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Lukman NA, Merry L. Religion, support and self-care experiences: A qualitative descriptive study with Indonesian adults with the chronic disease living in Montreal, Canada. J Adv Nurs 2022; 79:1765-1777. [PMID: 35975318 DOI: 10.1111/jan.15412] [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: 11/29/2021] [Revised: 06/17/2022] [Accepted: 08/03/2022] [Indexed: 11/26/2022]
Abstract
AIM To explore and describe the chronic illness self-care experiences of Indonesian immigrants living in Montreal, Canada and to gain a better understanding of how religion and support shaped these experiences. DESIGN Qualitative description. METHODS Data were collected from January to March 2020 via semi-structured interviews. Eight men and women participated. The data were thematically analysed. RESULTS Major themes identified were (1) religion, (2) being helpful to others, (3) family support, (4) transnational family support, (5) community support and (6) being in Indonesia versus Canada. Religion and faith were sources of motivation for self-care and provided guidance and strength to heal and accept the illness, mainly through the practice of prayer. 'Being helpful to others' (collectivism), including aiding others to avoid getting sick or giving 'health tips', and also just generally taking care of family also contributed to overall well-being. Spouses were the main source of assistance with disease monitoring and management and health maintenance, whereas support from the Indonesian community was minimal and mostly consisted of informational and social support. Transnational relationships with family members in Indonesia, however, provided an additional means for obtaining emotional support, advice and access to traditional medicines. Overall, there was little expectation that family or the community offer or provide support with self-care. These low expectations may partially be explained by the different cultural and social contexts in Canada compared with Indonesia. CONCLUSION Religious, cultural, social and family factors may be carried over from the home country and/or may be altered post-migration, and this may impact how Indonesian immigrants with chronic illness engage in self-care. IMPACT Cultural factors (collectivism, traditional medicines), religious beliefs and support networks, both locally and transnationally should be assessed and considered during care to better support and promote self-care among immigrants living with chronic diseases. PATIENT OR PUBLIC CONTRIBUTION Two Indonesian community organizations facilitated recruitment and data collection.
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Affiliation(s)
- Nurul Akidah Lukman
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada.,Jewish General Hospital, CIUSSS West-Central Montreal, Montreal, Quebec, Canada
| | - Lisa Merry
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada.,SHERPA, The University Institute with Regards to Cultural Communities, CIUSSS West-Central Montreal, Montreal, Quebec, Canada.,InterActions, Centre de recherche et de partage des savoirs, CIUSSS North Montreal, Montreal, Quebec, Canada
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2
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Bustamante J, Sainz T, Montojo FA, Almirón MD, Subirats M, Vega DM, Mellado MJ, López-Hortelano MG. Screening for parasites in migrant children. Travel Med Infect Dis 2022; 47:102287. [PMID: 35304329 DOI: 10.1016/j.tmaid.2022.102287] [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: 05/21/2021] [Revised: 01/26/2022] [Accepted: 02/23/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Globalization has pushed population movements in the last decades, turning imported diseases into the focus. Due to behavioral habits, children are at higher risk of acquiring iparasitosis. This study aims to investigate the prevalence of parasites in migrant children and factors associated with parasitic diseases. METHOD Retrospective cross-sectional study (2014-2018) including children diagnosed with parasitosis. The diagnosis was based on serology and/or microscopic stool-sample evaluation. Epidemiological and clinical data were recorded. RESULTS Out of 813 migrant children screened, 241 (29.6%) presented at least one parasite, and 89 (10.9%) more than one. The median age was 6.6 years (IQR: 3.1-11.9) and 58.9% were males. Most cases were referred for a health exam; only 52.3% of children were symptomatic, but 43.6% had eosinophilia. The most common diagnosis were giardiasis (35.3%), schistosomiasis (19.1%), toxocariasis (15.4%), and strongyloidiasis (9.1%). After the multivariate analysis, African origin and presenting with eosinophilia were the main risk factors for parasitism. CONCLUSIONS parasitosis are frequent among migrant children. Children are often asymptomatic, and thus active screening for parasitosis should be considered among high-risk populations. Eosinophilia can be useful to guide complimentary tests, as well as geographical origin, but normal eosinophil count does not exclude parasitosis.
