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Lerskullawat A, Puttitanun T. Impact of migrants on communicable diseases in Thailand. BMC Public Health 2024; 24:2016. [PMID: 39075400 PMCID: PMC11285427 DOI: 10.1186/s12889-024-19503-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 07/16/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND While foreign migrants contribute to economic development, they may impact public health by transmitting communicable diseases to the local population. With its geopolitical position, Thailand has been a primary destination for migrants from neighbouring countries in Southeast Asia and beyond. This positioning makes it a focal point for examining the complexities of migration dynamics and its implications for public health. Through a quantitative analysis, this paper investigates the influence of foreign migrants on physical health issues in Thailand, exploring their impact on various types of communicable diseases. The utilization of provincial-level data from Thailand offers insights into the localized effects of migrant populations on public health within the country. These insights can serve as a valuable resource for researchers and policymakers who conduct comparative analyses, facilitating a deeper understanding of the complex relationship between international migration and public health worldwide. METHODS A spatial panel autoregressive model (SAR) is applied on the provincial level communicable diseases and socio-economic data in Thailand from the period 2016 to 2021. RESULTS The results indicate that the influence of foreign migrants on communicable diseases in Thailand varies depending on the type of disease. While an increase in migrants correlates with a higher prevalence of respiratory and other communicable diseases, it conversely reduces the prevalence of vaccine-preventable diseases. Additionally, we found that migrants do not significantly impact the prevalence of food- and water-borne diseases, insect-borne diseases, animal-borne diseases, or sexually transmitted diseases in Thailand. Additionally, other factors, such as GPP per capita, unemployment, poverty, and technology access, strongly correlate with most types of communicable diseases. CONCLUSION As revealed by this study, the increase in migrants leads to a rise in respiratory and other communicable diseases, as well as a decrease in vaccine-preventable diseases, which carries significant policy implications. These results urge policymakers, the Ministry of Labour, and the Ministry of Public Health to implement tailored policies and measures to enhance public health and effectively mitigate the risk of communicable diseases transmitted by migrants in the future.
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Affiliation(s)
- Attasuda Lerskullawat
- Department of Economics, Faculty of Economics, Kasetsart University, 50 Ngam Wong Wan Rd., Lat Yao, Chatuchak, Bangkok, 10900, Thailand
| | - Thitima Puttitanun
- Department of Economics, Faculty of Economics, Kasetsart University, 50 Ngam Wong Wan Rd., Lat Yao, Chatuchak, Bangkok, 10900, Thailand.
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Abuali M, Navarro I, Baisch M, Bashkenova N, Chang-Escobar S, Paoletti A, Hassan J. Health Profile of Afghan Pediatric Refugees Resettled to Philadelphia in 2021-2022. Clin Pediatr (Phila) 2024; 63:222-225. [PMID: 37905725 DOI: 10.1177/00099228231208611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
To elucidate the physical and psychosocial health needs of newly arrived Afghan children, we conducted a retrospective chart review of patients 0 to 19 years re-settled to Philadelphia with ≥1 outpatient visit during August 2021 to August 2022. Findings on 121 patients include dental caries (74%), elevated lead (32%), eosinophilia (29%), malnutrition (25%), schistosomiasis (6%), strongyloidiasis (8%), latent tuberculosis (7%), and two cases of cutaneous leishmaniasis. Mental health symptoms include poor sleep in 16%, low energy in 10%, and behavioral concerns in 13%. Families with low English proficiency were more often met with delayed medical care (26.7% vs 11.5% P = .12). Parents with less than a high school education were more likely to experience delayed care (38.5% vs 9.1%; P = .001). We conclude that recently arrived Afghan children have unique physical and mental health needs that need to be addressed.
