Abstract
Background Asia hosts the second-largest international migrant population in the world. In Southeast Asia (SEA), key types of migration are labour migration, forced migration, and environmental migration. This scoping review seeks to identify key themes and gaps in current research on the ethics of healthcare for mobile and marginalised populations in SEA, and the ethics of research involving these populations. Methods We performed a scoping review using three broad concepts: population (stateless population, migrants, refugees, asylum seekers, internally displaced people), issues (healthcare and ethics), and context (11 countries in SEA). Three databases (PubMed, CINAHL, and Web of Science) were searched from 2000 until May 2023 over a period of four months (February 2023 to May 2023). Other relevant publications were identified through citation searches, and six bioethics journals were hand searched. All searches were conducted in English, and relevant publications were screened against the inclusion and exclusion criteria. Data were subsequently imported into NVivo 14, and thematic analysis was conducted. Results We identified 18 papers with substantial bioethical analysis. Ethical concepts that guide the analysis were 'capability, agency, dignity', 'vulnerability', 'precarity, complicity, and structural violence' (n=7). Ethical issues were discussed from the perspective of research ethics (n=9), clinical ethics (n=1) and public health ethics (n=1). All publications are from researchers based in Singapore, Thailand, and Malaysia. Research gaps identified include the need for more research involving migrant children, research from migrant-sending countries, studies on quality of migrant healthcare, participatory health research, and research with internal migrants. Conclusions More empirical research is necessary to better understand the ethical issues that exist in the domains of research, clinical care, and public health. Critical examination of the interplay between migration, health and ethics with consideration of the diverse factors and contexts involved is crucial for the advancement of migration health ethics in SEA.
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Affiliation(s)
- Shu Hui Ng
- School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, 47500, Malaysia
| | - Sharon Kaur
- Faculty of Law, University Malaya, Kuala Lumpur, Federal Territory of Kuala Lumpur, 50603, Malaysia
| | - Phaik Yeong Cheah
- Mahidol Oxford Tropical Medicine Research Unit, Bangkok, 10400, Thailand
- Centre for Tropical Medicine and Global Health, Oxford, OX3 7LG, UK
| | - Zhen Ling Ong
- Centre for Epidemiology and Evidence-based Practice, Department of Social and Preventive Medicine, University Malaya, Kuala Lumpur, Federal Territory of Kuala Lumpur, 50603, Malaysia
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Jane Lim
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
| | - Teck Chuan Voo
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
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25
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Vyas MV, Redditt V, Mohamed S, Abraha M, Sheth J, Shah BR, Ko DT, Ke C. Determinants, Prevention, and Incidence of Cardiovascular Disease Among Immigrant and Refugee Populations. Can J Cardiol 2024; 40:1077-1087. [PMID: 38387721 DOI: 10.1016/j.cjca.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/15/2024] [Accepted: 02/18/2024] [Indexed: 02/24/2024] Open
Abstract
Immigration policies shape the composition, socioeconomic characteristics, and health of migrant populations. The health of migrants is also influenced by a confluence of social, economic, environmental, and political factors. Immigrants and refugees often face various barriers to accessing health care because of factors such as lack of familiarity with navigating the health care system, language barriers, systemic racism, and gaps in health insurance. Social determinants of health and access to primary care health services likely influence the burden of cardiovascular risk factors among immigrants. The relatively low burden of many cardiovascular risk factors in many immigrant populations likely contributes to the generally lower incidence rates of acute myocardial infarction, heart failure, and stroke in immigrants compared with nonimmigrants, although cardiovascular disease incidence rates vary substantially by country of origin. The "healthy immigrant effect" is the hypothesis that immigrants to high-income countries, such as Canada, are healthier than nonimmigrants in the host population. However, this effect may not apply universally across all immigrants, including recent refugees, immigrants without formal education, and unmarried immigrants. As unfolding sociopolitical events generate new waves of global migration, policymakers and health care providers need to focus on addressing social and structural determinants of health to better manage cardiovascular risk factors and prevent cardiovascular disease, especially among the most marginalized immigrants and refugees.
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Affiliation(s)
- Manav V Vyas
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Division of Neurology, Li Ka Shing Knowledge Institute, St. Michael's Hospital-Unity Health, Toronto, Ontario, Canada
| | - Vanessa Redditt
- Crossroads Clinic, Women's College Hospital, Toronto, Ontario, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sebat Mohamed
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mosana Abraha
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Javal Sheth
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Baiju R Shah
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Department of Medicine, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Dennis T Ko
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Department of Medicine, Schulich Heart Centre, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Calvin Ke
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Department of Medicine, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
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26
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Stevens AJ, Boukari Y, English S, Kadir A, Kumar BN, Devakumar D. Discriminatory, racist and xenophobic policies and practice against child refugees, asylum seekers and undocumented migrants in European health systems. THE LANCET REGIONAL HEALTH. EUROPE 2024; 41:100834. [PMID: 39119094 PMCID: PMC11306214 DOI: 10.1016/j.lanepe.2023.100834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/20/2023] [Accepted: 12/29/2023] [Indexed: 08/10/2024]
Abstract
Child refugees, asylum seekers and undocumented migrants who have been forcibly displaced from their countries of origin have heightened health needs as a consequence of their migration experiences. Host countries have a duty to respond to these needs, yet across Europe we are seeing a rise in potentially harmful discriminative, hostile and restrictive migration policies and practices. Research exploring the role racism, xenophobia and discrimination in European health systems may play in child migrant health inequities is lacking. This Personal View seeks to highlight this knowledge gap and stimulate discourse on how discrimination in health information systems, data sharing practices, national health policy, healthcare entitlements, service access, quality of care, and healthcare workers attitudes and behaviours may infringe upon the rights of, and impact the health of child refugees, asylum-seekers and undocumented migrants. It calls for action to prevent and mitigate against potentially harmful policies and practices.
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Affiliation(s)
| | - Yamina Boukari
- Institute of Health Informatics, University College London, UK
| | - Sonora English
- Institute for Global Health, University College London, London, UK
| | - Ayesha Kadir
- Save the Children International, St Vincent House, London, UK
| | | | - Delan Devakumar
- Institute for Global Health, University College London, London, UK
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27
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Kumar BN, Bhopal A, Blanchet K, Wickramage K, Onarheim KH. Priority setting and migration health policies for European countries. THE LANCET REGIONAL HEALTH. EUROPE 2024; 41:100804. [PMID: 39119096 PMCID: PMC11306211 DOI: 10.1016/j.lanepe.2023.100804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/09/2023] [Accepted: 11/16/2023] [Indexed: 08/10/2024]
Abstract
The 2030 Sustainable Development Goals (SDG) agenda has committed to 'ensuring that no one is left behind'. Applying the right to health of non-citizens and international migrants is challenging in today's highly polarized political discourse on migration governance and integration. We explore the role of a priority setting approach to help support better, fairer and more transparent policy making in migration health. A priority setting approach must also incorporate migration health for more efficient and fair allocation of scarce resources. Explicitly recognizing the trade-offs as part of strategic planning, would circumvent ad hoc decision-making during crises, not well-suited for fairness. Discussions surrounding decisions about expanding services to migrants or subgroups of migrants, which services and to whom should be transparent and fair. We conclude that a priority setting approach can help better inform policy making by being more closely aligned with the practical challenges policy makers face towards the progressive realization of migration health.
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Affiliation(s)
- Bernadette N. Kumar
- Division of Health Services Research, Norwegian Institute of Public Health, Norway
| | - Anand Bhopal
- Bergen Centre for Ethics and Priority Setting, Department of Global Public Health and Primary Care, University of Bergen, Norway
- Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Harvard University, USA
| | - Karl Blanchet
- Geneva Centre of Humanitarian Studies, Faculty of Medicine University of Geneva, Switzerland
| | - Kolitha Wickramage
- Head, Global Migration Health Research & Epidemiology Unit, Migration Health Division, Global Data Institute (GDI), Berlin, Germany
| | - Kristine Husøy Onarheim
- Bergen Centre for Ethics and Priority Setting, Department of Global Public Health and Primary Care, University of Bergen, Norway
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28
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Sharma E, Duclos D, Howard N. The nexus between maternity care and bordering practices: A qualitative study of provider perspectives on maternal healthcare provision for Afghan women migrating through Serbia to Western Europe. Soc Sci Med 2024; 350:116880. [PMID: 38688089 DOI: 10.1016/j.socscimed.2024.116880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/04/2024] [Accepted: 04/10/2024] [Indexed: 05/02/2024]
Abstract
Serbia is a well-established transit country for Afghans travelling overland to seek protection in Western Europe, and Afghan women continue to experience pregnancy and birth during migration. This qualitative study aimed to explore the perspectives and experiences and of clinical and non-clinical perinatal care and support providers to Afghan women during migration through Serbia, using a critical border studies lens. Semi-structured interviews with 21 Serbia-based providers (conducted August 2021-October 2022 and analysed thematically) provided five inductive themes: (1) contours of life in Serbia for Afghan women; (2) providing maternity care and support to a highly mobile group; (3) enablers and barriers to accessing and using maternity care; (4) risks of onward migration; and (5) supporting women in a landscape of constant change. We identified ways in which regional geopolitics translated to bordering practices that interfered with maternity support provision to Afghan women in Serbia. We argue that non-exclusionary systems of care are needed to ensure women on the move receive adequate maternity support.