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Affiliation(s)
- Jorge Bustamante
- Department of Pediatrics, Hospital General de Valdepeñas, Ciudad Real, Spain; La Paz Research Institute (IdiPAZ) Madrid, Spain; Universidad Autónoma de Madrid (UAM), Spain
| | - Talía Sainz
- La Paz Research Institute (IdiPAZ) Madrid, Spain; Universidad Autónoma de Madrid (UAM), Spain; General Pediatrics and Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain; Red de Investigación Traslacional en Infectología Pediátrica (RITIP), Spain.
| | - Fátima Ara Montojo
- La Paz Research Institute (IdiPAZ) Madrid, Spain; General Pediatrics Department, Hospital de Quiron, Pozuelo, Spain
| | - Mariana Díaz Almirón
- La Paz Research Institute (IdiPAZ) Madrid, Spain; Biostatistics Department, La Paz University Hospital, Spain
| | - Mercedes Subirats
- La Paz Research Institute (IdiPAZ) Madrid, Spain; Department of Microbiology and Parasitology, Hospital La Paz Madrid, Spain
| | - Dolores Montero Vega
- La Paz Research Institute (IdiPAZ) Madrid, Spain; Department of Microbiology and Parasitology, Hospital La Paz Madrid, Spain
| | - María José Mellado
- La Paz Research Institute (IdiPAZ) Madrid, Spain; Universidad Autónoma de Madrid (UAM), Spain; General Pediatrics and Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain; Red de Investigación Traslacional en Infectología Pediátrica (RITIP), Spain
| | - Milagros García López-Hortelano
- La Paz Research Institute (IdiPAZ) Madrid, Spain; General Pediatrics and Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain; Red de Investigación Traslacional en Infectología Pediátrica (RITIP), Spain
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3
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Gieles NC, Tankink JB, van Midde M, Düker J, van der Lans P, Wessels CM, Bloemenkamp KWM, Bonsel G, van den Akker T, Goosen S, Rijken MJ, Browne JL. Maternal and perinatal outcomes of asylum seekers and undocumented migrants in Europe: a systematic review. Eur J Public Health 2020; 29:714-723. [PMID: 31098629 PMCID: PMC6734941 DOI: 10.1093/eurpub/ckz042] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Asylum seekers (AS) and undocumented migrants (UM) are at risk of adverse pregnancy outcomes due to adverse health determinants and compromised maternal healthcare access and service quality. Considering recent migratory patterns and the absence of a robust overview, a systematic review was conducted on maternal and perinatal outcomes in AS and UM in Europe. Methods Systematic literature searches were performed in MEDLINE and EMBASE (until 1 May 2017), complemented by a grey literature search (until 1 June 2017). Primary research articles reporting on any maternal or perinatal outcome, published between 2007 and 2017 in English/Dutch were eligible for inclusion. Review protocols were registered on Prospero: CRD42017062375 and CRD42017062477. Due to heterogeneity in study populations and outcomes, results were synthesized narratively. Results Of 4652 peer-reviewed articles and 145 grey literature sources screened, 11 were included from 4 European countries. Several studies reported adverse outcomes including higher maternal mortality (AS), severe acute maternal morbidity (AS), preterm birth (UM) and low birthweight (UM). Risk of bias was generally acceptable, although the limited number and quality of some studies preclude definite conclusions. Conclusion Limited evidence is available on pregnancy outcomes in AS and UM in Europe. The adverse outcomes reported imply that removing barriers to high-quality maternal care should be a priority. More research focussing on migrant subpopulations, considering potential risk factors such as ethnicity and legal status, is needed to guide policy and optimize care.
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Affiliation(s)
- Noor C Gieles
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Julia B Tankink
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Myrthe van Midde
- Research Department, Médecins du Monde/Dokters van de Wereld, Amsterdam, The Netherlands
| | - Johannes Düker
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Peggy van der Lans
- Department of Gynaecology and Obstetrics, Hospital Twente ZGT/MST, Enschede, The Netherlands.,Dutch Working Party on International Safe Motherhood and Reproductive Health, Amsterdam, The Netherlands
| | - Catherina M Wessels
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Kitty W M Bloemenkamp
- Department of Obstetrics, Birth Centre Wilhelmina Children Hospital, Division Women and Baby, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gouke Bonsel
- Department of Obstetrics, Birth Centre Wilhelmina Children Hospital, Division Women and Baby, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Thomas van den Akker
- Dutch Working Party on International Safe Motherhood and Reproductive Health, Amsterdam, The Netherlands.,Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Simone Goosen
- Netherlands Association of Community Health Services, Utrecht, The Netherlands
| | - Marcus J Rijken
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.,Dutch Working Party on International Safe Motherhood and Reproductive Health, Amsterdam, The Netherlands.,Department of Obstetrics, Birth Centre Wilhelmina Children Hospital, Division Women and Baby, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joyce L Browne
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.,Dutch Working Party on International Safe Motherhood and Reproductive Health, Amsterdam, The Netherlands
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4
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Durrans S, Last A, Boiro H, Goncalves A, Mabey D, Greenland K. "Moving like birds": A qualitative study of population mobility and health implications in the Bijagós Islands, Guinea Bissau. Soc Sci Med 2019; 230:204-213. [PMID: 31030011 PMCID: PMC6527861 DOI: 10.1016/j.socscimed.2019.03.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 02/23/2019] [Accepted: 03/11/2019] [Indexed: 10/27/2022]
Abstract