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Affiliation(s)
- Mayssa Abuali
- Department of Pediatrics, Einstein Medical Center Philadelphia-Jefferson Healthcare Network, Philadelphia, PA, USA
| | - Iris Navarro
- Department of Pediatrics, Einstein Medical Center Philadelphia-Jefferson Healthcare Network, Philadelphia, PA, USA
| | - Mina Baisch
- Department of Pediatrics, Einstein Medical Center Philadelphia-Jefferson Healthcare Network, Philadelphia, PA, USA
| | - Nazym Bashkenova
- Department of Pediatrics, Einstein Medical Center Philadelphia-Jefferson Healthcare Network, Philadelphia, PA, USA
| | - Sofia Chang-Escobar
- Department of Pediatrics, Einstein Medical Center Philadelphia-Jefferson Healthcare Network, Philadelphia, PA, USA
| | - Andrew Paoletti
- Department of Pediatrics, Einstein Medical Center Philadelphia-Jefferson Healthcare Network, Philadelphia, PA, USA
| | - Jeremy Hassan
- Department of Pediatrics, Einstein Medical Center Philadelphia-Jefferson Healthcare Network, Philadelphia, PA, USA
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Castello-Branco Ribeiro L, Paixão F, Costa F, Correia P. Migrant Pathology Screening in the Pediatric Population: A Five-Year Retrospective Study From a Level II Hospital. Cureus 2024; 16:e53770. [PMID: 38465108 PMCID: PMC10922216 DOI: 10.7759/cureus.53770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2024] [Indexed: 03/12/2024] Open
Abstract
INTRODUCTION The migrant population residing in Portugal has been growing. In 2015, the pediatrics department at Professor Doutor Fernando Fonseca Hospital, a level II hospital, implemented a screening for endemic pathologies in asymptomatic migrant children to enable their timely diagnosis and treatment. This study aimed to identify and characterize the main findings in the migrant pathology screening. METHODS This was a retrospective and descriptive study of asymptomatic children and adolescents who underwent opportunistic screening for migrant pathology in a hospital setting between January 2016 and April 2021. Data analysis was performed using Microsoft Excel®. RESULTS A total of 256 individuals were included in the study; 53.5% (137/256) were female, with a median age of eight years and two months (minimum five months; maximum 17 years and 10 months). The majority of the participants were from Guinea-Bissau (29.7%, 76/256), Angola (19.1%, 49/256) and Cape Verde (12.1%, 31/256) and had been residents in Portugal for a median time of five months (minimum two days; maximum three years and five months). A total of 42.6% (109/256) participants did not have the Portuguese vaccination schedule updated. Screening was carried out in an outpatient setting in 71.9% (184/256) of individuals. A total of 38.7% (99/256) presented screening alterations, including 65 anemia cases (18 caused by iron deficiency and one by sickle cell anemia), 5 cases of tuberculosis infection and 1 case of pulmonary tuberculosis, 1 of human immunodeficiency virus infection, 3 hepatitis B virus infection cases, 20 of parasitic infections and 2 cases of female genital mutilations. CONCLUSION The revised migrant pathology screening protocol enabled the detection of diseases with a significant impact on the health of individual children and adolescents. This protocol serves as a practical tool for accurately monitoring the health status of this population.
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Affiliation(s)
| | - Filipa Paixão
- Pediatric Service, Child and Youth Department, Hospital Professor Doutor Fernando Fonseca, Amadora, PRT
| | - Francisca Costa
- Pediatric Service, Child and Youth Department, Hospital Professor Doutor Fernando Fonseca, Amadora, PRT
| | - Paula Correia
- Pediatric Service, Child and Youth Department, Hospital Professor Doutor Fernando Fonseca, Amadora, PRT
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Amarasena L, Zwi K, Hu N, Lingam R, Raman S. Changing landscape of paediatric refugee health in South Western Sydney, Australia: a retrospective observational study. BMJ Open 2023; 13:e064497. [PMID: 37852766 PMCID: PMC10603544 DOI: 10.1136/bmjopen-2022-064497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 07/04/2023] [Indexed: 10/20/2023] Open
Abstract
OBJECTIVES To examine the changing health needs of refugee children and young people (CYP) entering Australia, in relation to key government policy changes. STUDY DESIGN Retrospective analysis of health service use data over 11 years. SETTING Paediatric refugee clinics in South Western Sydney (SWS), the Australian region with the largest annual resettlement of refugees. PARTICIPANTS Refugee CYP (≤25 years) attending the SWS paediatric refugee clinics for their first visit between 2009 and 2019. MEASURES Clinician defined health conditions categorised as communicable and non-communicable disease (NCD). RESULTS Data were analysed for 359 CYP, mean age 9.3 years; 212 male (59.1%). Most CYP (n=331, 92.2%) had health problems identified; 292 (81.3%) had ≥1 NCD and 24 (6.7%) had ≥1 communicable disease. The most frequent individual NCDs were dental disease (n=128, 35.7%) and vitamin D deficiency (n=72, 20.1%). Trend analysis showed increased odds of identifying an NCD from 2013 onwards (crude OR 1.77, 95% CI 1.06 to 2.96). Neurodevelopmental problems, especially Global Developmental Delay (n=31, 8.6%), emerged as more prevalent issues in the latter half of the decade. There were significantly increased odds of identifying a neurodevelopmental problem in 2016-2019, especially in 2016-2017 (adjusted OR 2.93, 95% CI 1.34 to 6.40). Key policy changes during this period included acceptance of refugees with disabilities from 2012, additional Australian Humanitarian Programme intake from the Eastern Mediterranean region and mandatory offshore processing for those seeking asylum by boat from 2013. In response to the changing needs, local health services adopted nurse-led primary healthcare screening, early childhood services, youth and disability clinics. CONCLUSIONS Refugee CYP in Australia are presenting with a growing burden of NCDs, with neurodevelopmental problems contributing. Government policy changes affect the sociodemographics of resettled populations, influencing health profiles. Paediatric refugee health services need to be responsive to the changing needs of these populations to optimise well-being.