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Affiliation(s)
- Esther Sharma
- London School of Hygiene and Tropical Medicine, Department of Global Health and Development, 15-17 Tavistock Place, London, WC1H 9SH, United Kingdom.
| | - Diane Duclos
- London School of Hygiene and Tropical Medicine, Department of Global Health and Development, 15-17 Tavistock Place, London, WC1H 9SH, United Kingdom.
| | - Natasha Howard
- London School of Hygiene and Tropical Medicine, Department of Global Health and Development, 15-17 Tavistock Place, London, WC1H 9SH, United Kingdom; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, 117549, Singapore.
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29
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Glaesmer H, Nesterko Y, Nohr L. [Psychosocial Care for Immigrants and Refugees - A Matter of Course (or not)?]. Psychother Psychosom Med Psychol 2024; 74:203-204. [PMID: 38865995 DOI: 10.1055/a-2301-5701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
Wir freuen uns, als Interessengruppe (IG) für Transkulturelle Klinische Psychologie
und Psychotherapie der Deutschen Gesellschaft für Psychologie (DGPs) Sie zur Lektüre
dieses Themenheftes einzuladen. Die IG gründete sich im Jahr 2017 im Rahmen der
Fachgruppe Klinische Psychologie, um Themen rund um Migration und psychische
Gesundheit gezielt in den Fokus von klinischer und psychotherapeutischer Forschung
und Praxis zu nehmen. Seitdem arbeiten interessierte Kolleg*innen im
deutschsprachigen Raum gemeinsam daran, kontext- und diskriminierungssensibel zu
forschen, Bedürfnissen von Menschen mit Migrations- und/ oder Fluchtgeschichte in
Forschung und psychotherapeutischer Versorgung gerechter zu werden und entsprechende
Konzepte in Lehre, Weiterbildung und Praxis zu verankern. Mit diesem Themenheft
möchten wir Ihnen einen Einblick in unsere wissenschaftliche Arbeit geben und
gleichzeitig auf aus unserer Sicht zentrale gesellschaftliche und berufspolitische
Herausforderungen hinzuweisen.
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Affiliation(s)
- Heide Glaesmer
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
| | - Yuriy Nesterko
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
| | - Laura Nohr
- Klinisch-Psychologische Intervention, Freie Universität Berlin
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30
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Walsh SD, Getahune S, Kogan SM. Risk, resilience and family relationships among at-risk Ethiopian immigrant youth in Israel: A focus group investigation. FAMILY PROCESS 2024; 63:711-730. [PMID: 37414724 DOI: 10.1111/famp.12915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 05/13/2023] [Accepted: 06/15/2023] [Indexed: 07/08/2023]
Abstract
Despite the pivotal role that parents play in their adolescent children's lives, intervention programs aimed at at-risk, immigrant youth have often neglected the role of the parents. Informed by an ecological perspective, the current study explored how the intersecting experiences of parents and adolescents in the Ethiopian immigrant community in Israel inform adolescent risk and resilience. A sample of 55 parents and adolescent children, who were involved in a program serving at-risk families, and eight service providers participated in five focus groups. Grounded theory analyses of transcripts provided insights into family processes in which the experience of disenfranchisement of parents (due to societal and familial processes) transacts with feelings of isolation and withdrawal of their adolescent children. We documented five issues that reinforced this core pattern: Stigma and discrimination, cultural and language differences between parents and youth, disempowerment in interactions with authorities, parental role strain, and negative influence of the neighborhood. We also documented three resilience processes that counter this pattern (community cohesion, cultural socialization and ethnic and cultural pride, and vigilant parental monitoring). Results suggest a need for family-based intervention programs that can counter reinforcing cycles of disenfranchisement and build on families' resilience resources.
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Affiliation(s)
- Sophie D Walsh
- Department of Criminology, Bar-Ilan University, Ramat Gan, Israel
| | - Simcha Getahune
- Department of Criminology, Bar-Ilan University, Ramat Gan, Israel
- Kibbutzim College, Tel Aviv, Israel
| | - Steven M Kogan
- Human Development and Family Science, University of Georgia, Athens, Georgia, USA
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31
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Diaz E, Gimeno-Feliu LA, Czapka E, Suurmond J, Razum O, Kumar BN. Capacity building in migration and health in higher education: lessons from five European countries. THE LANCET REGIONAL HEALTH. EUROPE 2024; 41:100818. [PMID: 39119097 PMCID: PMC11306207 DOI: 10.1016/j.lanepe.2023.100818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 08/10/2024]
Abstract
Capacity building in migration and health in higher education is key to better, sustainable, and equitable health care provision. However, developments so far have been patchy, non-structural, and often unsustainable. While training programs have been evaluated and competency standards developed, perspectives from individual teachers are hardly accessible. We present expert perspectives from five European countries to illustrate good examples in higher education and identify gaps to further the advancement of capacity building in migration and health. Based on these perspectives, we have identified thematic areas at four levels: conceptual evolution, policy and implementation, organization at the academic level and teaching materials and pedagogies. Finally, we propose creating spaces to share concrete educational practices and experiences for adaptation and replication. We summarize key recommendations for the advancement of capacity building in migration and health.
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Affiliation(s)
- Esperanza Diaz
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Health and Functioning, Western Norway University of Applied Sciences, Norway
| | - Luis Andrés Gimeno-Feliu
- San Pablo Health Centre, Aragón Health Service (SALUD), School of Medicine, University of Zaragoza, Spain
- EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute, Miguel Servet University Hospital, Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion-RICAPPS-(RICORS), Madrid, Spain
| | - Elzbieta Czapka
- Department of Social Sciences, Institute of Sociology, University of Gdańsk, Gdańsk, Poland
| | - Jeanine Suurmond
- Department of Public Health Academic Medical Center, University of Amsterdam, The Netherlands
| | - Oliver Razum
- School of Public Health, Bielefeld University, Germany
| | - Bernadette N. Kumar
- Division for Health Services Research, Norwegian Institute of Public Health, Oslo, Norway
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Brijnath B, Muoio R, Feldman P, Ghersi D, Chan AW, Welch V, Treweek S, Green H, Orkin AM, Owusu-Addo E. "We are not invited": Australian focus group results on how to improve ethnic diversity in trials. J Clin Epidemiol 2024; 170:111366. [PMID: 38631530 DOI: 10.1016/j.jclinepi.2024.111366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 03/26/2024] [Accepted: 04/09/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVES Lack of ethnic diversity in trials may contribute to health disparities and to inequity in health outcomes. The primary objective was to investigate the experiences and perspectives of ethnically diverse populations about how to improve ethnic diversity in trials. STUDY DESIGN AND SETTING Qualitative data were collected via 16 focus groups with participants from 21 ethnically diverse communities in Australia. Data collection took place between August and September 2022 in community-based settings in six capital cities: Sydney, Melbourne, Perth, Adelaide, Brisbane, and Darwin, and one rural town: Bordertown (South Australia). RESULTS One hundred and fifty-eight purposively sampled adults (aged 18-85, 49% women) participated in groups speaking Tamil, Greek, Punjabi, Italian, Mandarin, Cantonese, Karin, Vietnamese, Nepalese, and Arabic; or English-language groups (comprising Fijian, Filipino, African, and two multicultural groups). Only 10 participants had previously taken part in medical research including three in trials. There was support for medical research, including trials; however, most participants had never been invited to participate. To increase ethnic diversity in trial populations, participants recommended recruitment via partnering with communities, translating trial materials and making them culturally accessible using audiovisual ways, promoting retention by minimizing participant burden, establishing trust and rapport between participants and researchers, and sharing individual results. Participants were reluctant to join studies on taboo topics in their communities (eg, sexual health) or in which physical specimens (eg, blood) were needed. Participants said these barriers could be mitigated by communicating about the topic in more culturally cognizant and safe ways, explaining how data would be securely stored, and reinforcing the benefit of medical research to humanity. CONCLUSION Participants recognized the principal benefits of trials and other medical research, were prepared to take part, and offered suggestions on recruitment, consent, data collection mechanisms, and retention to enable this to occur. Researchers should consider these community insights when designing and conducting trials; and government, regulators, funders, and publishers should allow for greater innovation and flexibility in their processes to enable ethnic diversity in trials to improve.