Population movement is a major driver for infectious disease transmission and can impact the success of disease control and elimination strategies. The relationship between disease transmission and permanent migration is well documented, but fewer studies have considered how different types of population mobility affects disease transmission and control programmes. This qualitative study was conducted on two islands of the Bijagós archipelago, Guinea Bissau to understand spatial and temporal population movement, and reasons for these movements, within, between and away from the Bijagós islands. Data were collected on two islands using key informant interviews (n = 8), daily activity-location interviews (n = 30) and focus group discussions (n = 6). Data were analysed thematically using an adapted typology of mobility. Findings revealed that movement within and between islands, and from islands to the mainland, was a common feature of island life for men and women alike. It was usual for trips away from home to last for several months at a time. Five key reasons for travel were identified: subsistence activities; family events; income generating activities; cultural festivities and healthcare. These movements often occurred erratically all year round, with the exception of seasonal travel within and between islands for agricultural purposes. Our study characterised detailed patterns of human mobility in the Bijagós islands as a first step towards understanding the potential impact of different types of mobility on disease exposure, transmission and public health programmes. Short-term mobility may have a significant impact on the spread of infectious diseases with short incubation periods. Predictable movements, such as travel for seasonal agricultural work, should be taken into account for tailoring and increasing the reach of public health interventions. Further research is needed to understand the role of human behaviour and mobility in disease transmission and control across the archipelago.
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Affiliation(s)
- Sophie Durrans
- Department for Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK.
| | - Anna Last
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK.
| | - Hamadou Boiro
- National Institute for Studies and Research, Bissau, Guinea-Bissau and Faculty of Sociology, Anthropology and Folkloristics, University of Iceland, Reykjavik, Iceland.
| | - Adriana Goncalves
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK.
| | - David Mabey
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK.
| | - Katie Greenland
- Department for Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK.
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5
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Agbata EN, Morton RL, Bisoffi Z, Bottieau E, Greenaway C, Biggs BA, Montero N, Tran A, Rowbotham N, Arevalo-Rodriguez I, Myran DT, Noori T, Alonso-Coello P, Pottie K, Requena-Méndez A. Effectiveness of Screening and Treatment Approaches for Schistosomiasis and Strongyloidiasis in Newly-Arrived Migrants from Endemic Countries in the EU/EEA: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 16:ijerph16010011. [PMID: 30577567 PMCID: PMC6339107 DOI: 10.3390/ijerph16010011] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 12/12/2018] [Accepted: 12/17/2018] [Indexed: 01/08/2023]
Abstract
We aimed to evaluate the evidence on screening and treatment for two parasitic infections-schistosomiasis and strongyloidiasis-among migrants from endemic countries arriving in the European Union and European Economic Area (EU/EEA). We conducted a systematic search of multiple databases to identify systematic reviews and meta-analyses published between 1 January 1993 and 30 May 2016 presenting evidence on diagnostic and treatment efficacy and cost-effectiveness. We conducted additional systematic search for individual studies published between 2010 and 2017. We assessed the methodological quality of reviews and studies using the AMSTAR, Newcastle⁻Ottawa Scale and QUADAS-II tools. Study synthesis and assessment of the certainty of the evidence was performed using GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. We included 28 systematic reviews and individual studies in this review. The GRADE certainty of evidence was low for the effectiveness of screening techniques and moderate to high for treatment efficacy. Antibody-detecting serological tests are the most effective screening tests for detection of both schistosomiasis and strongyloidiasis in low-endemicity settings, because they have higher sensitivity than conventional parasitological methods. Short courses of praziquantel and ivermectin were safe and highly effective and cost-effective in treating schistosomiasis and strongyloidiasis, respectively. Economic modelling suggests presumptive single-dose treatment of strongyloidiasis with ivermectin for all migrants is likely cost-effective, but feasibility of this strategy has yet to be demonstrated in clinical studies. The evidence supports screening and treatment for schistosomiasis and strongyloidiasis in migrants from endemic countries, to reduce morbidity and mortality.
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Affiliation(s)
- Eric N. Agbata
- Faculty of Health Science, University of Roehampton London, London SW15 5PU, UK
- Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain
- Correspondence:
| | - Rachael L. Morton
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW 2050, Australia; (R.L.M.); (A.T.); (N.R.)
| | - Zeno Bisoffi
- Centre for Tropical Diseases (CTD), IRCCS Sacro Cuore Don Calabria Negrar, Negrar, 37024 Verona, Italy;
- Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, 155 Nationalestraat, 2000 Antwerp, Belgium;
| | - Christina Greenaway
- Division of Infectious Diseases and Clinical Epidemiology, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC H3A 0G4, Canada;
| | - Beverley-A. Biggs
- Department of Medicine at the Doherty Institute, University of Melbourne, Parkville, VIC 3010, Australia;
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital RMH, Parkville VIC 3050, Australia
| | - Nadia Montero
- Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnológica Equinoccial, Quito 170509, Ecuador; (N.M.); (I.A.-R.)
| | - Anh Tran
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW 2050, Australia; (R.L.M.); (A.T.); (N.R.)
| | - Nick Rowbotham
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW 2050, Australia; (R.L.M.); (A.T.); (N.R.)
| | - Ingrid Arevalo-Rodriguez
- Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnológica Equinoccial, Quito 170509, Ecuador; (N.M.); (I.A.-R.)