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Affiliation(s)
- Lahiru Amarasena
- School of Women's and Children's Health, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
| | - Karen Zwi
- School of Women's and Children's Health, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
- Department of Community Child Health, Sydney Children's Hospitals Network Randwick and Westmead, Sydney, New South Wales, Australia
| | - Nan Hu
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Raghu Lingam
- School of Women's and Children's Health, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
- Department of Community Child Health, Sydney Children's Hospitals Network Randwick and Westmead, Sydney, New South Wales, Australia
| | - Shanti Raman
- School of Women's and Children's Health, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
- Department of Community Paediatrics, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
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Naranjo L, Williams Y, Levy J, Obando R, González JA, Pachar M, Chen R, Franco-Paredes C, Higuita NA, Henao-Martínez A, Diaz Y, Suárez JA. The Endless Vulnerability of Migrant Children In-Transit across the Darién Gap. Am J Trop Med Hyg 2023; 109:515-519. [PMID: 37487560 PMCID: PMC10484268 DOI: 10.4269/ajtmh.22-0765] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 05/22/2023] [Indexed: 07/26/2023] Open
Abstract
Many people from poverty-stricken countries are migrating across South and Central America to reach the México-United States border, a movement exacerbated by the COVID-19 pandemic. Migrant people who begin their northbound journey in South America must transit across a significant geographic bottleneck, the Darién Gap, a mountainous rainforest region between Colombia and Panama. Most migrant people crossing this region originate from Cuba, Haiti, and Venezuela. Other people reach the shores of South American countries from west and central Africa or central and southeastern Asia and continue to the Darién Gap. Poverty and violence drive families with children to flee their homes and endure incalculable risks in their path. Children traveling with their families or as unaccompanied minors across the Darién Gap are exposed to life-threatening situations and human rights violations, including abuse, exploitation, malnourishment, and limited access to medical care. In addition to experiencing untreated medical illnesses, children experience mental health disorders during migration and after they reach their destination as a result of victimization and adverse traumatic experiences. Therefore, providing migrants, especially children, with rapid medical screenings and mental health support when they arrive at their destination is critical to reduce health inequities. Furthermore, making these interventions available during their transit and ensuring their safety may prevent further human rights abuses in children and families. Latin American governments must address the ongoing humanitarian crisis endured by migrants throughout their migratory path by offering access to essential healthcare services and safeguarding the rights and security of children and vulnerable groups.