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Affiliation(s)
- Bianca Brijnath
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; Social Gerontology, National Ageing Research Institute, Melbourne, Australia; School of Social Sciences, University of Western Australia, Perth, Australia.
| | - Rachel Muoio
- Social Gerontology, National Ageing Research Institute, Melbourne, Australia
| | - Peter Feldman
- Social Gerontology, National Ageing Research Institute, Melbourne, Australia
| | - Davina Ghersi
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - An-Wen Chan
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Vivian Welch
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Shaun Treweek
- Health Services Research Unit, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland
| | - Heidi Green
- Health Services Research Unit, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland; Research and Insights Team, COUCH Health, Manchester, UK
| | - Aaron M Orkin
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Li Ka Shing Knowledge Institute of Unity Health, Toronto, Canada
| | - Ebenezer Owusu-Addo
- Social Gerontology, National Ageing Research Institute, Melbourne, Australia; Bureau of Integrated Rural Development, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana
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Jaiswal A, Núñez Carrasco L, Arrow J. Do black women's lives matter? A study of the hidden impact of the barriers to access maternal healthcare for migrant women in South Africa. FRONTIERS IN SOCIOLOGY 2024; 9:983148. [PMID: 38873343 PMCID: PMC11171126 DOI: 10.3389/fsoc.2024.983148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 04/24/2024] [Indexed: 06/15/2024]
Abstract
Background Studies on the barriers migrant women face when trying to access healthcare services in South Africa have emphasized economic factors, fear of deportation, lack of documentation, language barriers, xenophobia, and discrimination in society and in healthcare institutions as factors explaining migrants' reluctance to seek healthcare. Our study aims to visualize some of the outcome effects of these barriers by analyzing data on maternal death and comparing the local population and black African migrant women from the South African Development Countries (SADC) living in South Africa. The heightened maternal mortality of black migrant women in South Africa can be associated with the hidden costs of barriers migrants face, including xenophobic attitudes experienced at public healthcare institutions. Methods Our analysis is based on data on reported causes of death (COD) from the South African Department of Home Affairs (DHA). Statistics South Africa (Stats SA) processed the data further and coded the cause of death (COD) according to the WHO classification of disease, ICD10. The dataset is available on the StatsSA website (http://nesstar.statssa.gov.za:8282/webview/) for research and statistical purposes. The entire dataset consists of over 10 million records and about 50 variables of registered deaths that occurred in the country between 1997 and 2018. For our analysis, we have used data from 2002 to 2015, the years for which information on citizenship is reliably included on the death certificate. Corresponding benchmark data, in which nationality is recorded, exists only for a 10% sample from the population and housing census of 2011. Mid-year population estimates (MYPE) also exist but are not disaggregated by nationality. For this reason, certain estimates of death proportions by nationality will be relative and will not correspond to crude death rates. Results The total number of female deaths recorded from the years 2002 to 2015 in the country was 3740.761. Of these, 99.09% (n = 3,707,003) were deaths of South Africans and 0.91% (n = 33,758) were deaths of SADC women citizens. For maternal mortality, we considered the total number of deaths recorded for women between the ages of 15 and 49 years of age and were 1,530,495 deaths. Of these, deaths due to pregnancy-related causes contributed to approximately 1% of deaths. South African women contributed to 17,228 maternal deaths and SADC women to 467 maternal deaths during the period under study. The odds ratio for this comparison was 2.02. In other words, our findings show the odds of a black migrant woman from a SADC country dying of a maternal death were more than twice that of a South African woman. This result is statistically significant as this odds ratio, 2.02, falls within the 95% confidence interval (1.82-2.22). Conclusion The study is the first to examine and compare maternal death among two groups of women, women from SADC countries and South Africa, based on Stats SA data available for the years 2002-2015. This analysis allows for a better understanding of the differential impact that social determinants of health have on mortality among black migrant women in South Africa and considers access to healthcare as a determinant of health. As we examined maternal death, we inferred that the heightened mortality among black migrant women in South Africa was associated with various determinants of health, such as xenophobic attitudes of healthcare workers toward foreigners during the study period. The negative attitudes of healthcare workers toward migrants have been reported in the literature and the media. Yet, until now, its long-term impact on the health of the foreign population has not been gaged. While a direct association between the heightened death of migrant populations and xenophobia cannot be established in this study, we hope to offer evidence that supports the need to focus on the heightened vulnerability of black migrant women in South Africa. As we argued here, the heightened maternal mortality among migrant women can be considered hidden barriers in which health inequality and the pervasive effects of xenophobia perpetuate the health disparity of SADC migrants in South Africa.
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Affiliation(s)
- Abha Jaiswal
- Bronx Community College (BCC), City College of New York (CUNY), New York, NY, United States
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Jiang W, Yang Y, He Y, Liu Q, Deng X, Hua Y, Hayixibayi A, Ni Y, Guo L. Contribution of diversity of social participation on the mental health of humanitarian migrants during resettlement. Epidemiol Psychiatr Sci 2024; 33:e29. [PMID: 38779823 PMCID: PMC11362679 DOI: 10.1017/s2045796024000313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 03/20/2024] [Accepted: 05/01/2024] [Indexed: 05/25/2024] Open
Abstract
AIMS By the end of 2022, an estimated 108.4 million individuals worldwide experienced forced displacement. Identifying modifiable factors associated with the mental illness of refugees is crucial for promoting successful integration and developing effective health policies. This study aims to examine the associations between the changes in the diversity of social participation and psychological distress among refugees throughout the resettlement process, specifically focusing on gender differences. METHODS Utilizing data from three waves of a longitudinal, nationally representative cohort study conducted in Australia, this study involved 2399 refugees interviewed during Wave 1, 1894 individuals interviewed during Wave 3 and 1881 respondents during Wave 5. At each wave, we assessed psychological distress and 10 types of social participation across 3 distinct dimensions, including social activities, employment and education. The primary analysis employed mixed linear models and time-varying Cox models. Gender-stratified analyses and sensitivity analyses were performed. RESULTS Refugees engaging in one type or two or more types of social participation, compared with those not engaging in any, consistently had lower psychological distress scores (β = -0.62 [95% confidence interval (CI), -1.07 to -0.17] for one type of social participation; β = -0.57 [95% CI, -1.04 to -0.10] for two or more types of social participation) and a reduced risk of experiencing psychological distress (hazard ratio [HR] = 0.81 [95% CI, 0.65-0.99] for one type of social participation; HR = 0.77 [95% CI, 0.61-0.97] for two or more types of social participation) during the resettlement period. When stratifying the results by gender, these associations in the adjusted models only remained significant in male refugees. Moreover, three specific types of social participation, namely sporting activities, leisure activities and current employment status, were most prominently associated with a reduced risk of psychological distress. CONCLUSIONS The findings of this cohort study suggest that social participation was consistently associated with reduced risks of psychological distress among male refugees during resettlement. These findings highlight the significance of promoting meaningful social participation and interaction may be an effective strategy to improve the mental health of refugees and facilitate their successful integration into society, especially among male refugees.
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Affiliation(s)
- Weiqing Jiang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Yuwei Yang
- Institute of Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, People’s Republic of China
| | - Yitong He
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Qianyu Liu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Xueqing Deng
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Yilin Hua
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Alimila Hayixibayi
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia
| | - Yanyan Ni
- LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
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De-María B, Topa G, López-González MA. Cultural Competence Interventions in European Healthcare: A Scoping Review. Healthcare (Basel) 2024; 12:1040. [PMID: 38786450 PMCID: PMC11120989 DOI: 10.3390/healthcare12101040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/08/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
Europe is undergoing rapid social change and is distinguished by its cultural superdiversity. Healthcare is facing an increasing need for professionals to adapt to this environment. Thus, the promotion of cultural competence in healthcare has become a priority. However, the training being developed and their suitability for the European context are not well known. The aim of this qualitative study has been to map the scientific literature in order to comprehend the current state of research on this topic. For this purpose, we conducted a systematic scoping review of the empirical publications focused on cultural competence interventions for healthcare professionals in European countries. The search was conducted in eight thematic (PsycINFO, MedLine, and PubPsych) and multidisciplinary databases (Academic Search Ultimate, E-Journals, Scopus, ProQuest, and Web of Science) to identify relevant publications up to 2023. Results were presented qualitatively. Out of the initial 6506 records screened, a total of 63 publications were included. Although the interventions were implemented in 23 different European countries, cultural competence interventions have not been widely adopted in Europe. Significant heterogeneity was observed in the conception and operacionalización of cultural competence models and in the implementation of the interventions. The interventions have mostly aimed at improving healthcare for minority population groups and have focused on the racial and ethnic dimensions of the individual. Future research is needed to contribute to the conceptual development of cultural competence to design programs tailored to European superdiversity. This scoping review has been registered in OSF and is available for consultation.