- Clinical Biostatistics Unit, Hospital Universitario Ramon y Cajal (IRYCIS); CIBER Epidemiology and Public Health (CIBERESP), 28034 Madrid, Spain
| | - Daniel T. Myran
- Bruyere Research Institute, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Teymur Noori
- European Centre for Disease Prevention and Control, Gustav III: s Boulevard 40, 169 73 Solna, Sweden;
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Center, Biomedical Research Institute Sant Pau (IIB Sant Pau-CIBERESP), 08025 Barcelona, Spain;
| | - Kevin Pottie
- Centre for Global Health Institute of Population Health, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Ana Requena-Méndez
- ISGlobal, Barcelona Institute for Global Health (ISGlobal-CRESIB, Hospital Clínic-University of Barcelona), E-08036 Barcelona, Spain;
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6
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Davey C, Cowan F, Hargreaves J. The effect of mobility on HIV-related healthcare access and use for female sex workers: A systematic review. Soc Sci Med 2018; 211:261-273. [PMID: 29966821 DOI: 10.1016/j.socscimed.2018.06.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 05/09/2018] [Accepted: 06/19/2018] [Indexed: 11/28/2022]
Abstract
Female sex workers (FSW) experience a high HIV burden and are often mobile. FSW access to HIV-related healthcare is essential for equitable welfare and to reduce new HIV infections. We systematically reviewed the literature on mobility and HIV-related healthcare access and use among FSW. Outcome measures included: HIV/STI testing, STI treatment, PrEP (initiation or adherence), and ART (initiation or adherence). We summarised the results with a narrative synthesis. From 7417 non-duplicated citations, nine studies from Canada (3), Guatamala, Honduras (2), India, South Africa, and Vietnam were included. Only one of the studies was designed to address mobility and healthcare access, and only six reported adjusted effect estimates. Mobility was measured over four time-frames (from 'current' to 'ever'), as having lived or worked elsewhere or in another town/province/country. Three studies from Canada, Guatemala, and India found mobility associated with increased odds of poor initial access to healthcare (adjusted odds ratios (AOR) from 1.33, 95% CI 1.02, 1.75, to 2.27, 95% CI 1.09, 4.76), and one from Vietnam found no association (odds ratio (OR): 0.92, 95% CI 0.65, 1.28). The study from South Africa found no association with initiating ART (risk ratio: 0.86, 95% CI 0.65, 1.14). Two studies from Canada and Honduras found increased odds of ART interruption (AOR 2.74, 95% CI 0.89, 8.42; 5.19, 95% CI 1.38, 19.56), while two other studies from Canada and Honduras found no association with detectable viral load (OR 0.84, 95% CI 0.08, 8.33; AOR 0.79, 95% CI 0.41, 1.69). We found that mobility is associated with reduced initial healthcare access and interruption of ART, consistent with literature from the general population. Discordance between effects on adherence and viral load may be due to measurement of mobility. Future research should carefully construct measures of mobility and consider a range of HIV-related healthcare outcomes.
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Affiliation(s)
- Calum Davey
- London School of Hygiene and Tropical Medicine, London, UK.
| | - Frances Cowan
- Liverpool School of Tropical Medicine, Liverpool, UK.
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7
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Crawford G, Lobo R, Brown G, Macri C, Smith H, Maycock B. HIV, Other Blood-Borne Viruses and Sexually Transmitted Infections amongst Expatriates and Travellers to Low- and Middle-Income Countries: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E1249. [PMID: 27999275 PMCID: PMC5201390 DOI: 10.3390/ijerph13121249] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 12/01/2016] [Accepted: 12/12/2016] [Indexed: 11/23/2022]
Abstract
In some high-income countries, a proportion of human immunodeficiency virus (HIV), other blood-borne virus (BBV) or sexually transmitted infection (STI) diagnoses have been reported as acquired overseas in low- and middle-income countries. A review was conducted to explore HIV, other BBV or STI related knowledge, risk behavior and acquisition amongst expatriates and travelers, particularly males, travelling from high to low- and middle-income countries. Seven academic databases were searched for 26 peer reviewed articles that met inclusion criteria. Significant variability in the studies was noted, in age, travel duration and frequency and outcomes/risk factors measured and reported on. Risk factors described included longer duration of stay; being single; travel for romance or sex; alcohol and other drug use; lack of travel advice; being male; higher number of sexual partners; and inconsistent condom use. Vaccination, pre-travel health advice, and having fewer sexual partners were described as protective. Studies are needed focusing on the social context in which risk-taking occurs. Better collaboration is essential to deliver comprehensive health promotion interventions alongside more consistent pre- and post- travel testing and advice. Policy measures are crucial, including consistent evaluation indicators to assess impacts of HIV, other BBVs or STIs in the context of mobility. Risks and responses for these epidemics are shared globally.