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Affiliation(s)
- Laura Naranjo
- GlaxoSmithKline Vaccines CARICAM, Panama City, Republic of Panama
- Sistema Nacional de Investigación, SNI-Senacyt, Panama City, Republic of Panama
| | - Yesenia Williams
- Hospital de Niños José Renán Esquivel, Panama City, Republic of Panama
| | - Jacqueline Levy
- Hospital de Niños José Renán Esquivel, Panama City, Republic of Panama
| | - Rosela Obando
- Caja del Seguro Social, Panama City, Republic of Panama
| | - José A. González
- Hospital Irma De Lourdes Tzanetato, Panama City, Republic of Panama
| | - Mónica Pachar
- Hospital Santo Tomás, Panama City, Republic of Panama
- Hospital Oncológico, Panama City, Republic of Panama
| | - Roderick Chen
- Instituto Conmemorativo Gorgas, Panama City, Republic of Panama
| | - Carlos Franco-Paredes
- Hospital Infantil de México, Federico Gómez, Mexico DF, Mexico
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado
| | - Nelson Agudelo Higuita
- Department of Medicine, Section of Infectious Diseases, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Andrés Henao-Martínez
- Department of Medicine, Division of Infectious Diseases, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - Yamilka Diaz
- Instituto Conmemorativo Gorgas, Panama City, Republic of Panama
| | - José A. Suárez
- Sistema Nacional de Investigación, SNI-Senacyt, Panama City, Republic of Panama
- Facultad de Ciencias Exactas, Universidad de Panama, Panama City, Republic of Panama
- Facultad de Ciencias de la salud, Uisek, Ecuador
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Scarso S, Marchetti G, Russo ML, D’Angelo F, Tosti ME, Bellini A, De Marchi C, Ferrari C, Gatta A, Caminada S, Papaevgeniou N, Dalma N, Karnaki P, Marceca M, Declich S. Access to Vaccination for Newly Arrived Migrants: Developing a General Conceptual Framework for Understanding How to Improve Vaccination Coverage in European Countries. Int J Public Health 2023; 68:1605580. [PMID: 37609078 PMCID: PMC10440383 DOI: 10.3389/ijph.2023.1605580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 07/20/2023] [Indexed: 08/24/2023] Open
Abstract
Objectives: Access to vaccination for newly arrived migrants (NAMs) is a relevant concern that requires urgent attention in EU/EEA countries. This study aimed to develop a General Conceptual Framework (GCF) for understanding how to improve vaccination coverage for NAMs, by characterizing and critically analyzing system barriers and possible strategies to increase vaccination. Methods: A theoretical conceptualization of the GCF was hypothesized based on conceptual hubs in the immunization process. Barriers and solutions were identified through a non-systematic desktop literature review and qualitative research. The GCF guided the activities and facilitated the integration of results, thereby enriching the GCF with content. Results: The study explores the vaccination of NAMs and proposes strategies to overcome barriers in their vaccination process. It introduces a framework called GCF, which consists of five interconnected steps: entitlement, reachability, adherence, achievement, and evaluation of vaccination. The study also presents barriers and solutions identified through literature review and qualitative research, along with strategies to enhance professionals' knowledge, improve reachability, promote adherence, achieve vaccination coverage, and evaluate interventions. The study concludes by recommending strategies such as proximity, provider training, a migrant-sensitive approach, and data collection to improve vaccination outcomes for NAMs. Conclusion: Ensuring equitable access to healthcare services, including vaccination, is crucial not only from a humanitarian perspective but also for the overall public health of these countries.
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Affiliation(s)
- Salvatore Scarso
- National Center for Global Health, National Institute of Health (ISS), Rome, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Giulia Marchetti
- National Center for Global Health, National Institute of Health (ISS), Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Maria Laura Russo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Franca D’Angelo
- National Center for Global Health, National Institute of Health (ISS), Rome, Italy
| | - Maria Elena Tosti
- National Center for Global Health, National Institute of Health (ISS), Rome, Italy
| | - Arianna Bellini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
| | - Chiara De Marchi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
| | - Caterina Ferrari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
| | - Angela Gatta
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
| | - Susanna Caminada
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
| | - Nikoletta Papaevgeniou
- Prolepsis Institute for Preventive Medicine and Environmental and Occupational Health, Marousi, Greece
| | - Nadia Dalma
- Prolepsis Institute for Preventive Medicine and Environmental and Occupational Health, Marousi, Greece
| | - Pania Karnaki
- Prolepsis Institute for Preventive Medicine and Environmental and Occupational Health, Marousi, Greece
| | - Maurizio Marceca
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Silvia Declich
- National Center for Global Health, National Institute of Health (ISS), Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
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Alhendi F, Burahmah A. Delusional Parasitosis or Morgellons Disease: A Case of an Overlap Syndrome. Case Rep Dent 2023; 2023:3268220. [PMID: 37152271 PMCID: PMC10159739 DOI: 10.1155/2023/3268220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/22/2022] [Accepted: 04/18/2023] [Indexed: 05/09/2023] Open
