1
|
Antón-Berenguer V, Cabrera-Rodrigo I, Valle-Borrego B, Ligero-López J, Merino-Fernández FJ, Gómez-de-Frutos S, Rubio JM. Imported malaria in a non-endemic country: sixteen years of cases in a hospital in the South of Madrid, Spain. Eur J Clin Microbiol Infect Dis 2024:10.1007/s10096-024-04938-0. [PMID: 39287796 DOI: 10.1007/s10096-024-04938-0] [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: 02/08/2024] [Accepted: 09/04/2024] [Indexed: 09/19/2024]
Abstract
PURPOSE Malaria keeps on being a serious global health threat, especially in many tropical countries, where it is endemic. Also in non-endemic countries, like Spain, malaria is an issue that requires attention due to the presence of imported cases. METHODS This is a retrospective study, including all patients diagnosed with malaria at Severo Ochoa University Hospital from 2006 to 2022, being classified according to: (I) their type of stay in an endemic area as visiting friends and relatives (VFR), migrants of recent arrival (MRA), or tourism and business (T&B), and (II) the mode of presentation as microscopic (MM) or submicroscopic (SMM) malaria. RESULTS In this study, 132 patients (23.7% of all suspected) were diagnosed with malaria. The PCR was the most sensitive technique (99.2%), followed by antigen detection (78.8%) and microscopy (75%), with Plasmodium falciparum being the predominant species (94.7%). VFR was the largest group infected with malaria (69.7%), mostly symptomatic (98.2%) and presenting MM (90.2%). Instead, MRA patients (25%) presented milder (47.4%) or no symptoms (31.6%) and higher cases of SMM (42.4%). Coinfection with another imported pathogen was present in 19 patients (14.4%), being MRA more frequently coinfected (30.3%) CONCLUSION: This study shows the need for establishing systems for VFRs to attend pre-travel consultations to reduce malaria imported risk. In the case of MRA, screening for imported diseases should be conducted upon their arrival. Finally, we highlight two cases of co-infection with imported viruses, showing that presence of symptoms resembling malaria from another imported pathogen does not exclude malaria.
Collapse
Affiliation(s)
- Víctor Antón-Berenguer
- Severo Ochoa University Hospital, Avenida de Orellana s/n Leganés, Madrid, 28911, Spain
- Malaria & Emerging Parasitic Diseases Laboratory, Parasitology Department, National Centre of Microbiology. Instituto de Salud Carlos III, Cra. Majadahonda Pozuelo Km.2, Majadahonda, Madrid, 28220, Spain
| | - Irene Cabrera-Rodrigo
- Severo Ochoa University Hospital, Avenida de Orellana s/n Leganés, Madrid, 28911, Spain
- Faculty of Medicine, Alfonso X el Sabio University, Madrid, Spain
| | - Beatriz Valle-Borrego
- Severo Ochoa University Hospital, Avenida de Orellana s/n Leganés, Madrid, 28911, Spain
- Faculty of Medicine, Alfonso X el Sabio University, Madrid, Spain
| | - Jorge Ligero-López
- Severo Ochoa University Hospital, Avenida de Orellana s/n Leganés, Madrid, 28911, Spain
- Department of Microbiology, Faculty of Medicine, Paediatrics, Radiology and Public Health, Zaragoza University, Zaragoza, Spain
| | - Francisco J Merino-Fernández
- Severo Ochoa University Hospital, Avenida de Orellana s/n Leganés, Madrid, 28911, Spain
- Faculty of Medicine, Alfonso X el Sabio University, Madrid, Spain
| | - Sara Gómez-de-Frutos
- Severo Ochoa University Hospital, Avenida de Orellana s/n Leganés, Madrid, 28911, Spain
| | - José Miguel Rubio
- Malaria & Emerging Parasitic Diseases Laboratory, Parasitology Department, National Centre of Microbiology. Instituto de Salud Carlos III, Cra. Majadahonda Pozuelo Km.2, Majadahonda, Madrid, 28220, Spain.