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Affiliation(s)
- Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Perth 6845, Australia.
| | - Roanna Lobo
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Perth 6845, Australia.
| | - Graham Brown
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Perth 6845, Australia.
- Australian Research Centre in Sex Health and Society, La Trobe University, Melbourne 3083, Australia.
| | - Chloe Macri
- School of Public Health, Curtin University, Perth 6845, Australia.
| | - Hannah Smith
- School of Public Health, Curtin University, Perth 6845, Australia.
| | - Bruce Maycock
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Perth 6845, Australia.
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8
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Merry L, Semenic S, Gyorkos TW, Fraser W, Small R, Gagnon AJ. International migration as a determinant of emergency caesarean. Women Birth 2016; 29:e89-e98. [PMID: 27150314 DOI: 10.1016/j.wombi.2016.04.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 11/20/2015] [Accepted: 04/01/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND High caesarean rates are of concern given associated risks. International migrant women (women born abroad) represent a substantial proportion of women giving birth in high-income countries (HICs) and face social conditions that may exacerbate childbearing health risks. Among migrant women, emergency rather than planned caesareans, tend to be more prevalent. This method of delivery can be stressful, physically harmful and result in an overall negative birth experience. Research establishing evidence of risk factors for emergency caesareans in migrants is insufficient. AIMS (1) Describe potential pathways (with a focus on modifiable factors) by which migration, using internationally recommended migration indicators: country of birth, length of time in country, fluency in receiving-country language, migration classification and ethnicity, may lead to emergency caesarean; and (2) propose a framework to guide future research for understanding "potentially preventable" emergency caesareans in migrant women living in HICs. DISCUSSION "Potentially preventable" emergency caesareans in migrant women are likely due to several modifiable, interrelated factors pre-pregnancy, during pregnancy and during labour. Migration itself is a determinant and also shapes other determinants. Complications and ineffective labour progress and/or foetal distress and ultimately the decision to perform an emergency caesarean may be the result of poor health (i.e., physiological effects), lack of support and disempowerment (i.e., psychological effects) and sub-optimal care. CONCLUSION Understanding the direct and indirect effects of migration on emergency caesarean is crucial so that targeted strategies can be developed and implemented for reducing unnecessary caesareans in this vulnerable population.
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Affiliation(s)
- Lisa Merry
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada.
| | - Sonia Semenic
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada; Women's Health Mission, McGill University Health Centre (MUHC), Montreal, Quebec, Canada
| | - Theresa W Gyorkos
- Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, McGill University Health Centre (MUHC), Montreal, Quebec, Canada
| | - William Fraser
- Centre hospitalier universitaire de Sherbrooke (CHUS) Research Centre, Sherbrooke, Quebec, Canada; Department of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Rhonda Small
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Anita J Gagnon
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada; The Research Institute of the McGill University Health Centre (RI-MUHC), Montreal, Quebec, Canada
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9
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Islam MM, Gagnon AJ. Use of reproductive health care services among urban migrant women in Bangladesh. BMC WOMENS HEALTH 2016; 16:15. [PMID: 26961123 PMCID: PMC4785632 DOI: 10.1186/s12905-016-0296-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 03/08/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Recent internal migration flows from rural to urban areas pose challenges to women using reproductive health care services in their migratory destinations. No studies were found which examined the relationship between migration, migration-associated indicators and reproductive health care services in Bangladesh. METHODS We analyzed the 2006 Bangladesh Urban Health Survey (data made publically available in June 2013) of 14,191 ever-married women aged 10-59 years. Cross tabulations and logistic regression were conducted. RESULTS Migrants and non-migrants did not differ significantly in their use of modern contraceptives and treatment for STI but were less likely to receive ANC even after controlling for a range of variables. Compared to non-migrants, more migrants had home births, did not take vitamin A after delivery, and had no medical exam post-birth. Migrant women being village-born (rather than urban-born) were associated with risk of diminished: use of ANC; treatment for STI; medical exam post-birth; vitamin A post-birth. Migrating for work or education (rather than other reasons) was associated with risk of diminished: use of ANC; use of modern facilities for birth; and medical exam post-birth. Each additional year lived in urban areas was associated with a greater likelihood of receiving ANC. CONCLUSIONS Women who migrated to urban areas in Bangladesh were significantly less likely than non-migrants to use reproductive health care services related to pregnancy care. Pro-actively identifying migrant women, especially those who originated from villages or migrated for work or education may be warranted to ensure optimal use of pregnancy-related services.