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Affiliation(s)
- Berta De-María
- Department of Social and Organizational Psychology, Faculty of Psychology, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain; (B.D.-M.); (G.T.)
| | - Gabriela Topa
- Department of Social and Organizational Psychology, Faculty of Psychology, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain; (B.D.-M.); (G.T.)
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König A, Sappayabanphot J, Liang L, Fleßa S, Winkler V. The impact of the health microinsurance M-FUND on the utilization of health services among migrant workers and their dependents in Thailand: A case-control study. J Migr Health 2024; 9:100236. [PMID: 38799076 PMCID: PMC11127229 DOI: 10.1016/j.jmh.2024.100236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 04/23/2024] [Accepted: 05/12/2024] [Indexed: 05/29/2024] Open
Abstract
Background Even though Thailand has launched multiple migrant health policies, migrants still face various barriers in accessing health care. To some extent, these barriers may be reduced by health microinsurance. The M-FUND is a low-cost, not-for-profit health protection scheme for migrant workers in Thailand, created by Dreamlopments Social Enterprise and Foundation to support sustainable access to quality healthcare services for migrants. We aimed to investigate the impact of the M-FUND on utilization of health services. Methods Over a period of three months, we conducted quantitative face-to-face interviews with 408 M-FUND members, and 452 age, sex and location matched non-member controls in Tak Province, Thailand. We compared utilization of health services between members and non-members using logistic regression controlling for a number of socio-demographic variables and variables related to migration such as years in Thailand, legal status, etc. Findings M-FUND members were more likely to have utilized outpatient services (adjusted odds ratio: 1·74, 95 % confidence interval: 1·24-2·44), inpatient services (2·96, 1.11-7·92), and emergency care (1·89, 0·78-4·56), although the latter was not statistically significant. Members were more likely not to have purchased medicines over-the-counter (1·67, 1·22-2·27) than non-members. Members were also more likely to have utilized any additional specific service during a consultation (2·31, 1·49-3·58) including any type of imaging method (2·62, 1·29-5·29) and blood tests (1·64, 0·99-2·71). There were some differences between men and women, but most were not statistically significant. Interpretation The M-FUND health microinsurance was positively associated with the utilization of all major types of health services among migrant workers and their dependents in Thailand. For migrants, particularly vulnerable migrant workers and their dependents, the M-FUND appears to be a good approach to reducing barriers to health care. This study of the impact of health microinsurance for migrants provides important information for policy and program planners in the field of migrant health. However, more research is needed on health microinsurance schemes for migrants in different settings and for other underserved communities as well as the sex-specific impact on health service utilization.
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Affiliation(s)
- Andrea König
- Epidemiology of Transition, Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, Heidelberg 69120, Germany
| | | | - Li Liang
- Faculty of Public Health, Thammasat University, Pathum Thani, Thailand
| | - Steffen Fleßa
- Faculty of Law and Economics, University of Greifswald, Germany
| | - Volker Winkler
- Epidemiology of Transition, Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, Heidelberg 69120, Germany
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Szinger D, Berki T, Drenjančević I, Samardzic S, Zelić M, Sikora M, Požgain A, Markovics Á, Farkas N, Németh P, Böröcz K. Raising Epidemiological Awareness: Assessment of Measles/MMR Susceptibility in Highly Vaccinated Clusters within the Hungarian and Croatian Population-A Sero-Surveillance Analysis. Vaccines (Basel) 2024; 12:486. [PMID: 38793737 PMCID: PMC11125914 DOI: 10.3390/vaccines12050486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 04/26/2024] [Accepted: 04/29/2024] [Indexed: 05/26/2024] Open
Abstract
Perceptions of the complete eradication of vaccine-preventable diseases such as measles, mumps, and rubella (MMR) may foster complacency and compromise vaccination efforts. Decreased measles vaccination rates during the COVID-19 pandemic have heightened the risk of outbreaks, even in adequately vaccinated populations. To address this, we have aligned with ECDC recommendations, leveraging previous cross-border sero-epidemiological assessments between Pécs, Hungary, and Osijek, Croatia, to identify latent risk groups and uncover potential parallels between our nations. Testing 2680 Hungarian and 1764 Croatian serum samples for anti-MMR IgG via ELISAs revealed anti-measles seropositivity ratios below expectations in Croatian cohorts aged ~20-30 (75.7%), ~30-40 (77.5%) and ~40-50 years (73.3%). Similarly, Hungarian samples also showed suboptimal seropositivity ratios in the ~30-40 (80.9%) and ~40-50 (87.3%) age groups. Considering mumps- and rubella-associated seropositivity trends, in both examined populations, individuals aged ~30-50 years exhibited the highest vulnerability. Additionally, we noted congruent seropositivity trends across both countries, despite distinct immunization and epidemiological contexts. Therefore, we propose expanding research to encompass the intricate dynamics of vaccination, including waning long-term immunity. This understanding could facilitate targeted interventions and bolster public awareness. Our findings underscore persistent challenges in attaining robust immunity against measles despite vaccination endeavors.
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Affiliation(s)
- Dávid Szinger
- Department of Immunology and Biotechnology, Clinical Center, Medical School, University of Pécs, 7624 Pécs, Hungary; (D.S.); (T.B.); (P.N.)
| | - Timea Berki
- Department of Immunology and Biotechnology, Clinical Center, Medical School, University of Pécs, 7624 Pécs, Hungary; (D.S.); (T.B.); (P.N.)
| | - Ines Drenjančević
- Department of Physiology and Immunology, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia;
- Scientific Centre for Excellence for Personalized Health Care, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Senka Samardzic
- Department of Public Health, Teaching Institute of Public Health for The Osijek-Baranja County, 31000 Osijek, Croatia; (S.S.); (M.Z.); (M.S.); (A.P.)
| | - Marija Zelić
- Department of Public Health, Teaching Institute of Public Health for The Osijek-Baranja County, 31000 Osijek, Croatia; (S.S.); (M.Z.); (M.S.); (A.P.)
| | - Magdalena Sikora
- Department of Public Health, Teaching Institute of Public Health for The Osijek-Baranja County, 31000 Osijek, Croatia; (S.S.); (M.Z.); (M.S.); (A.P.)
| | - Arlen Požgain
- Department of Public Health, Teaching Institute of Public Health for The Osijek-Baranja County, 31000 Osijek, Croatia; (S.S.); (M.Z.); (M.S.); (A.P.)
- Department of Microbiology, Parasitology and Clinical Laboratory Diagnostics, Medical Faculty of Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Ákos Markovics
- Department of General and Physical Chemistry, Faculty of Natural Sciences, University of Pécs, 7622 Pécs, Hungary;
| | - Nelli Farkas
- Department of Bioanalysis, Medical School, University of Pécs, Szigeti u. 12, 7643 Pécs, Hungary;
| | - Péter Németh
- Department of Immunology and Biotechnology, Clinical Center, Medical School, University of Pécs, 7624 Pécs, Hungary; (D.S.); (T.B.); (P.N.)
| | - Katalin Böröcz
- Department of Immunology and Biotechnology, Clinical Center, Medical School, University of Pécs, 7624 Pécs, Hungary; (D.S.); (T.B.); (P.N.)
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Vyas MV, Kapral MK, Alonzo R, Fang J, Rotstein DL. Proportion of Life Spent in Canada and the Incidence of Multiple Sclerosis in Permanent Immigrants. Neurology 2024; 102:e209350. [PMID: 38657190 DOI: 10.1212/wnl.0000000000209350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND AND OBJECTIVES While immigrants to high-income countries have a lower risk of multiple sclerosis (MS) compared with host populations, it is unknown whether this lower risk among immigrants increases over time. Our objective was to evaluate the association between proportion of life spent in Canada and the hazard of incident MS in Canadian immigrants. METHODS We conducted a population-based retrospective cohort study in Ontario, using linked health administrative databases. We followed immigrants, who arrived in Ontario between 1985 and 2003, from January 1, 2003, to December 31, 2016, to record incident MS using a validated algorithm based on hospital admission or outpatient visits. We derived proportion of life spent in Canada based on age at arrival and time since immigration obtained from linked immigration records. We used multivariable proportional hazard models, adjusting for demographics and comorbidities, to evaluate the association between proportion of life in Canada and the incidence of MS, where proportion of life was modelled using restricted cubic spline terms. We further evaluated the role of age at migration (15 or younger vs older than 15 years), sex, and immigration class in sensitivity analyses. RESULTS We included 1.5 million immigrants (49.9% female, mean age 35.9 [SD 14.2] years) who had spent a median of 20% (Q1-Q3 10%-30%) of their life in Canada. During a mean follow-up of 13.9 years (SD 1.0), 934 (0.44/100,000 person-years) were diagnosed with MS. Compared with the median, a higher risk of MS was observed at higher values of proportion of life spent (e.g., hazard ratio [70% vs 20% proportion of life] 1.38; 1.07-1.78). This association did not vary by sex (p(sex × proportion of life) = 0.70) or immigration class (p(immigration class × proportion of life) = 0.13). The results did not vary by age at migration but were statistically significant only at higher values of proportion of life for immigrants aged 15 years or younger at arrival. DISCUSSION The risk of incident MS in immigrants varied with the proportion of life spent in Canada, suggesting an acculturation effect on MS risk. Further work is required to understand environmental and sociocultural factors driving the observed association.