Abstract
Background. Delusional parasitosis (DP) is a monosymptomatic hypochondriacal psychosis where the patient has the delusion of being infested with parasites, whereas Morgellons disease (MD) is described when the patient has fixed ideation of fibers or other materials emerging from skin. Both psychological and organic causes can result into the delusion of infestation, and careful examination is required to exclude secondary causes. Oral DP can result in self-inflected mutilations of the oral mucosa. To our knowledge, oral DP is only rarely reported in the literature. Here, we describe and discuss the management of a case of overlap between oral DP and oral MD at the oral medicine (OM) clinic. Case Report. A 50-year-old male presented to the OM clinic with ulcerations of oral and perioral tissues. Patient reported inflicting wounds to himself using a shaving blade to extirpate worms and pieces of glass from underneath his oral and perioral mucosa. Clinical and laboratory investigations ruled out parasitic infestations. Self-inflected ulcers were treated with topical steroids and prophylactic antifungals, and the patient was referred for psychiatric evaluation. A diagnosis of primary DP was reached, and the patient was managed with antipsychotics. Practical Implications. Oral health care providers should be familiar with oral manifestations of psychiatric disorders and should be able to manage such patients in a multidisciplinary team of internist, dermatologist, and psychiatrist.
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Affiliation(s)
- Fatmah Alhendi
- Department of Oral Medicine, Ministry of Health of Kuwait, P. O. Box (5), Safat 13001, Kuwait
| | - Abdullatif Burahmah
- Department of Oral Medicine, Ministry of Health of Kuwait, P. O. Box (5), Safat 13001, Kuwait
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Duffey MM, Patel T, Koukaz Y, Sepulveda T, Barbour K, Fredricks K, Weatherhead JE. The impact of neglected tropical diseases on women and girl refugees: A call for increased awareness and strategic intervention. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2022.1095174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
As the number of forcibly displaced women and girls increases, it becomes ever important to recognize the negative health impacts of being displaced. Women and girl refugees are disproportionately affected by sexual and gender-based violence and mental health concerns. In addition to these health concerns in women, crowding and lack of clean water in refugee camps leads to the spread of infectious diseases in general. Neglected tropical diseases (NTDs) are infectious diseases of poverty found in tropical areas, and longstanding infections lead to significant morbidity. Particularly for women, these diseases can impact fertility, chronic disease in pregnancy, and social stigma. Despite being a high-risk group, there are minimal data on the impact of NTDs on the health of Women and girl refugees. Diseases such as schistosomiasis, soil-transmitted helminth infections, strongyloidiasis, and leishmaniasis have all been shown to affect Women and girl refugees, but the majority of these data describe NTDs in this population only after resettlement. Access to medical care with providers that are knowledgeable about NTDs while in situations of displacement as well as after third-country resettlement is crucial to their timely diagnosis and treatment to prevent longstanding sequalae. More studies in this at-risk population are needed to understand the extent of this issue and begin to work towards lasting, equitable healthcare.
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Al Janabi T, Petrillo G, Chung S, Pino M. Predictors of Vaccine Uptake among Migrants in the United States: A Rapid Systematic Review. EPIDEMIOLOGIA (BASEL, SWITZERLAND) 2022; 3:465-481. [PMID: 36547256 PMCID: PMC9777676 DOI: 10.3390/epidemiologia3040035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/12/2022] [Accepted: 10/14/2022] [Indexed: 12/24/2022]
Abstract
Evaluating challenges to vaccine uptake in non-US-born individuals is necessary for increasing national vaccination rates. This rapid review was conducted to investigate predictors of vaccine utilization among US migrants. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) checklist was utilized, along with the Rayyan webtool, to facilitate the process of identifying primary research articles. Data were independently extracted by using a piloted, customized form. This was tabulated and the results were reported. Of the 186 abstracts reviewed, nine articles were included. Populations included in this review were refugees (n = 1), undocumented migrants (n = 1), migrants crossing the US-Mexico border (n = 2), Blacks (n = 1), and US-born vs. non-US-born adults (n = 1). Three studies focused on "foreign-born" children. The vaccines included in the literature reviewed were both combined series and individual, with one study addressing immunization instead of specific vaccines. Detailed characteristics of these studies and their quality evaluations were also reported. This review identified gaps in research regarding immunization among different migrant groups. Multilevel interventions should be considered to leverage the existing facilitators and address the known modifiable barriers to creating an accessible and supportive environment for marginalized populations.