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Affiliation(s)
| | - Anita J Gagnon
- Ingram School of Nursing, McGill University, Montreal, QC, Canada.,Research Institute of the McGill University Health Centre, Montreal, QC, Canada
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Merry L, Gagnon AJ, Hemlin I, Clarke H, Hickey J. Cross-border movement and women's health: how to capture the data. Int J Equity Health 2011; 10:56. [PMID: 22104395 PMCID: PMC3235058 DOI: 10.1186/1475-9276-10-56] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Accepted: 11/21/2011] [Indexed: 11/28/2022] Open
Abstract
Introduction The movement of women across international borders is occurring at greater rates than ever before, yet the relationship between migration and women's health has been under-explored. One reason may be difficulty measuring migration variables including country of birth, length of time in country, immigration status, language ability, and ethnicity. A range of social, environmental, cultural, and medical characteristics associated with the pre-, during- and post-migration phases are also important to consider. The objective of this paper is to present challenges and solutions in measuring migration and related variables via survey-like questionnaires administered to international migrant women. Methods The development, validation, and translation of two questionnaires subsequently applied in studies of migrant women during pregnancy, birth and postpartum were used as case examples to highlight related measurement issues. Results Challenges: (1) Measuring socio-cultural, medical and environmental variables across the pre-during-post migration phases (since questions must be framed so that data relating to each phase of migration are captured); (2) Obtaining data for complex patterns of migration (i.e., multiple movements between multiple destinations); and (3) answering long questions across a time continuum. Solutions: (1) Using interviewer-assisted rather than self-administered questions; (2) Adding probes and explanations to 'walk' participants through their migration experiences; (3) Identifying variables (e.g., trafficking) better captured using non-questionnaire data collection methods or better not collected (e.g., ethnicity) due to extreme variations in meaning. Conclusion Carefully constructed and translated survey questionnaires are practical tools for the collection of a breadth of migrant data. These data, including detailed accounts of countries lived in, length of time in those countries, immigration status, change in status, language fluency, and health insurance eligibility offer rich descriptions of the population under study and make research findings with regards to migration more interpretable. Analyses by a range of migration indicators are facilitated through survey-like questionnaire data of this type.
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Affiliation(s)
- Lisa Merry
- School of Nursing, McGill University, 3506 University St,, Montreal, QC, H3A 2A7, Canada.
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Abstract
In the second article in a six-part PLoS Medicine series on Migration & Health, Brian Gushulak and Douglas MacPherson discuss the pre-departure phase of migration and the specific health risks and policy needs associated with this phase.
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Swinkels H, Pottie K, Tugwell P, Rashid M, Narasiah L. Development of guidelines for recently arrived immigrants and refugees to Canada: Delphi consensus on selecting preventable and treatable conditions. CMAJ 2010; 183:E928-32. [PMID: 20547714 DOI: 10.1503/cmaj.090290] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Setting priorities is critical to ensure guidelines are relevant and acceptable to users, and that time, resources and expertise are used cost-effectively in their development. Stakeholder engagement and the use of an explicit procedure for developing recommendations are critical components in this process. METHODS We used a modified Delphi consensus process to select 20 high-priority conditions for guideline development. Canadian primary care practitioners who care for immigrants and refugees used criteria that emphasize inequities in health to identify clinical care gaps. RESULTS Nine infectious diseases were selected, as well as four mental health conditions, three maternal and child health issues, caries and periodontal disease, iron-deficiency anemia, diabetes and vision screening. INTERPRETATION Immigrant and refugee medicine covers the full spectrum of primary care, and although infectious disease continues to be an important area of concern, we are now seeing mental health and chronic diseases as key considerations for recently arriving immigrants and refugees.
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Affiliation(s)
- Helena Swinkels
- Department of Family Practice, University of British Columbia, Vancouver, BC.
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Monge-Maillo B, Jiménez BC, Pérez-Molina JA, Norman F, Navarro M, Pérez-Ayala A, Herrero JM, Zamarrón P, López-Vélez R. Imported infectious diseases in mobile populations, Spain. Emerg Infect Dis 2010; 15:1745-52. [PMID: 19891861 PMCID: PMC2857245 DOI: 10.3201/eid1511.090718] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Health screening of immigrant populations is needed to ensure early diagnosis and treatment. Migration has contributed to the emergence of certain infectious diseases. To determine which infectious diseases were most common among 2 mobile immigrant groups (sub-Saharan Africans and Latin Americans) in Spain, we analyzed health and demographic characteristics of 2,198 immigrants referred to the Tropical Medicine Unit of Ramón y Cajal Hospital over a 20-year period. The most frequent diagnoses were for latent tuberculosis (716 patients [32.6%]), filariasis (421 [19.2%]), hepatropic virus chronic infection (262 [19.2%]), intestinal parasites (242 [11.0%]), and malaria (212 [9.6%]). Health screening of immigrant populations is needed to ensure early diagnosis and treatment of potentially transmissible infections.