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Affiliation(s)
- Manav V Vyas
- From the Division of Neurology (M.V.V., D.L.R.), Department of Medicine, University of Toronto; St. Michael's Hospital-Unity Health Toronto (M.V.V., D.L.R.); ICES (M.V.V., M.K.K., R.A., J.F.); and Division of General Internal Medicine (M.K.K.), Department of Medicine, University of Toronto, Ontario, Canada
| | - Moira K Kapral
- From the Division of Neurology (M.V.V., D.L.R.), Department of Medicine, University of Toronto; St. Michael's Hospital-Unity Health Toronto (M.V.V., D.L.R.); ICES (M.V.V., M.K.K., R.A., J.F.); and Division of General Internal Medicine (M.K.K.), Department of Medicine, University of Toronto, Ontario, Canada
| | - Rea Alonzo
- From the Division of Neurology (M.V.V., D.L.R.), Department of Medicine, University of Toronto; St. Michael's Hospital-Unity Health Toronto (M.V.V., D.L.R.); ICES (M.V.V., M.K.K., R.A., J.F.); and Division of General Internal Medicine (M.K.K.), Department of Medicine, University of Toronto, Ontario, Canada
| | - Jiming Fang
- From the Division of Neurology (M.V.V., D.L.R.), Department of Medicine, University of Toronto; St. Michael's Hospital-Unity Health Toronto (M.V.V., D.L.R.); ICES (M.V.V., M.K.K., R.A., J.F.); and Division of General Internal Medicine (M.K.K.), Department of Medicine, University of Toronto, Ontario, Canada
| | - Dalia L Rotstein
- From the Division of Neurology (M.V.V., D.L.R.), Department of Medicine, University of Toronto; St. Michael's Hospital-Unity Health Toronto (M.V.V., D.L.R.); ICES (M.V.V., M.K.K., R.A., J.F.); and Division of General Internal Medicine (M.K.K.), Department of Medicine, University of Toronto, Ontario, Canada
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Jaramillo Contreras AC, Cabieses B, Knipper M, Rocha-Jiménez T. Borders and liminality in the right to health of migrants in transit: The case of Colchane in Chile and Necoclí in Colombia. J Migr Health 2024; 9:100230. [PMID: 38707968 PMCID: PMC11067324 DOI: 10.1016/j.jmh.2024.100230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 04/11/2024] [Accepted: 04/11/2024] [Indexed: 05/07/2024] Open
Abstract
The absence of the right to health of migrants in transit has evolved into a significant global health concern, particularly in the border regions thus, this study aims to improve knowledge in this area by exploring the effects of the spatio-temporal liminal characteristics at borders in the achievement of the right to health of migrants in transit moving across two of the most transited and dangerous borders in Latin America: Colchane (Chile-Bolivia) and the Darién Gap (Colombia-Panamá). Through a qualitative descriptive multi-case study, we implemented 50 semi-structured interviews (n = 30 in Chile and n = 20 in the Darién/Necoclí) involving national, regional, and local stakeholders. The findings highlight that the fulfilment of the right to health of migrants in transit is hindered by liminal dynamics at the borders. These dynamics include closure of borders, (in)securities, uncertainty and waiting, lack of economic resources, lack of protection to all, liminal politics, and humanitarian interventions. These findings surface how the borders' liminality exacerbates the segregation of migrants in transit by placing them in a temporospatial limbo that undermines their right to health. Our study concludes that not just the politics but also the everyday practices, relationships and social infrastructure at borders impedes the enjoyment of the right to health of distressed migrants in transit. The short-term humanitarian response; illicit dynamics at borders; migratory regulations; and border and cross-border political structures are some of the most significant determinants of health at these borderlands.
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Affiliation(s)
| | - Báltica Cabieses
- Director of the research Centre of Global Intercultural Health at ICIM Universidad del Desarrollo, Chile, Avenida Plaza 680 Edificio O, ICIM UDD, Las Condes, Santiago Chile
- Senior visiting scholar, Department of Health Sciences, University of York, England. Seebohm Rowntree Building University of York, Heslington, York, YO10 5DD, UK
| | - Michael Knipper
- Institute of History, Theory, Ethics of Medicine at Justus-Liebig University of Giessen, Leihgesterner Weg 52, 35392 Giessen, Germany
| | - Teresita Rocha-Jiménez
- Society and Health Research Centre, Faculty of Social Sciences and Arts, Universidad Mayor, José Toribio Medina 29, Santiago Centro, Santiago, Chile
- Principal Investigator, Millennium Nucleus on Sociomedicine, José Toribio Medina 29, Santiago Centro, Santiago, Chile
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Bockey AJ, Braun C, Camp J, Janda A, Kern WV, Müller AM, Stete K, Rieg SR, Lange B. Health care utilisation of asylum seekers and refugees in the South-West of Germany. PLoS One 2024; 19:e0299886. [PMID: 38635695 PMCID: PMC11025777 DOI: 10.1371/journal.pone.0299886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/16/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Limited evidence on utilisation of health care by recently arrived asylum seekers and refugees in high-income countries is available. This study aims to describe the implementation of an integrated care facility (ICF) in an initial reception centre and measure the utilisation of care and the influence of operational parameters. METHODS In a retrospective cohort study design, using medical records, we followed inhabitants of a reception centre in Germany between 11.10.2015 and 30.05.2018. We assessed frequency of visits and revisits to a newly established integrated care facility (ICF), and the effects of the ICF on visits to the local emergency department (LED) in the regional tertiary hospital using survival analysis and time series regression. We also explore the influence of operational parameters on the different implementation phases; phase 1: provisional clinic with 1-2 hours of physician presence daily, phase 2: implementation of ICF with 2-4 hours of care by a team of doctors and nurses daily, phase 3: routine running of ICF with daily operational hours of 10am-2pm with care provided by an interdisciplinary team of doctors and nurses. RESULTS 14,419 total medical visits were recorded from 1,883 persons seeking health care in the ICF. The absolute number of visits per day remained similar over the study period (19·9/day), yet the relative number of visits changed from 2·2 to 15 per 100 inhabitants from phase 2 to 3, respectively. Most visits were due to respiratory infections (612/3080, 20%), and trauma and musculoskeletal conditions (441/3080, 14%). The rate of revisits to ICF was 2·9 per person per month (95%CI 2·9-3), more for those older, female, from North Africa and those with a translator present. The ratio of visits to the LED changed from 0·3/100 inhabitants per day to 0·14/100 inhabitants after implementation of the ICF and back to 0·3/100 inhabitants during the routine running. CONCLUSIONS Though seasonal variation and referral practices must be considered, a high rate of revisits to the ICF were recorded. While visits to the LED decreased after the implementation of the ICF, visits returned to the pre-ICF levels during the routine running of the ICF. The results show that AS&R require reliable access to health care, yet the needs of specific groups of migrants may be different, especially those with language barriers, minority groups or those from certain regions. As such, care should be migrant sensitive and adapt to the changing needs of the population. Though more research is required to better understand the differing needs of migrants, this study may help to inform guidelines surrounding migrant sensitive standards of care in Germany.