| |
Collapse
|
2
|
Horak P, Auer H, Wiedermann U, Walochnik J. Malaria in Austria : A retrospective analysis of malaria cases diagnosed at a reference center in 2010-2020. Wien Klin Wochenschr 2023; 135:617-624. [PMID: 37069405 PMCID: PMC10108813 DOI: 10.1007/s00508-023-02179-3] [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: 11/17/2022] [Accepted: 02/25/2023] [Indexed: 04/19/2023]
Abstract
BACKGROUND Although malaria is not endemic to Austria, each year infections are imported by travellers, migrants and refugees. This study aims to provide an overview of malaria cases diagnosed at an Austrian institute for tropical medicine between 2010 and 2020. METHODS A retrospective, descriptive study was conducted based on the data of malaria cases confirmed at the Institute of Specific Prophylaxis and Tropical Medicine of the Medical University of Vienna. Laboratory diagnostics included microscopy, polymerase chain reaction (PCR) and real-time quantitative PCR. RESULTS Overall, 122 cases were identified. Annual case numbers were consistently higher from 2016 to 2020 than during the first half of the decade. Most malaria cases were diagnosed during summer and early autumn. This seasonal trend was not observed during the year 2020. With 55.1% (65/118) Plasmodium falciparum was the most common species, followed by Plasmodium vivax (19.5%, 23/118). The majority of patients were male (71.1%, 86/121) and the median age was 34.5 years (interquartile range, IQR 22.5-47.0 years). With a median age of 20.0 years (IQR 14.0-32.0 years), patients with P. vivax infections were younger than those infected with other Plasmodium species. Moreover, they were mostly male (82.6%, 19/23). CONCLUSION From 2010 to 2020, the number of malaria cases diagnosed at the center increased. Growing international mobility and changing travel behavior could at least partly be responsible for this trend and there are indications that particularly P. vivax infections were imported by migrants and refugees.
Collapse
Affiliation(s)
- Paul Horak
- Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria
| | - Herbert Auer
- Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria
| | - Ursula Wiedermann
- Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria
| | - Julia Walochnik
- Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria.
| |
Collapse
|
3
|
Dorrucci M, Boccolini D, Bella A, Lucarelli C, D'Amato S, Caraglia A, Maraglino FP, Severini C, Gradoni L, Pezzotti P. Malaria surveillance system and Hospital Discharge Records: Assessing differences in Italy, 2011–2017 database analysis. Travel Med Infect Dis 2022; 48:102322. [DOI: 10.1016/j.tmaid.2022.102322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 03/17/2022] [Accepted: 03/27/2022] [Indexed: 11/16/2022]
|
4
|
Agagliati F, Silvestro E, Denina M, Garazzino S, Mignone F, Zoppo M, Pruccoli G, Scolfaro C. Imported malaria in children: A 13 years retrospective study. Travel Med Infect Dis 2022; 46:102273. [DOI: 10.1016/j.tmaid.2022.102273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/15/2022] [Accepted: 01/31/2022] [Indexed: 11/29/2022]
|
5
|
Seo EB, du Plessis LH, Viljoen JM. Solidification of Self-Emulsifying Drug Delivery Systems as a Novel Approach to the Management of Uncomplicated Malaria. Pharmaceuticals (Basel) 2022; 15:ph15020120. [PMID: 35215233 PMCID: PMC8877057 DOI: 10.3390/ph15020120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/14/2022] [Accepted: 01/15/2022] [Indexed: 01/27/2023] Open
Abstract
Malaria affects millions of people annually, especially in third-world countries. The mainstay of treatment is oral anti-malarial drugs and vaccination. An increase in resistant strains of malaria parasites to most of the current anti-malarial drugs adds to the global burden. Moreover, existing and new anti-malarial drugs are hampered by significantly poor aqueous solubility and low permeability, resulting in low oral bioavailability and patient noncompliance. Lipid formulations are commonly used to increase solubility and efficacy and decrease toxicity. The present review discusses the findings from studies focusing on specialised oral lipophilic drug delivery systems, including self-emulsifying drug delivery systems (SEDDSs). SEDDSs facilitate the spontaneous formation of liquid emulsions that effectively solubilise the incorporated drugs into the gastrointestinal tract and thereby improve the absorption of poorly-soluble anti-malaria drugs. However, traditional SEDDSs are normally in liquid dosage forms, which are delivered orally to the site of absorption, and are hampered by poor stability. This paper discusses novel solidification techniques that can easily and economically be up-scaled due to already existing industrial equipment that could be utilised. This method could, furthermore, improve product stability and patient compliance. The possible impact that solid oral SEDDSs can play in the fight against malaria is highlighted.