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Gagnon AJ, Merry L, Bocking J, Rosenberg E, Oxman-Martinez J. South Asian migrant women and HIV/STIs: Knowledge, attitudes and practices and the role of sexual power. Health Place 2010; 16:10-5. [DOI: 10.1016/j.healthplace.2009.06.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2008] [Revised: 06/05/2009] [Accepted: 06/13/2009] [Indexed: 11/25/2022]
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Hickey J, Gagnon AJ, Merry L. Partnering with migrant friendly organizations: a case example from a Canadian school of nursing. NURSE EDUCATION TODAY 2010; 30:67-72. [PMID: 19581028 DOI: 10.1016/j.nedt.2009.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2008] [Revised: 04/06/2009] [Accepted: 06/02/2009] [Indexed: 05/28/2023]
Abstract
Worldwide immigration to many high-income countries suggests that these countries' health care systems must become responsive to a more diverse population. Experiences working with newly arrived populations can provide healthcare students, professionals, and teachers, with valuable insight into the health and social conditions these newcomers face in both source and receiving countries. One way to gain this experience may be by developing partnerships between schools of nursing in receiving countries and international health organizations working in areas that are major migrant source regions for these countries. In this paper, we use a case example to describe, the process of identifying international, migrant-focused organizations, and the steps involved in developing partnerships with these organizations, for the implementation of a migrant health component in health professional curricula. After creating a set of criteria to evaluate partnership potential, we identified a list of international health organizations with whom we thought a partnership might be possible. Following application of our criteria, future work is being pursued with two organizations. Potential implications of this partnership include benefits to all parties involved that may help us move towards increased population and public health capacity.
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Affiliation(s)
- Jason Hickey
- McGill University, Wilson Hall, Room 207, 3506 University St., Montreal, QC H3A 2A7, Canada
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Abstract
BACKGROUND Immigration to Italy has increased drastically, but there is a paucity of data on the health of these immigrant populations and the need to improve their health care. Therefore, we analyzed a multiethnic immigrant population in Bologna (northern Italy) to identify the risk factors for health. This anthropometric study was part of a multiregional project "Health Assistance and Monitoring for Indigent Italian Citizens and Immigrants" funded by the Italian Ministry of Health. METHODS The sample consisted of 401 adult immigrants from southeastern Europe (Kosovars, Gypsies, or Roma) and four extra European countries (Senegalese, Moroccans, Tunisians, and Pakistanis). Ethnic ancestry was self-reported. Anthropometric (height, weight, and waist circumference) and blood pressure data were collected during the survey. RESULTS The prevalence of overweight (and obesity) exceeded 50% in Moroccans and Kosovars of both sexes and in male Roma. The ethnic heterogeneity was associated with different patterns of obesity: the highest prevalence of abdominal obesity was in Moroccan and Kosovar women and in male Kosovars and Gypsies. The highest prevalence of hypertension (more than 20%) was in Senegalese, Kosovar, and Gypsy males. CONCLUSIONS Some of the immigrant subsamples had a high prevalence of obesity, which is associated with morbidity. Our findings on the relationships between the anthropometric traits and the blood pressure suggest different cardiovascular disease risk profiles in the ethnic groups (higher for Kosovars and Roma) and an urgent need for preventive measures.
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Fricker M, Steffen R. Travel and public health. J Infect Public Health 2008; 1:72-7. [PMID: 20701848 PMCID: PMC7102744 DOI: 10.1016/j.jiph.2008.10.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2008] [Revised: 10/23/2008] [Accepted: 10/24/2008] [Indexed: 12/01/2022] Open
Abstract
Increasing international travel and migration can interfere with public health in both the country of destination and back home. The revised International Health Regulations (IHR) and travel disease sentinel networks are means to protect public and individual health. Public health risks related to infectious disease are higher in mass gatherings, in travellers visiting friends and relatives and in sexual encounters away from home. In contrast, in-flight transmission of infections plays only a limited role.