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Affiliation(s)
- Annabelle J. Bockey
- Department of Medicine II, Division of Infectious Diseases, Medical Centre—University Hospital Freiburg, Faculty of Medicine, Freiburg, Germany
- PhD Programme “Epidemiology” Braunschweig-Hannover, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Cornelia Braun
- Department of Medicine II, Division of Infectious Diseases, Medical Centre—University Hospital Freiburg, Faculty of Medicine, Freiburg, Germany
- Clinic for Refugee Medicine, Medical Centre–University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Johannes Camp
- Department of Medicine II, Division of Infectious Diseases, Medical Centre—University Hospital Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Aleš Janda
- Clinic for Refugee Medicine, Medical Centre–University of Freiburg, Faculty of Medicine, Freiburg, Germany
- Centre for Paediatrics and Adolescent Medicine, Medical Centre–University of Freiburg, Faculty of Medicine, Freiburg, Germany
- Department of Paediatrics and Adolescent Medicine, University Medical Centre Ulm, Germany
| | - Winfried V. Kern
- Department of Medicine II, Division of Infectious Diseases, Medical Centre—University Hospital Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Anne-Maria Müller
- Clinic for Refugee Medicine, Medical Centre–University of Freiburg, Faculty of Medicine, Freiburg, Germany
- Centre for Mental Health, Department of Psychosomatic Medicine and Psychotherapy, Medical Centre–University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Katarina Stete
- Department of Medicine II, Division of Infectious Diseases, Medical Centre—University Hospital Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Siegbert R. Rieg
- Department of Medicine II, Division of Infectious Diseases, Medical Centre—University Hospital Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Berit Lange
- Department of Medicine II, Division of Infectious Diseases, Medical Centre—University Hospital Freiburg, Faculty of Medicine, Freiburg, Germany
- Helmholtz Centre for Infection Research, Braunschweig, Germany
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Alves YM, Berra TZ, Tavares RBV, Popolin MAP, da Costa FBP, de Jezus SV, Ferezin LP, Tártaro AF, Serrano-Gallardo MDP, Pinto IC, Maciel ELN, Arcêncio RA. International Migration, Refugees, and Spread of Tuberculosis in Brazil: Analysis of Clusters, Trends, and Associated Factors (2010-2021). Trop Med Infect Dis 2024; 9:82. [PMID: 38668543 PMCID: PMC11053982 DOI: 10.3390/tropicalmed9040082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/04/2024] [Accepted: 04/05/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND International migration is a global phenomenon with significant implications on the health-disease process due to exposures along transit routes and local/destination epidemiological indicators. We aimed to analyze the transmission and spread of tuberculosis among international migrants and refugees from a spatiotemporal perspective and the associated factors. METHOD This was an ecological study of cases of tuberculosis in international migrants in Brazil, between 2010 and 2021. Annual incidence rates were calculated and spatiotemporal scan techniques were used to identify municipalities at risk. Multiple logistic regression was used to identify factors associated with tuberculosis in international migrants. RESULTS A total of 4037 cases of tuberculosis were reported in Brazil in international migrants. Municipalities at risk for this event were identified using the spatiotemporal scan technique, and a cluster was identified with ITT: +52.01% and ETT: +25.60%. A higher probability of TB infection was identified in municipalities with a TB incidence rate >14.40 cases/100 inhabitants, population >11,042 inhabitants, Gini index >0.49, and illiteracy rate >13.12%. A lower probability was found in municipalities with average per capita household income >BRL 456.43. CONCLUSIONS It is recommended that health authorities implement monitoring and rigorous follow-up in affected areas to ensure proper diagnosis and treatment completion for international migrants, preventing disease spread to other communities.
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Affiliation(s)
- Yan Mathias Alves
- Ribeirão Preto College of Nursing, University of São Paulo, São Paulo 14040-902, Brazil; (T.Z.B.); (R.B.V.T.); (M.A.P.P.); (F.B.P.d.C.); (L.P.F.); (A.F.T.); (R.A.A.)
| | - Thaís Zamboni Berra
- Ribeirão Preto College of Nursing, University of São Paulo, São Paulo 14040-902, Brazil; (T.Z.B.); (R.B.V.T.); (M.A.P.P.); (F.B.P.d.C.); (L.P.F.); (A.F.T.); (R.A.A.)
| | - Reginaldo Bazon Vaz Tavares
- Ribeirão Preto College of Nursing, University of São Paulo, São Paulo 14040-902, Brazil; (T.Z.B.); (R.B.V.T.); (M.A.P.P.); (F.B.P.d.C.); (L.P.F.); (A.F.T.); (R.A.A.)
| | - Marcela Antunes Paschoal Popolin
- Ribeirão Preto College of Nursing, University of São Paulo, São Paulo 14040-902, Brazil; (T.Z.B.); (R.B.V.T.); (M.A.P.P.); (F.B.P.d.C.); (L.P.F.); (A.F.T.); (R.A.A.)
- Nursing Department, Federal University of Tocantins, Palmas 77001-090, Brazil
| | - Fernanda Bruzadelli Paulino da Costa
- Ribeirão Preto College of Nursing, University of São Paulo, São Paulo 14040-902, Brazil; (T.Z.B.); (R.B.V.T.); (M.A.P.P.); (F.B.P.d.C.); (L.P.F.); (A.F.T.); (R.A.A.)
| | - Sonia Vivian de Jezus
- Instituto de Ciências da Saúde, Federal University of Mato Grosso, Sinop 78550-728, Brazil
| | - Letícia Perticarrara Ferezin
- Ribeirão Preto College of Nursing, University of São Paulo, São Paulo 14040-902, Brazil; (T.Z.B.); (R.B.V.T.); (M.A.P.P.); (F.B.P.d.C.); (L.P.F.); (A.F.T.); (R.A.A.)
| | - Ariela Fehr Tártaro
- Ribeirão Preto College of Nursing, University of São Paulo, São Paulo 14040-902, Brazil; (T.Z.B.); (R.B.V.T.); (M.A.P.P.); (F.B.P.d.C.); (L.P.F.); (A.F.T.); (R.A.A.)
| | | | - Ione Carvalho Pinto
- Ribeirão Preto College of Nursing, University of São Paulo, São Paulo 14040-902, Brazil; (T.Z.B.); (R.B.V.T.); (M.A.P.P.); (F.B.P.d.C.); (L.P.F.); (A.F.T.); (R.A.A.)
| | - Ethel Leonor Noia Maciel
- Ministry of Health, Secretary of Health Surveillance and Environment, Brasília 70058-900, Brazil;
| | - Ricardo Alexandre Arcêncio
- Ribeirão Preto College of Nursing, University of São Paulo, São Paulo 14040-902, Brazil; (T.Z.B.); (R.B.V.T.); (M.A.P.P.); (F.B.P.d.C.); (L.P.F.); (A.F.T.); (R.A.A.)
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de Leeuw AE, Ester WA, Bolhuis K, Hoek HW, Jansen PW. Maternal Migration, Prenatal Stress and Child Autistic Traits: Insights From a Population-Based Cohort Study. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00183-7. [PMID: 38599371 DOI: 10.1016/j.jaac.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 02/02/2024] [Accepted: 04/01/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVE There is emerging evidence for an increased prevalence of autism in children of mothers with a migration background. To date, the mechanisms underlying this relationship are poorly understood. We investigated whether prenatal stress exposure mediates the association between maternal migration and child autistic traits, assessing first- and second-generation migrant mothers in the Netherlands and their children. METHOD The study was embedded in the prospective population-based Generation R cohort. Of the 4,727 participants, 1,773 mothers (38%) had a migration background. Prenatal stress was assessed using questionnaires related to stressful life events, family functioning, self-esteem, long-lasting difficulties, symptoms of psychopathology, social support, and perceived discrimination. Autistic traits were measured at age 6 years with the parent-reported Social Responsiveness Scale exclusively. Longitudinal multiple mediation analyses were performed. Analyses were stratified by migration origin (Europe and outside Europe) because of differences in migration characteristics. RESULTS Maternal migration background was associated with more experienced stress and with higher child autistic trait scores (Europe: mean = 0.42, SD = 0.25; outside Europe: mean = 0.50, SD = 0.24) compared to no migration background (Netherlands: mean = 0.38, SD = 0.23; both p < .01). Prenatal stress, especially perceived discrimination and maternal psychopathology, accounted for up to half of the total effect of maternal migration, which remained after adjusting for sociodemographic factors (Bindirect = 0.035, 95% CI = 0.027, 0.043, Btotal = 0.074). CONCLUSION Stress during pregnancy mediated the association between maternal migration status and child autistic traits. Future research should focus on early interventions to assess whether reducing prenatal stress exposure among women with a migration background can result in lower offspring autistic traits. DIVERSITY & INCLUSION STATEMENT We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We actively worked to promote sex and gender balance in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.
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Affiliation(s)
- Anne E de Leeuw
- Parnassia Psychiatric Institute, The Hague, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Wietske A Ester
- Parnassia Psychiatric Institute, The Hague, the Netherlands; Leiden University Medical Center, Curium, Oegstgeest, the Netherlands; Sarr Autism Rotterdam, Youz, Parnassia Group, Rotterdam, the Netherlands
| | - Koen Bolhuis
- Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Hans W Hoek
- Parnassia Psychiatric Institute, The Hague, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Columbia University, Mailman School of Public Health, New York
| | - Pauline W Jansen
- Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands; Erasmus University Rotterdam, the Netherlands.
