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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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Baggio S, Chacowry Pala K, Rieder JP, Tran NT, Wolff H, Gétaz L. Infectious diseases in post-trial detention and comparisons with pre-trial detention: A study in Geneva, Switzerland. J Infect Public Health 2019; 13:521-526. [PMID: 31780249 DOI: 10.1016/j.jiph.2019.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 10/30/2019] [Accepted: 11/11/2019] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Prevalence rates of infectious diseases in post-trial prisons have been scarcely investigated. Due to the specific characteristics of these prison populations, these prevalence rates may differ from pre-trial prisons and more information is needed for developing adequate prevention and treatment interventions. This study compared prevalence rates of hepatitis B virus (HBV), hepatitis C virus (HCV), susceptibility to varicella zoster virus (VZV) and measles in pre- and post-trial detention. METHODS Data were collected in Geneva post-trial prisons among males (n=250), including serological tests, demographics, and risk factors, and were compared to those of the Geneva pre-trial prison (n=273). RESULTS AND CONCLUSIONS Incarcerated men in post-trial detention shared a disproportionate burden of infectious diseases compared to community (chronic HBV: 5.9%, HVC: 2.8%, susceptibility to VZV: 5.9%, to measles: 4.7%). Susceptibility to VZV and prevalence rate of HCV were lower in post-trial prisons (p=.034 and p=.080). Prevalence rates of infectious diseases in prison should be interpreted in light of the prison population's characteristics. Screening and treatment should be promoted in all types of prison settings. Since overcrowding and turnover of pre-trial prisons restrict the access to screening, prevention and treatment of infectious diseases, interventions are crucial in post-trial prisons.
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Affiliation(s)
- Stéphanie Baggio
- Division of Prison Health, Geneva University Hospitals, University of Geneva, Chemin du Petit Bel Air 2, 1226 Thônex, Switzerland; Department of Forensic Psychiatry, Institute of Forensic Medicine, University of Bern, Falkenplatz 16, 3012 Bern, Switzerland.
| | - Komal Chacowry Pala
- Division of Prison Health, Geneva University Hospitals, University of Geneva, Chemin du Petit Bel Air 2, 1226 Thônex, Switzerland.
| | - Jean-Pierre Rieder
- Centre médical Rue de Lausanne, groupe Magellan, rue de Lausanne 80, 1202 Geneva, Switzerland.
| | - Nguyen Toan Tran
- Division of Prison Health, Geneva University Hospitals, University of Geneva, Chemin du Petit Bel Air 2, 1226 Thônex, Switzerland; Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology, 15 Broadway, Ultimo NSW 2007, Sydney, Australia.
| | - Hans Wolff
- Division of Prison Health, Geneva University Hospitals, University of Geneva, Chemin du Petit Bel Air 2, 1226 Thônex, Switzerland.
| | - Laurent Gétaz
- Division of Prison Health, Geneva University Hospitals, University of Geneva, Chemin du Petit Bel Air 2, 1226 Thônex, Switzerland; Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, University of Geneva, Rue Gabrielle Perret-Gentil 4, 1205 Geneva, Switzerland.
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Jackson Y, Paignon A, Wolff H, Delicado N. Health of undocumented migrants in primary care in Switzerland. PLoS One 2018; 13:e0201313. [PMID: 30052674 PMCID: PMC6063438 DOI: 10.1371/journal.pone.0201313] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 07/12/2018] [Indexed: 12/15/2022] Open
Abstract
Background Undocumented migrants endure adverse living conditions while facing barriers to access healthcare. Evidence is lacking regarding their healthcare needs, notably in regards to chronic diseases. Our goal was to investigate health conditions in undocumented migrants attended in primary care setting. Methods This study was conducted at the primary care outpatient clinic, Geneva University Hospitals, Switzerland. We retrospectively recorded and coded all medical conditions of a random sample of 731 undocumented migrants using the International Classification of Primary Care, 2nd version (ICPC-2). We dichotomized conditions as chronic or non-chronic and considered multimorbidity in the presence of three or more chronic conditions. Results Participants originated from 72 countries and were mainly female (65.5%) with a mean age of 42.4 (standard deviation [SD]: 11.4) years. They presented a mean of 2.9 (SD: 2.1; range: 1–17) health conditions. In multivariable analysis, the number of conditions was associated with female gender (p = 0.011) and older age (p <0.001), but not with origin (p = 0.373). The body systems most frequently affected were endocrine, metabolic and nutritional (n = 386; 18.4%), musculoskeletal (n = 308, 14.7%) and digestive (n = 266, 12.8%). Hypertension (17.9%; 95% CI: 15.2%, 29.9%), obesity or overweight (16%; 95% CI: 13.4%, 18.9%) and gastric problems (14.1%; 95% CI: 11.6%, 16.8%) were most prevalent. Overall, 71.8% (95% CI: 68.5%, 75%) participants had at least one chronic condition while 20% (95% CI: 17.2%, 23.1%) had three or more. In multivariable analysis, age (p <0.001) was the only predictor of presenting at least one or three or more chronic conditions. Conclusions Undocumented migrants present multiple health problems in primary care settings and bear an important burden of chronic diseases. The extent of multimorbidity highlights the need to provide and facilitate the access to comprehensive and long-term primary healthcare services.