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El-Ghitany EM, Ashour A, Fekry MM, Elrewany E, Farghaly AG, Omran EA. Seroprevalence of Hepatitis A, B and C Among a Sample of Refugees in Egypt: An Exploratory Survey. J Epidemiol Glob Health 2022; 12:430-440. [PMID: 36107333 PMCID: PMC9723078 DOI: 10.1007/s44197-022-00060-6] [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: 07/15/2022] [Accepted: 08/29/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Estimating the prevalence of infectious diseases, including viral hepatitis, among refugees is important for evaluating their health needs and predicting the burden on the health system of the host country. This study aimed at estimating the seroprevalence of viral hepatitis among refugees in Egypt. METHODS This cross-sectional study involved a heterogeneous group of 501 refugees. Enzyme-linked immunosorbent assays were used to detect IgG antibodies against hepatitis A virus (HAV), B virus (HBV) surface antigen (anti-HBsAg), C virus (HCV), and HBV surface antigen (HBsAg). RESULTS Anti-HAV was the most prevalent marker (n = 482, 96.2%), followed by anti-HBs (n = 142, 28.3%) and HBsAg (n = 21, 4.2%), while only four refugees (0.8%) had positive anti-HCV IgG. Anti-HBs was higher in males (p < 0.05). Older refugees and non-working subjects had significantly higher seropositive rates of anti-HAV (p = 0.051 and p = 0.023, respectively), while students and those below 15 years of age had higher rates of anti-HBs (p < 0.05). Positive HBsAg results were associated with history of hepatitis (p < 0.001). Obese participants were more likely to be positive for HBsAg (p = 0.025) and anti-HBs (p < 0.05). Sudanese refugees had significantly higher rates of anti-HAV antibodies (p = 0.049), while Yemini refugees had significantly higher rates for HBsAg (p = 0.019) positivity. Residents of Dakahlia had significantly higher rates of anti-HAV (p = 0.008) and anti-HBs (p < 0.05). None of the studied risk factors was significantly associated with anti-HCV. CONCLUSION Refugees in Egypt have poor immunity against HBV with intermediate to high HBV and low HCV prevalence rates. Despite that 65% of refugees received the HAV vaccine, almost all had IgG anti-HAV, denoting previous infection.
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Affiliation(s)
- Engy Mohamed El-Ghitany
- grid.7155.60000 0001 2260 6941Department of Tropical Health, High Institute of Public Health, Alexandria University, 165 El-Horreya Avenue–El-Ibrahimia, Alexandria, Egypt
| | - Ayat Ashour
- grid.7155.60000 0001 2260 6941Department of Family Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Marwa M. Fekry
- grid.7155.60000 0001 2260 6941Department of Microbiology, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Ehab Elrewany
- grid.7155.60000 0001 2260 6941Department of Tropical Health, High Institute of Public Health, Alexandria University, 165 El-Horreya Avenue–El-Ibrahimia, Alexandria, Egypt
| | - Azza Galal Farghaly
- grid.7155.60000 0001 2260 6941Department of Tropical Health, High Institute of Public Health, Alexandria University, 165 El-Horreya Avenue–El-Ibrahimia, Alexandria, Egypt
| | - Eman A. Omran
- grid.7155.60000 0001 2260 6941Department of Microbiology, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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Greene M, Nasir SL. Care of the Refugee. Fam Med 2022. [DOI: 10.1007/978-3-030-54441-6_137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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Description of a migrant pediatric population visiting the Toulouse Children's Hospital emergency department. Arch Pediatr 2021; 28:514-519. [PMID: 34511280 DOI: 10.1016/j.arcped.2021.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 05/20/2021] [Accepted: 08/09/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Today, one in eight migrants and one in two refugees are children. Since this population has been less studied than the adult population, there is little data available on the state of health of this pediatric migrant population and the reasons they seek care. OBJECTIVE The objective of this study was to describe the sociodemographic and medical characteristics of a pediatric migrant population visiting an emergency department in order to better understand their specific needs. MATERIALS AND METHODS This was a retrospective observational study using data from medical records and social surveys of migrant children who had visited the Toulouse pediatric emergency department between 1 January 2018 and 31 December 2018. RESULTS A total of 203 migrant children, i.e., 344 emergency visits, were analyzed. The average age of the children was 3.3 years old. More than half (58.1%) of the children were from Eastern Europe; 71% visited due to infectious pathologies. The severity of the reasons for visiting (90% of the reasons for visiting had a CCMU (Clinical Classification of Emergency Patients) of 1 or 2) and the hospitalization rate (9%) were not higher in the pediatric migrant population than in the general pediatric population. We discovered associated diagnoses (e.g., scabies, anemia, oral and dental disorders) in connection with migration and/or the resulting vulnerability. There was a language barrier in 78% of the visits analyzed with underuse of professional interpreting (7%). CONCLUSION Because of the journey they make, migrant children are likely to have specific health needs and require dedicated care.