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Beyrer C, Kamarulzaman A, Isbell M, Amon J, Baral S, Bassett MT, Cepeda J, Deacon H, Dean L, Fan L, Giacaman R, Gomes C, Gruskin S, Goyal R, Mon SHH, Jabbour S, Kazatchkine M, Kasoka K, Lyons C, Maleche A, Martin N, McKee M, Paiva V, Platt L, Puras D, Schooley R, Smoger G, Stackpool-Moore L, Vickerman P, Walker JG, Rubenstein L. Under threat: the International AIDS Society-Lancet Commission on Health and Human Rights. Lancet 2024; 403:1374-1418. [PMID: 38522449 DOI: 10.1016/s0140-6736(24)00302-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 09/26/2023] [Accepted: 02/12/2024] [Indexed: 03/26/2024]
Affiliation(s)
- Chris Beyrer
- Duke Global Health Institute, Duke University, Durham, NC, USA; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA.
| | | | | | - Joseph Amon
- Office of Global Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Mary T Bassett
- François-Xavier Bagnoud Center for Health and Human Rights, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Javier Cepeda
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Harriet Deacon
- Treatied Spaces Research Group and Centre of Excellence in Data Science, Artificial Intelligence and Modelling, University of Hull, Hull, UK
| | - Lorraine Dean
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | | | - Rita Giacaman
- Institute of Community and Public Health, Birzeit University, Birzeit, West Bank, Palestine
| | - Carolyn Gomes
- UNAIDS HIV & Human Rights Reference Group, Kingston, Jamaica
| | - Sofia Gruskin
- Institute on Inequalities in Global Health, University of Southern California, Los Angeles, CA, USA
| | - Ravi Goyal
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, San Diego, CA, USA
| | | | | | | | | | - Carrie Lyons
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Allan Maleche
- Kenya Legal & Ethical Issues Network on HIV and AIDS, Nairobi, Kenya
| | - Natasha Martin
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, San Diego, CA, USA
| | - Martin McKee
- London School of Hygiene & Tropical Medicine, London, UK
| | - Vera Paiva
- Institute of Psychology, University of Sao Paulo, Sao Paulo, Brazil
| | - Lucy Platt
- London School of Hygiene & Tropical Medicine, London, UK
| | - Dainius Puras
- Clinic of Psychiatry, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Robert Schooley
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, San Diego, CA, USA
| | | | | | | | | | - Leonard Rubenstein
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
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Acquadro-Pacera G, Valente M, Facci G, Molla Kiros B, Della Corte F, Barone-Adesi F, Ragazzoni L, Trentin M. Exploring differences in the utilization of the emergency department between migrant and non-migrant populations: a systematic review. BMC Public Health 2024; 24:963. [PMID: 38580984 PMCID: PMC10996100 DOI: 10.1186/s12889-024-18472-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/28/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Migrants face several barriers when accessing care and tend to rely on emergency services to a greater extent than primary care. Comparing emergency department (ED) utilization by migrants and non-migrants can unveil inequalities affecting the migrant population and pave the way for public health strategies aimed at improving health outcomes. This systematic review aims to investigate differences in ED utilization between migrant and non-migrant populations to ultimately advance research on migrants' access to care and inform health policies addressing health inequalities. METHODS A systematic literature search was conducted in March 2023 on the Pubmed, Scopus, and Web of Science databases. The included studies were limited to those relying on data collected from 2012 and written in English or Italian. Data extracted included information on the migrant population and the ED visit, the differences in ED utilization between migrants and non-migrants, and the challenges faced by migrants prior to, during, and after the ED visit. The findings of this systematic review are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. RESULTS After full-text review, 23 articles met the inclusion criteria. All but one adopted a quantitative methodology. Some studies reported a higher frequency of ED visits among migrants, while others a higher frequency among non-migrants. Migrants tend to leave the hospital against medical advice more frequently than the native population and present at the ED without consulting a general practitioner (GP). They are also less likely to access the ED via ambulance. Admissions for ambulatory care-sensitive conditions, namely health conditions for which adequate, timely, and effective outpatient care can prevent hospitalization, were higher for migrants, while still being significant for the non-migrant population. CONCLUSIONS The comparison between migrants' and non-migrants' utilization of the ED did not suggest a clear pattern. There is no consensus on whether migrants access EDs more or less than non-migrants and on whether migrants are hospitalized at a higher or lower extent. However, migrants tend to access EDs for less urgent conditions, lack a referral from a GP and access the ED as walk-ins more frequently. Migrants are also discharged against medical advice more often compared to non-migrants. Findings of this systematic review suggest that migrants' access to care is hindered by language barriers, poor insurance coverage, lack of entitlement to a GP, and lack of knowledge of the local healthcare system.
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Affiliation(s)
- Giulia Acquadro-Pacera
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Universià del Piemonte Orientale, Novara, 28100, Italy
| | - Martina Valente
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Universià del Piemonte Orientale, Novara, 28100, Italy
- Department for Sustainable Development and Ecological Transition, Università del Piemonte Orientale, Vercelli, 13100, Italy
| | - Giulia Facci
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Universià del Piemonte Orientale, Novara, 28100, Italy
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, 28100, Italy
| | | | - Francesco Della Corte
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Universià del Piemonte Orientale, Novara, 28100, Italy
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, 28100, Italy
| | - Francesco Barone-Adesi
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Universià del Piemonte Orientale, Novara, 28100, Italy
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, 28100, Italy
| | - Luca Ragazzoni
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Universià del Piemonte Orientale, Novara, 28100, Italy
- Department for Sustainable Development and Ecological Transition, Università del Piemonte Orientale, Vercelli, 13100, Italy
| | - Monica Trentin
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Universià del Piemonte Orientale, Novara, 28100, Italy.
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, 28100, Italy.
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Alshehri OM, Shabnam M, Asiri SA, Mahnashi MH, Sadiq A, Jan MS. Isolation, invitro, invivo anti-inflammatory, analgesic and antioxidant potential of Habenaria plantegania Lindl. Inflammopharmacology 2024; 32:1353-1369. [PMID: 38334860 DOI: 10.1007/s10787-023-01425-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 12/27/2023] [Indexed: 02/10/2024]
Abstract
Habenaira plantaginea belong to orchid family which is native to Asia. Members of this family are commonly famous for the cure of pain and inflammation. To date, no research was found on isolation of compounds from this plant for the treatment of inflammation and analgesia nor has been published to our knowledge. The purpose of this study was to evaluate an analgesic, anti-inflammatory and anti-oxidant activity of the isolated compound from the most potent chloroform sub-fraction and the isolated compounds form the habenaria plantaginea. Anti-inflammatory analgesic and antioxidant potential of the various chloroform sub-fractions and isolated compounds from the most potent sub-fraction (HP-1 & HP-1) were screened for their in vitro enzymatic assays. Furthermore, prior to in-vivo investigation, the isolated compounds were subjected for their toxicity study. The potent compound was then examined for acetic acid-induced writhing, hot plate test, carrageenan-induced inflammation assays. Further various phlogistic agents were used for the evaluation of mechanism. In the COX-2 inhibitory assay the chloroform sub fraction Cf-4 demonstrated excellent activity as compared to the other sub-fraction with 92.15% inhibition. The COX-2 enzyme make prostaglandins which are directly involved in inflammation. Likewise against 5-LOX the Cf-4 was the most potent sub-fraction with IC50 3.77 µg/mL. The 5-LOX catalyzes the biosynthesis of leukotrienes which is a group of lipid mediators of inflammation derived from arachidonic acid. Free radicals can induce inflammation through cellular damage while chronic inflammation generates a large number of free radicals, whose eventually lead to inflammation. In antioxidant assays the Cf-4 fraction was displayed excellent results against ABTS, DPPH and H2O2 free radical with 88.88, 77.44, and 65.52% inhibition at highest concentration. Likewise, the compound HP-1 demonstrated 88.81, 89.34 and 80.43% inhibition while compound HP-2 displayed 84.34, 91.52 and 82.34% inhibition against ABTS, DPPH and H2O2 free radical which were comparable to the standard drug ascorbic acid respectively. This study's findings validate the use of this species as traditional use.
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Affiliation(s)
- Osama M Alshehri
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Najran University, Najran, Saudi Arabia
| | - Madeeha Shabnam
- Department of Chemistry, Women University Mardan, Mardan, KP, Pakistan
| | - Saeed Ahmed Asiri
- Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Najran University, 1988, Najran, 61441, Saudi Arabia
| | - Mater H Mahnashi
- Department of Pharmaceutical Chemistry, College of Pharmacy, Najran University, Najran, Kingdom of Saudi Arabia
| | - Abdul Sadiq
- Department of Pharmacy, Faculty of Biological Sciences, University of Malakand, Dir (L), Chakdara, 18000, KP, Pakistan
| | - Muhammad Saeed Jan
- Department of Pharmacy, Bacha Khan University, Charsadda, 24420, KP, Pakistan.
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Petersen E, Al-Abri S, Al-Jardani A, Memish ZA, Aklillu E, Ntoumi F, Mwaba P, Wejse C, Zumla A, Al-Yaquobi F. Screening for latent tuberculosis in migrants-status quo and future challenges. Int J Infect Dis 2024; 141S:107002. [PMID: 38479577 DOI: 10.1016/j.ijid.2024.107002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/05/2024] [Accepted: 03/05/2024] [Indexed: 03/25/2024] Open
Abstract
OBJECTIVES To review the evidence that migrants from tuberculosis (TB) high-incidence countries migrating to TB low-incidence countries significantly contribute to active TB cases in the counties of destination, primarily through reactivation of latent TB. METHODS This is a narrative review. The different screening programs in the countries of destination are reviewed either based on screening and preventive treatment of latent TB pre or more commonly - post arrival. RESULTS Screening can be performed using interferon-gamma release assays (IGRA) or tuberculin skin tests (TST). Preventive treatment of latent TB is using either monotherapy with isoniazid, or in combination with rifampicin or rifapentine. We discuss the ethical issues of preventive treatment in asymptomatic individuals and how these are addressed in different screening programs. CONCLUSION Screening migrants from TB high endemic countries to TB low endemic countries is beneficial. There is a lack of standardization and agreement on screening protocols, follow up and treatment.