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Affiliation(s)
- Yves Jackson
- Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Global Health Institute, University of Geneva, Geneva, Switzerland
- * E-mail:
| | - Adeline Paignon
- HES-SO University of Applied Sciences and Arts Western Switzerland, School of Health Sciences, Geneva, Switzerland
| | - Hans Wolff
- Division of Prison Health, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Noelia Delicado
- HES-SO University of Applied Sciences and Arts Western Switzerland, School of Health Sciences, Geneva, Switzerland
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Salvador F, Sulleiro E, Piron M, Sánchez-Montalvá A, Sauleda S, Molina-Morant D, Moure Z, Molina I. Strongyloides stercoralis infection increases the likelihood to detect Trypanosoma cruzi DNA in peripheral blood in Chagas disease patients. Trop Med Int Health 2017; 22:1436-1441. [PMID: 28869694 DOI: 10.1111/tmi.12970] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES In a previous study performed by our group, Strongyloides stercoralis infection in patients with Chagas disease was associated with higher proportion of Trypanosoma cruzi DNA detection in peripheral blood. The aim of the study was to confirm this association in a larger cohort of patients. METHODS Cross-sectional study of all patients with Chagas disease diagnosed from 2005 to 2015 during blood donation at the Catalan Blood Bank. Demographic data and T. cruzi RT-PCR were collected. S. stercoralis infection diagnosis was based on a serological test. RESULTS Two hundred and two blood donors were included. T. cruzi RT-PCR was positive in 72 (35.6%) patients, and S. stercoralis serology was positive in 22 (10.9%) patients. Patients with positive S. stercoralis serology had higher proportion of positive T. cruzi RT-PCR than those with negative serology (54.5% vs. 33.3%, P = 0.050), and the difference increased when taking a serological index cut-off of 2.5, which increases the specificity of the test to detect a confirmed strongyloidiasis (60% vs. 33%, P = 0.017). CONCLUSIONS Patients with Chagas disease with positive S. stercoralis serology had higher proportion of positive T. cruzi RT-PCR in peripheral blood than those with negative serology, which reflects the potential immunomodulatory effects of S. stercoralis in T. cruzi co-infected patients.
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Affiliation(s)
- Fernando Salvador
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Sulleiro
- Department of Microbiology, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Maria Piron
- Catalan Blood and Tissue Bank, Transfusion Safety Laboratory, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Silvia Sauleda
- Catalan Blood and Tissue Bank, Transfusion Safety Laboratory, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
| | - Daniel Molina-Morant
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Zaira Moure
- Department of Microbiology, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Israel Molina
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
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Spinicci M, Macchioni F, Mantella A, Gabrielli S, Roselli M, Rojo Mayaregua D, Monasterio Pinckert J, Gamboa Barahona H, Paredes GA, Halkyer P, Cancrini G, Olliaro P, Montresor A, Bartoloni A. Seroepidemiological trend of strongyloidiasis in the Bolivian Chaco (1987-2013) in the absence of disease-specific control measures. Trop Med Int Health 2017; 22:1457-1462. [PMID: 28929562 DOI: 10.1111/tmi.12977] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The prevalence of Strongyloides stercoralis infections is grossly underestimated because infections go mostly undetected, although they can persist for a lifetime due to the auto-infective cycle. In the Bolivian Chaco, the prevalence of soil-transmitted nematodes dropped dramatically in the past 25 years, but the mebendazole used for preventive chemotherapy has no effect on S. stercoralis. Meanwhile, the prevalence of intestinal protozoan infections remains unchanged. We compared S. stercoralis seroprevalence in rural communities of the Bolivian Chaco from 1987 to 2013. METHODS Sera collected during two previous serosurveys, conducted in the Chaco region in 1987 and 2013, were tested for S. stercoralis using a commercial assay (Bordier-ELISA, Bordier Affinity Products, Switzerland). RESULTS Overall, 355 sera were analysed, 122 from the 1987 survey and 233 from the 2013 survey. Seropositivity for S. stercoralis was significantly more prevalent in 1987 (19/122, 16% in 1987 vs. 15/233, 6% in 2013, P = 0.006), accounted for by a drop from 17% to 3% in people under 26 years of age. Multivariate analysis showed a significant association between seropositivity for S. stercoralis and age in the 2013 population (OR 1.03 for each one-year increase, 95%CI 1.00-1.05, P = 0.04), but none in 1987. CONCLUSIONS The significant reduction in S. stercoralis seroprevalence in Bolivian Chaco cannot be explained by preventive chemotherapy or improved social-sanitary conditions. As the drop is seen in younger generations, it is consistent with little transmission occurring. However, the risk of transmission still exists, as prevalence is persistently high in older individuals, who present a potential reservoir due to the lifelong nature of S. stercoralis infections.
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Affiliation(s)
- Michele Spinicci
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, Firenze, Italy
| | - Fabio Macchioni
- Dipartimento di Scienze Veterinarie, Università degli Studi di Pisa, Pisa, Italy
| | - Antonia Mantella
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, Firenze, Italy
| | - Simona Gabrielli
- Dipartimento di Sanità Pubblica e Malattie Infettive, Università di Roma Sapienza, Roma, Italy
| | - Mimmo Roselli
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, Firenze, Italy
| | - David Rojo Mayaregua
- Escuela de Salud del Chaco Tekove Katu, Gutierrez, Plurinational State of Bolivia
| | | | - Herlan Gamboa Barahona
- Facultad Integral del Chaco, Universidad Autonoma Gabriel René Moreno, Camiri, Plurinational State of Bolivia
| | - Grover Adolfo Paredes
- Ministerio de Salud, Programa Nacional de Zoonosis, La Paz, Plurinational State of Bolivia
| | - Percy Halkyer
- Immunization, Pan-American Health Organization, La Paz, Plurinational State of Bolivia
| | - Gabriella Cancrini
- Dipartimento di Sanità Pubblica e Malattie Infettive, Università di Roma Sapienza, Roma, Italy
| | - Piero Olliaro
- Special Programme for Research and Training in Tropical Diseases (WHO/TDR), WHO, Geneva, Switzerland
| | - Antonio Montresor
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Alessandro Bartoloni
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, Firenze, Italy
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