Collapse
|
6
|
Comelli A, Guarner ME, Tomasoni LR, Fanetti Zamboni A, Moreno Pavón B, Zanotti P, Caligaris S, Matteelli A, Soriano-Arandes A, Castelli F. Severe imported Plasmodium falciparum malaria in children: characteristics and useful factors in the risk stratification. Travel Med Infect Dis 2021; 44:102196. [PMID: 34748988 DOI: 10.1016/j.tmaid.2021.102196] [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: 11/02/2020] [Revised: 08/09/2021] [Accepted: 11/01/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Severe imported pediatric malaria is of concern in non-endemic settings. We aimed to determine the features of pediatric severe cases in order to design a model able to stratify patients at presentation. METHODS We conducted a retrospective cross-sectional study including all imported P. falciparum malaria infection in patients ≤14 years of age, treated from January 2008 to February 2019 in two tertiary hospitals: Brescia, Italy and Barcelona, Spain. Severe malaria was defined according to World Health Organization criteria. Mortality rate, pediatric intensive care unit (PICU) stay and blood transfusion were analysed as adverse outcomes. RESULTS Out of 139 children included, 30.9% were severe malaria. Twenty-seven (19.4%) were admitted to PICU, and transfusion was required in 14 cases (10.1%). Predictors for severe malaria were: young age, low hemoglobin, high white blood cells (WBC) and high C-reactive protein. Platelet <130,000/μl correlated with severe malaria (without statistical significance). A model that includes age, WBC and C-reactive protein shows a high specificity to classify patients without severe malaria (92.3%) with 70% PPV and 75% NPV. CONCLUSIONS A score based on patient's age, WBC and C-reactive protein easily available at emergency room can help to identify children with higher risk of adverse outcomes.
Collapse
Affiliation(s)
- Agnese Comelli
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, Italy.
| | - María Espiau Guarner
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall D'Hebron. PROSICS Barcelona. Universitat Autònoma de Barcelona. Barcelona, Spain
| | - Lina Rachele Tomasoni
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, Italy
| | - Agnese Fanetti Zamboni
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, Italy
| | - Belén Moreno Pavón
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall D'Hebron. PROSICS Barcelona. Universitat Autònoma de Barcelona. Barcelona, Spain
| | - Paola Zanotti
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, Italy
| | - Silvio Caligaris
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, Italy
| | - Alberto Matteelli
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, Italy
| | - Antoni Soriano-Arandes
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall D'Hebron. PROSICS Barcelona. Universitat Autònoma de Barcelona. Barcelona, Spain
| | - Francesco Castelli
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, Italy
| |
Collapse
|
7
|
Dupré A, Argy N, Houze S, Leleu A, Choquet C, Matheron S, Bleibtreu A. Imported malaria in metropolitan France, from recommendations to clinical practice - proposal for improvement. Infect Dis Now 2021; 51:667-672. [PMID: 34464757 DOI: 10.1016/j.idnow.2021.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/23/2021] [Accepted: 08/24/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Approximately 5000 cases of imported malaria are observed each year in metropolitan France. Guidelines for the prevention and management of imported malaria were published by the French infectious disease society (French acronym SPILF) in 2017. OBJECTIVE Study objective was to describe in a retrospective analysis (2015-2016) imported malaria cases recorded in a Parisian hospital, to analyze the congruence to previous guidelines (2014), deviation in respect to post hoc published guidelines and potential areas for improvement. RESULTS Two hundred and one cases were analyzed using medical charts. There was a majority of men (sex ratio 2/1), with a mean age of 43 years at diagnosis. The main area of infection acquisition was sub-Saharan Africa (97%). The average time since return from the endemic area was 20 days. Patients consulted the emergency department for flu-like syndrome (32%), fever or chills (28%), and gastrointestinal symptoms (22%). Blood smears mainly identified Plasmodium falciparum (n=180, 90%). There were 52 (26%) severe malaria episodes. CONCLUSION The analysis of national guideline adequacy highlighted difficulties in obtaining a complete biological workup at baseline, managing patients with vomiting, and in the post-treatment follow-up.