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Affiliation(s)
- Eskild Petersen
- PandemiX Center of Excellence, Roskilde University, Roskilde, Denmark; European Society for Clinical Microbiology and Infectious Diseases Task Force for Emerging Infections, Basel, Switzerland; International Society for Infectious Diseases, Boston, MA, USA
| | - Seif Al-Abri
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman.
| | - Amina Al-Jardani
- Central Public Health Laboratory, Ministry of Health, Muscat, Oman
| | - Ziad A Memish
- Research and Innovation Center, King Saud Medical City, Ministry of Health & College of Medicine, Al Faisal University, Riyadh, Saudi Arabia; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Eleni Aklillu
- Department of Global Public Health, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, People's Republic of Congo; Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Peter Mwaba
- UNZA-UCLMS Research and Training Program, UTH, Lusaka, Zambia; Lusaka Apex Medical University, Faculty of Medicine, Lusaka, Zambia
| | - Christian Wejse
- Department of Public Health, Faculty of Health Science, Aarhus University, Aarhus, Denmark
| | - Alimuddin Zumla
- Department of Infection, Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, London, United Kingdom; NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, United Kingdom
| | - Fatma Al-Yaquobi
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
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Nayakarathna R, Patel N, Currie C, Faulkner G, Riazi N, Tremblay MS, Trudeau F, Larouche R. Correlates of Physical Activity in Children from Families Speaking Non-official Languages at Home: a Multi-site Canadian Study. J Racial Ethn Health Disparities 2024; 11:815-825. [PMID: 36913115 DOI: 10.1007/s40615-023-01563-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/22/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Children from families speaking a non-official language at home may be particularly at risk for low physical activity (PA), underscoring a need to investigate correlates of PA in this subpopulation. METHODS We recruited 478 children in 37 schools stratified by area-level socioeconomic status (SES) and type of urbanization within three regions of Canada. Steps/day were measured using SC-StepRx pedometers. We assessed potential social-ecological correlates with child and parent surveys. We used gender-stratified linear mixed models to examine the correlates of steps/day. RESULTS Outdoor time was the strongest correlate of boys' and girls' PA. Lower area-level SES was associated with less PA among boys, but outdoor time attenuated this difference. The strength of association between outdoor time and PA decreased with age in boys and increased with age in girls. DISCUSSION Outdoor time was the most consistent correlate of PA. Future interventions should promote outdoor time and address socioeconomic disparities.
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Affiliation(s)
| | - Nimesh Patel
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada
| | - Cheryl Currie
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Negin Riazi
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, ON, Canada
| | - François Trudeau
- Département des Sciences de l'Activité Physique, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Richard Larouche
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada.
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48
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Kondili LA, Lazarus JV, Jepsen P, Murray F, Schattenberg JM, Korenjak M, Craxì L, Buti M. Inequities in primary liver cancer in Europe: The state of play. J Hepatol 2024; 80:645-660. [PMID: 38237866 DOI: 10.1016/j.jhep.2023.12.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 12/01/2023] [Accepted: 12/11/2023] [Indexed: 02/12/2024]
Abstract
Given the increasing burden of liver cancer in Europe, it is crucial to investigate how social determinants of health (SDoH) affect liver cancer risk factors and access to care in order to improve health outcomes equitably. This paper summarises the available evidence on the differential distribution of liver cancer risk factors, incidence, and health outcomes in the European Economic Area and the United Kingdom from an SDoH perspective. Vulnerable and marginalised populations have low socio-economic and educational levels and are the most affected by liver cancer risk factors. Reasons for this include varied access to hepatitis B virus vaccination and limited access to viral hepatitis B and C screening, harm reduction, and treatment. Additionally, alcohol-related liver disease remains highly prevalent among individuals with low education, insecure employment, economic instability, migrants, and deprived populations. Moreover, significant variation exists across Europe in the proportion of adults with steatotic liver disease, overweight/obesity, and diabetes, based on geographical area, gender, socio-economic and educational background, and density of ultra-processed food outlets. Inequities in cirrhosis mortality rates have been reported, with the highest death rates among individuals living in socio-economically disadvantaged areas and those with lower educational levels. Furthermore, insufficient healthcare access for key populations with primary liver cancer is influenced by complex healthcare systems, stigmatisation, discrimination, low education, language barriers, and fear of disclosure. These challenges contribute to inequities in liver cancer care pathways. Future studies are needed to explore the different SDoH-interlinked effects on liver cancer incidence and outcomes in European countries. The ultimate goal is to develop evidence-based multilevel public health interventions that reduce the SDoH impact in precipitating and perpetuating the disproportionate burden of liver cancer in specific populations.
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Affiliation(s)
- Loreta A Kondili
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy, UniCamillus International Medical University, Rome, Italy
| | - Jeffrey V Lazarus
- CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, USA; Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain; Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Peter Jepsen
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Frank Murray
- Beaumont Private Clinic, Beaumont, Dublin 9, Ireland
| | - Jörn M Schattenberg
- Department of Internal Medicine II, Saarland University Medical Center, Homburg and Saarland University, Saarbrücken, Germany
| | | | - Lucia Craxì
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Maria Buti
- Liver Unit, Hospital Universitario Vall d'Hebrón, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.
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49
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Spiegel PB, Karadag O, Blanchet K, Undie CC, Mateus A, Horton R. The CHH-Lancet Commission on Health, Conflict, and Forced Displacement: reimagining the humanitarian system. Lancet 2024; 403:1215-1217. [PMID: 38493793 DOI: 10.1016/s0140-6736(24)00426-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 03/19/2024]
Affiliation(s)
- Paul B Spiegel
- Johns Hopkins Center for Humanitarian Health and Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Ozge Karadag
- Bahcesehir University (BAU), School of Medicine, Istanbul, Türkiye
| | | | - Chi-Chi Undie
- Baobab Research Programme Consortium, Population Council, Nairobi, Kenya
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50
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Wimer G, Larrea M, Streeter J, Hassan A, Angulo A, Armijos A, Bonz A, Tol WA, Greene MC. Accessibility and Perceived Impact of a Group Psychosocial Intervention for Women in Ecuador: A Comparative Analysis by Migration Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:380. [PMID: 38673293 PMCID: PMC11049989 DOI: 10.3390/ijerph21040380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024]
Abstract
There is increasing guidance promoting the provision of mental health and psychosocial support programs to both migrant and host community members in humanitarian settings. However, there is a lack of information on the respective experiences and benefits for migrant and host community members who are participating in mental health and psychosocial support programming. We evaluated a community-based psychosocial program for migrant and host community women, Entre Nosotras, which was implemented with an international non-governmental organization in Ecuador in 2021. Data on participant characteristics and psychosocial wellbeing were collected via pre/post surveys with 143 participants, and qualitative interviews were conducted with a subset (n = 61) of participants. All quantitative analyses were conducted in STATA, and qualitative analysis was done in NVivo. Attendance was higher for host community members. Specifically, 71.4% of host community members attended 4-5 sessions, whereas only 37.4% of migrants attended 4-5 sessions (p = 0.004). Qualitative analysis shows that the intervention was less accessible for migrants due to a variety of structural barriers. However, this analysis also demonstrated that both groups of women felt a greater sense of social connectedness after participating in the program and expressed gratitude for the bonds they formed with other women. Some migrant women described negative experiences with the host community because they felt as though they could not confide in host community women and speak freely in front of them. These results underscore how the migratory context influences the implementation of mental health and psychosocial support (MHPSS) programs. As humanitarian guidelines continue to emphasize the integration of host community members and displaced persons, it is critical to account for how the same intervention may impact these populations differently.
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Affiliation(s)
- Gabrielle Wimer
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA;
| | | | | | - Amir Hassan
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA;
| | | | - Andrea Armijos
- HIAS, Silver Spring, MD 62471, USA; (A.A.); (A.A.); (A.B.)
| | - Annie Bonz
- HIAS, Silver Spring, MD 62471, USA; (A.A.); (A.A.); (A.B.)
| | - Wietse A. Tol
- Department of Public Health, University of Copenhagen, 1172 Copenhagen, Denmark;
| | - M. Claire Greene
- Mailman School of Public Health, Columbia University, New York, NY 10032, USA;
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