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Mphephu MG, Ekwanzala MD, Momba MNB. Cryptosporidium species and subtypes in river water and riverbed sediment using next-generation sequencing. Int J Parasitol 2021; 51:339-351. [PMID: 33421439 DOI: 10.1016/j.ijpara.2020.10.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 10/06/2020] [Accepted: 10/11/2020] [Indexed: 12/11/2022]
Abstract
This study uncovered the prevalence, harboured species, and subtype diversity of Cryptosporidium species in river water and its sediment from the Apies River in South Africa. Cryptosporidium spp. concentrations in freshwater and its sediment were determined using Ziehl-Neelsen staining and quantitative Polymerase Chain Reaction (qPCR) techniques. Next-generation sequencing (NGS) targeting the 60 kDa glycoprotein (gp60) gene of Cryptosporidium spp. was performed to reveal the species, subtype families and subtypes harboured in freshwater and its sediment. Although the results revealed that water samples had a higher prevalence (30%) compared with sediment (28%), the number of observable Cryptosporidium spp. oocysts in sediment samples (ranging from 4.90 to 5.81 log10 oocysts per 1 Liter) was higher than that of river water samples (ranging from 4.60 to 5.58 log10 oocysts per 1 L) using Ziehl-Neelsen staining. The 18S ribosomal ribonucleic acid (rRNA) gene copy of Cryptosporidium in riverbed sediments ranged from 6.03 to 7.65 log10, whereas in river water, it was found to be between 4.20 and 6.79 log10. Subtyping results showed that in riverbed sediments, Cryptosporidium parvum accounted for 40.72% of sequences, followed by Cryptosporidium hominis with 23.64%, Cryptosporidium cuniculus with 7.10%, Cryptosporidium meleagridis with 4.44% and the least was Cryptosporidium wrairi with 2.59%. A considerable percentage of reads in riverbed sediment (21.25%) was not assigned to any subtype. River water samples had 45.63% of sequences assigned to C. parvum, followed by 30.32% to C. hominis, 17.99% to C. meleagridis and 5.88% to C. cuniculus. The data obtained are concerning, as Cryptosporidium spp. have intrinsic resistance to water treatment processes and low infectious doses, which can pose a risk to human health due to the various uses of water (for human consumption, leisure, and reuse).
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Affiliation(s)
- Muofhe Grace Mphephu
- Department of Environmental, Water and Earth Sciences, Tshwane University of Technology, Arcadia Campus, Private BagX680, Pretoria 0001, South Africa
| | - Mutshiene Deogratias Ekwanzala
- Department of Environmental, Water and Earth Sciences, Tshwane University of Technology, Arcadia Campus, Private BagX680, Pretoria 0001, South Africa
| | - Maggy Ndombo Benteke Momba
- Department of Environmental, Water and Earth Sciences, Tshwane University of Technology, Arcadia Campus, Private BagX680, Pretoria 0001, South Africa.