Collapse
Affiliation(s)
- A Dupré
- Service des maladies infectieuses et tropicales, hôpital Bichat-Claude-Bernard, groupe hospitalier universitaire AP-HP Nord, AP-HP, Paris, France
| | - N Argy
- Laboratoire de parasitologie, hôpital Bichat - Claude-Bernard, Paris, France; Centre national de référence du paludisme, hôpital Bichat-Claude-Bernard, Paris, France; MERIT UMR 261, faculté de pharmacie, université de Paris, Paris, France
| | - S Houze
- Laboratoire de parasitologie, hôpital Bichat - Claude-Bernard, Paris, France; Centre national de référence du paludisme, hôpital Bichat-Claude-Bernard, Paris, France; MERIT UMR 261, faculté de pharmacie, université de Paris, Paris, France
| | - A Leleu
- Département des urgences, hôpital Bichat-Claude-Bernard, Paris, France
| | - C Choquet
- Département des urgences, hôpital Bichat-Claude-Bernard, Paris, France
| | - S Matheron
- Service des maladies infectieuses et tropicales, hôpital Bichat-Claude-Bernard, groupe hospitalier universitaire AP-HP Nord, AP-HP, Paris, France; UMR 1137 Inserm, université Paris Diderot, Paris, France
| | - A Bleibtreu
- Service des maladies infectieuses et tropicales, hôpital Bichat-Claude-Bernard, groupe hospitalier universitaire AP-HP Nord, AP-HP, Paris, France; Service de maladies infectieuses et tropicales, hôpitaux universitaires Pitié-Salpêtrière Charles Foix, Sorbonne Université, AP-HP, Paris, France.
| |
Collapse
|
8
|
Piccioni MG, Del Negro V, Vena F, Capone C, Merlino L, Moore JM, Giancotti A, Porpora MG, Brunelli R. Diagnosis & management of imported malaria in pregnant women in non-endemic countries. Indian J Med Res 2021; 152:449-455. [PMID: 33707386 PMCID: PMC8157900 DOI: 10.4103/ijmr.ijmr_851_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Malaria in pregnancy is an important cause of maternal and foetal morbidity and is a potentially life-threatening infection. With ever-growing global exchanges, imported malaria in pregnancy is becoming an issue of concern in non-endemic countries where women, because of low immunity, have higher risk of severe diseases and death. Malaria in pregnancy is a dangerous condition which can be associated with important consequences for both mother and child such as stillbirth, low birth weight, maternal anaemia. In non-endemic-countries it is more frequent in its severe form which can lead to maternal death if not treated adequately. Specific anti-malarial interventions such as the use of repellents and insecticide treated bed nets in addition to chemoprophylaxis should be used by pregnant women if they are travelling to endemic areas. In cases of confirmed infection, specific treatment regimens vary according to gestational age and the presence of complications. Malaria should be considered a global health problem, increasingly involving western countries. Clinicians all over the world need to be prepared for this emerging disease both in terms of prevention and therapy.
Collapse
Affiliation(s)
- Maria Grazia Piccioni
- Department of Gynecological, Obstetrical & Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Valentina Del Negro
- Department of Gynecological, Obstetrical & Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Flaminia Vena
- Department of Gynecological, Obstetrical & Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Carmela Capone
- Department of Gynecological, Obstetrical & Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Lucia Merlino
- Department of Gynecological, Obstetrical & Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - James Matthaus Moore
- Department of Uro-Gynaecology, Gynaecology Oncology, University Hospital of Wales, Cardiff, Wales, United Kingdom
| | - Antonella Giancotti
- Department of Gynecological, Obstetrical & Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Grazia Porpora
- Department of Gynecological, Obstetrical & Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Roberto Brunelli
- Department of Gynecological, Obstetrical & Urological Sciences, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
9
|
Martini M, Angheben A, Riccardi N, Orsini D. Fifty years after the eradication of Malaria in Italy. The long pathway toward this great goal and the current health risks of imported malaria. Pathog Glob Health 2021; 115:215-223. [PMID: 33734023 DOI: 10.1080/20477724.2021.1894394] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Fifty years ago, Italy was declared a malaria-free country by the World Health Organization (WHO). In remembering this important anniversary, the authors of this paper describe the long journey that led to this goal. In the century following the unification of Italy, malaria was one of the main public health problems. At the end of the 19th century, malaria cases amounted to 2 million, with 15,000-20,000 deaths per year. This manuscript examines the state of public and social health in Italy from the end of the 19th century to the beginning of the 20th century, with particular regard to the government's measures for the prevention, prophylaxis and treatment of malaria. The authors describe the main findings of Italian malariologists during the period under review, from the identification of Plasmodium as a malaria pathogen and the recognition of the Anopheles mosquito as its vector. They also make some considerations regarding the current situation and the importation of malaria by travelers and migrants from countries where the disease is still endemic.
