Practical diagnosis of red cell disorders in southern Spain

Newly Arrived African Migrants to Spain: Epidemiology and Burden of Disease

The aim of this study is to describe the epidemiological profile, clinical characteristics, and microbiological findings in African immigrants newly arrived to Spain attended at a specialized reference unit from October 2004 to February 2017. A common protocol for the screening of imported and cosmopolitan diseases was designed to evaluate patients with ≤ 12 months of stay in Spain. A total of 523 patients were included in the study, 488 (93.3%) of sub-Saharan origin. A high number of helminthic infections were diagnosed in sub-Saharan patients, including geohelminthiasis (hookworms 14.3%; Trichuris trichiura 4.1%; Ascaris lumbricoides 3.1%), schistosomiasis (12.3%), strongyloidiasis (17.2%), and filariasis (8.4%). Thirty-five patients (7.2%) had malaria, most by Plasmodium falciparum. Among communicable diseases, 33.6% of sub-Saharans presented HBsAg positivity compared with 5.7% of North African patients (P = 0.001). Thirteen patients were diagnosed with active tuberculosis. Seventy percent of the sub-Saharans and 40% of the North Africans who were tested had a latent tuberculosis infection (LTI). Treatment of LTI was administered in selected cases (14%), achieving end of treatment in 80% of them. In light of these results, effective screening strategies, particularly within the sub-Saharan immigrant population, including potentially communicable diseases and certain potentially serious parasitic diseases (Strongyloides, Schistosoma), should be implemented. It is necessary to facilitate fully and free of charge access to the public health system to newly arrived immigrants, as well as to implement programs and actions aimed at favoring care and follow-up, especially for communicable diseases. Empirical treatment of some parasitic diseases could be a cost-effective action.

Red blood cell disorders in recently arrived African immigrants to Gran Canaria, Spain

BACKGROUND

In the last decade immigration to Europe has increased, with Africa being the source of a large number of immigrants. In addition to infections, this group has other less known health problems, such as erythrocyte abnormalities.

METHODS

The objectives of this study were: the systematic evaluation of red cell abnormalities in 200 newly arrived asymptomatic African immigrants on the Canaries; the systematic evaluation of haemoglobinopathies and their characterization in this population; and the relationship of red blood cell disorders and parasitic infections.

RESULTS

Of the studied immigrants 53 (26.5%) had red cell disorders according to their CBC parameters (Hb and/or MCV). In 48 people (24.0%) one or more etiologic diagnoses were made. Specifically, in order of frequency, a total of 26 structural haemoglobinopathies, 14 α-thalassemias, 2 β-thalassemias and 14 iron deficiencies were diagnosed. There was a statistically significant association between the presence of anemia, microcytosis, structural haemoglobinopathies or α thalassemia and sub-Saharan origin. However, no statistically significant association between the abovementioned parameters and eosinophilia or helminthic infection was observed.

CONCLUSIONS

These results suggest that, even in the presence of normal Hb and MCV values, including haemoglobinopathies in the initial screening of newly arrived sub-Saharan immigrants would be very useful.