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Care of the Refugee. Fam Med 2021. [DOI: 10.1007/978-1-4939-0779-3_137-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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15
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Marrone R, Baglio G, Bruscino G, Costanzo G, Cavani A, Mirisola C. Prevalence of latent tuberculosis infection, hepatitis B, hepatitis C, and syphilis among newly arrived unaccompanied minors living in reception centers in Rome. Int J Infect Dis 2020; 101:126-130. [PMID: 32947054 DOI: 10.1016/j.ijid.2020.09.020] [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: 04/06/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE This study aimed to address the prevalence of infectious diseases in a population of unaccompanied immigrant minors living in reception centres of Rome, Italy. METHODS The study was carried out from January 2013 to January 2019. All unaccompanied immigrant minors were screened for hepatitis B, hepatitis C, syphilis and latent tuberculosis infection. RESULTS A total of 879 unaccompanied immigrant minors, 858 males and 21 females, aged 13-18 years old were studied. Of these, 615 were from Africa, 179 from Asia and 84 from Eastern Europe. A low prevalence of HBsAg carriage (2.5%) was observed as was very low prevalence of hepatitis C (0.72%) and latent syphilis (0.4%); latent tuberculosis, defined as tuberculin skin test (TST)+ X-ray case, was diagnosed in 102 (12%) minors. CONCLUSIONS Similar to previous studies, these data demonstrate that migrant minors are generally healthy. However, given the relatively high prevalence of hepatitis B and latent tuberculosis, systematic screening for these diseases among immigrant minors immigrants is highly recommended for early detection and treatment of potentially transmissible diseases.
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Affiliation(s)
- Rosalia Marrone
- National Institute for Health Migration and Poverty (INMP), Rome, Italy
| | - Giovanni Baglio
- National Institute for Health Migration and Poverty (INMP), Rome, Italy
| | - Giusy Bruscino
- National Institute for Health Migration and Poverty (INMP), Rome, Italy
| | | | - Andrea Cavani
- National Institute for Health Migration and Poverty (INMP), Rome, Italy.
| | - Concetta Mirisola
- National Institute for Health Migration and Poverty (INMP), Rome, Italy
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Dinleyici EC, Borrow R. Meningococcal infections among refugees and immigrants: silent threats of past, present and future. Hum Vaccin Immunother 2020; 16:2781-2786. [PMID: 32347773 PMCID: PMC7746237 DOI: 10.1080/21645515.2020.1744979] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Globally, there is an increasing number of international migrants. The majority are forced displaced refugees and children unaccompanied by a caregiver, and have limited access to essential public health interventions. Routine vaccination might be interrupted or be incomplete due to conflict areas with limited public health services or a long-unplanned journey. Refugees and migrants may bring infectious disease risks to their country of destination and may be exposed to new risk factors during transit or at their destination. There are lessons learned strategies among refugees and asylum seekers in different countries (vaccination campaign during outbreak, maintain vaccination systems for refugees and medical screening and/or vaccination on arrival) against vaccine-preventable diseases – other than meningococcal infections. Since the 1980s, invasive meningococcal disease (IMD) has been reported as a critical healthcare issue in places of humanitarian crisis such as Thailand and African’s meningitis belt. Refugees and migrants are at increased risk of IMD compared with the overall population due to sero-epidemiology in their country of origin, specific characteristics of the IMD, and a number of contacts during the journey. Recently, IMD cases due to serogroups X and W have been reported and are an emerging health threat for persons arriving from Africa to refugee camps in Italy. There have been sporadic case reports of IMD due to serogroup B in Turkey; however, there has not yet been increased disease activity in this population and no outbreaks have been observed. Outbreaks of IMD in refugee camps have been and could be successfully controlled through the implementation of timely and high-coverage vaccination campaigns, and individual cases of IMD can be treated with antibiotics. Research is needed to determine the prevalence of meningococcal carriage and serogroup distribution among refugees and migrants to inform vaccine recommendations. There is no official recommendation for meningococcal vaccination of refugees. Further strategies for prevention and treatment of human immunodeficiency virus, tuberculosis and antibiotic resistance among refugees are directly related to potential prevention methods for IMD. Meningococcal vaccines have been administered only to risk groups in most host countries Thus, further strategies for the definition of new/emerging risk factors for IMD would be helpful to guide vaccine implementation for refugees and immigrants.
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Affiliation(s)
- Ener Cagri Dinleyici
- Department of Pediatrics, Eskisehir Osmangazi University Faculty of Medicine , Eskisehir, Turkey
| | - Ray Borrow
- Vaccine Evaluation Unit, Public Health England , Manchester, UK
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