Collapse
Affiliation(s)
- Mariano Martini
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Andrea Angheben
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar Di Valpolicella, Verona, Italy
| | - Niccolò Riccardi
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar Di Valpolicella, Verona, Italy
| | - Davide Orsini
- University Museum System of Siena (Simus), History of Medicine, University of Siena, Siena, Italy
| |
Collapse
|
10
|
Domínguez García M, Feja Solana C, Vergara Ugarriza A, Bartolomé Moreno C, Melús Palazón E, Magallón Botaya R. Imported malaria cases: the connection with the European ex-colonies. Malar J 2019; 18:397. [PMID: 31801538 PMCID: PMC6891950 DOI: 10.1186/s12936-019-3042-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 11/27/2019] [Indexed: 12/03/2022] Open
Abstract
Background Imported malaria is increasing in non-endemic areas due to the increment of international travels, migration and, probably, other unknown factors. The objective of this study was to describe the epidemiological and clinical characteristics of malaria cases in a region of Spain; analyse the possible association between the variables of interest; compare this series with others; and evaluate the characteristics of imported malaria cases according to the country of origin, particularly cases from Equatorial Guinea (Spanish ex-colony) and from the rest of sub-Saharan Africa. Methods A descriptive observational study was carried out with a retrospective data collection of cases of malaria reported in Aragon from 1996 to 2017. Univariate and bivariate analysis of clinical–epidemiological variables was performed. In addition, an analysis of cases from sub-Saharan Africa was carried out using logistic regression, calculating odds ratio with its 95% confidence interval. Results 609 cases of malaria were recorded in Aragon from 1996 to 2017. An autochthonous case in 2010. 50.33% were between 15 and 39 years old. 45.65% of the cases were notified of the 4-weeks 9 to 12. 82.6% reside in the main province, urban area, of which 65.4% were VFR (Visiting Friends and Relatives), 23.8% new immigrants and 10.9% travellers. The infectious Plasmodium species par excellence was Plasmodium falciparum (88%). Analysing the cases from sub-Saharan Africa (95.2% of the total), 48.1% were from Equatorial Guinea. Comparing these with the cases from the rest of sub-Saharan Africa, it was observed that the cases from the Spanish ex-colony have association with the female gender, being under 5 years old, residing in the main province (urban area) and being a new immigrant. Conclusions The epidemiological profile of imported malaria cases can be defined as VFR between 15 and 39 years old, coming from sub-Saharan Africa, particularly from Equatorial Guinea. Immigrants education about the importance of chemoprophylaxis when travelling to visit friends and relatives, emphasizing on those who are originally from the ex-colonies of destination country, is necessary; as well as to raise awareness among health professionals to make advice in consultations, specially before summer vacations.
Collapse
Affiliation(s)
- Marta Domínguez García
- Aragonese Primary Care Research Group, IIS (Instituto de Investigación Sanitaria Aragón) GIIS-011, 50015, Zaragoza, Spain. .,Aragonese Health Service, Zaragoza, Spain. .,Aragonese Primary Care Research Group, B21-17R, Aragon Government, Zaragoza, Spain.