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Affiliation(s)
- Manuel Fricker
- Division of Epidemiology and Prevention of Communicable Diseases, WHO Centre for Travellers Health, cc Institute of Social and Preventive Medicine, University of Zurich, Hirschengraben 84, CH-8001 Zurich, Switzerland
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Perea-Milla E, Pons SM, Rivas-Ruiz F, Gallofre A, Jurado EN, Ales MAN, Jimenez-Puente A, Fernandez-Nieto F, Cerda JCM, Carrasco M, Martin L, Cano DL, Gutierrez GE, Macías RC, Garcia-Ruiz JA. Estimation of the real population and its impact on the utilisation of healthcare services in Mediterranean resort regions: an ecological study. BMC Health Serv Res 2007; 7:13. [PMID: 17266744 PMCID: PMC1796873 DOI: 10.1186/1472-6963-7-13] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2006] [Accepted: 01/31/2007] [Indexed: 11/21/2022] Open
Abstract
Background The demographic structure has a significant influence on the use of healthcare services, as does the size of the population denominators. Very few studies have been published on methods for estimating the real population such as tourist resorts. The lack of information about these problems means there is a corresponding lack of information about the behaviour of populational denominators (the floating population or tourist load) and the effect of this on the use of healthcare services. The objectives of the study were: a) To determine the Municipal Solid Waste (MSW) ratio, per person per day, among populations of known size; b) to estimate, by means of this ratio, the real population in an area where tourist numbers are very significant; and c) to determine the impact on the utilisation of hospital emergency healthcare services of the registered population, in comparison to the non-resident population, in two areas where tourist numbers are very significant. Methods An ecological study design was employed. We analysed the Healthcare Districts of the Costa del Sol and the island of Menorca. Both are Spanish territories in the Mediterranean region. Results In the two areas analysed, the correlation coefficient between the MSW ratio and admissions to hospital emergency departments exceeded 0.9, with p < 0.001. On the basis of MSW generation ratios, obtained for a control zone and also measured in neighbouring countries, we estimated the real population. For the summer months, when tourist activity is greatest and demand for emergency healthcare at hospitals is highest, this value was found to be double that of the registered population. Conclusion The MSW indicator, which is both ecological and indirect, can be used to estimate the real population in areas where population levels vary significantly during the year. This parameter is of interest in planning and dimensioning the provision of healthcare services.
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Affiliation(s)
- Emilio Perea-Milla
- Unidad de Apoyo a la Investigación, Evaluación y Contabilidad (Red IRYSS), Hospital Costa del Sol, Ctra Nacional 340, km 187, 29600 Marbella, Spain
| | - Sergi Mari Pons
- l' Observatori Socioambiental de Menoría, Camí des Castell, 28 1r pis, 07702 Maó, Spain
| | - Francisco Rivas-Ruiz
- Unidad de Apoyo a la Investigación, Evaluación y Contabilidad (Red IRYSS), Hospital Costa del Sol, Ctra Nacional 340, km 187, 29600 Marbella, Spain
| | - Anna Gallofre
- l' Observatori Socioambiental de Menoría, Camí des Castell, 28 1r pis, 07702 Maó, Spain
| | - Enrique Navarro Jurado
- Departamento de Geografía, Facultad de Filosofía y Letras, Universidad de Málaga, 29071 Málaga, Spain
| | - Marco A Navarro Ales
- Mancomunidad Municipios de la Costa del Sol Occidental, Urb. Elviria, N-340, Km. 190, 29600 Marbella, Spain
| | - Alberto Jimenez-Puente
- Unidad de Apoyo a la Investigación, Evaluación y Contabilidad (Red IRYSS), Hospital Costa del Sol, Ctra Nacional 340, km 187, 29600 Marbella, Spain
| | | | - Joan C March Cerda
- Escuela Andaluza de Salud Pública, Campus Universitario de Cartuja s/n, 18080 Granada, Spain
| | - Manuel Carrasco
- Unidad de Apoyo a la Investigación, Evaluación y Contabilidad (Red IRYSS), Hospital Costa del Sol, Ctra Nacional 340, km 187, 29600 Marbella, Spain
| | - Lydia Martin
- Unidad de Apoyo a la Investigación, Evaluación y Contabilidad (Red IRYSS), Hospital Costa del Sol, Ctra Nacional 340, km 187, 29600 Marbella, Spain
| | - Damian Lopez Cano
- Departamento de Geografía, Facultad de Filosofía y Letras, Universidad de Málaga, 29071 Málaga, Spain
| | - Gonzalo E Gutierrez
- Departamento de Geografía, Facultad de Filosofía y Letras, Universidad de Málaga, 29071 Málaga, Spain
| | - Rafael Cortes Macías
- Departamento de Geografía, Facultad de Filosofía y Letras, Universidad de Málaga, 29071 Málaga, Spain
| | - Jose A Garcia-Ruiz
- Unidad de Apoyo a la Investigación, Evaluación y Contabilidad (Red IRYSS), Hospital Costa del Sol, Ctra Nacional 340, km 187, 29600 Marbella, Spain
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