| | | | | | - Cruz Bartolomé Moreno
- Aragonese Primary Care Research Group, IIS (Instituto de Investigación Sanitaria Aragón) GIIS-011, 50015, Zaragoza, Spain.,Aragonese Health Service, Zaragoza, Spain.,Aragonese Primary Care Research Group, B21-17R, Aragon Government, Zaragoza, Spain
| | - Elena Melús Palazón
- Aragonese Primary Care Research Group, IIS (Instituto de Investigación Sanitaria Aragón) GIIS-011, 50015, Zaragoza, Spain.,Aragonese Health Service, Zaragoza, Spain.,Aragonese Primary Care Research Group, B21-17R, Aragon Government, Zaragoza, Spain.,University of Zaragoza, Zaragoza, Spain
| | - Rosa Magallón Botaya
- Aragonese Primary Care Research Group, IIS (Instituto de Investigación Sanitaria Aragón) GIIS-011, 50015, Zaragoza, Spain.,Aragonese Health Service, Zaragoza, Spain.,Aragonese Primary Care Research Group, B21-17R, Aragon Government, Zaragoza, Spain.,University of Zaragoza, Zaragoza, Spain
| |
Collapse
|
11
|
Greenaway C, Castelli F. Infectious diseases at different stages of migration: an expert review. J Travel Med 2019; 26:5307656. [PMID: 30726941 DOI: 10.1093/jtm/taz007] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 01/29/2019] [Accepted: 02/01/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Human migration is increasing in magnitude and scope. The majority of migrants arriving in high-income countries originate from countries with a high prevalence of infectious diseases. The risk and burden of infectious diseases are not equally distributed among migrant groups and vary with migration stage. METHODS A broad literature review was conducted on the drivers for infectious diseases and associated health outcomes among migrants across different stages of migration. The aim was to provide practitioners with an overview of the key infectious disease risks at each stage to guide health promotion strategies. RESULTS A complex interaction of factors leads to infectious diseases and associated poor health outcomes among migrants. The most important drivers are the epidemiology of infectious diseases in their countries of origin, the circumstances and conditions of the migration journey and barriers accessing healthcare post-arrival. During the recent large waves of forced migration into Europe, the primary health concerns on arrival were psychological, traumatic and chronic non-communicable diseases. In the early settlement period, crowded and unhygienic living conditions in reception camps facilitated outbreaks of respiratory, gastrointestinal, skin infections and vaccine preventable diseases. After re-settlement, undetected and untreated latent infections due to tuberculosis, viral hepatitis, HIV, chronic helminthiasis and Chagas' disease led to poor health outcomes. Migrants are disproportionally affected by preventable travel-related diseases such as malaria, typhoid and hepatitis due to poor uptake of pre-travel prophylaxis and vaccination. Infectious diseases among migrants can be decreased at all migration stages with health promotion strategies adapted to their specific needs and delivered in a linguistically and culturally sensitive manner. CONCLUSIONS Tailored health promotion and screening approaches and accessible and responsive health systems, regardless of legal status, will be needed at all migration stages to limit the burden and transmission of infectious diseases in the migrant population.
Collapse
Affiliation(s)
- Christina Greenaway
- Division of Infectious Diseases, Jewish General Hospital, McGill University, Montreal, Canada.,Centre for Clinical Epidemiology of the Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Canada.,JD MacLean Centre for Tropical Diseases at McGill, McGill University Health Centre, McGill University, Montreal, Canada
| | - Francesco Castelli
- JD MacLean Centre for Tropical Diseases at McGill, McGill University Health Centre, McGill University, Montreal, Canada.,University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, Italy.,UNESCO Chair 'Training and Empowering Human Resources for Health Development in Resource-Limited Countries', University of Brescia, Brescia, Italy
| |
Collapse
|
12
|
Antinori S, Napolitano M, Grande R, Passerini S, Ridolfo AL, Galimberti L, Oreni L, Schinaia S, Milazzo L, Galli M, Corbellino M, Gismondo MR, Zanchetta N, Cordier L, Rizzardini G. Epidemiological and clinical characteristics of imported malaria in adults in Milan, Italy, 2010-2015. Eur J Intern Med 2018; 57:e13-e16. [PMID: 30064716 DOI: 10.1016/j.ejim.2018.07.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 07/25/2018] [Indexed: 11/19/2022]
Affiliation(s)
- Spinello Antinori
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy; III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Maria Napolitano
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Romualdo Grande
- Department of Diagnostic Services, Clinical Microbiology, Virology and Bioemergent Diagnostics, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Simone Passerini
- I Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Anna Lisa Ridolfo
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Laura Galimberti
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Letizia Oreni
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Sara Schinaia
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Laura Milazzo
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Massimo Galli
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy; III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Mario Corbellino
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Maria Rita Gismondo
- Department of Diagnostic Services, Clinical Microbiology, Virology and Bioemergent Diagnostics, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Nadia Zanchetta
- Department of Diagnostic Services, Clinical Microbiology, Virology and Bioemergent Diagnostics, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Laura Cordier
- I Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Giuliano Rizzardini
- I Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| |
Collapse
|
13
|
Greenaway C. Promoting the health of migrants: what is the role of the travel medicine community? J Travel Med 2018; 25:5061334. [PMID: 30060128 DOI: 10.1093/jtm/tay060] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 07/29/2018] [Indexed: 12/24/2022]
Affiliation(s)
- C Greenaway
- Department of Medicine, Division of Infectious Diseases, Jewish General Hospital, McGill University, Montreal, Canada.,Lady Davis Institute for Medical Research, Centre of Clinical Epidemiology, Montreal, Canada
| |
Collapse
|