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Rubio Maturana C, Guerrero M, Casas Claramunt M, Ayala-Cortés SN, López V, Martínez-Vallejo P, Treviño B, Sulleiro E, Esperalba J, Rando A, Pou D, Aznar ML, Bosch-Nicolau P, Salvador F, Oliveira-Souto I, Molina I, Serre-Delcor N. Seroprevalence status of vaccine-preventable diseases in migrants living in shelter centers in Barcelona, Spain. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2024:S2529-993X(24)00152-7. [PMID: 38902155 DOI: 10.1016/j.eimce.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/14/2024] [Indexed: 06/22/2024]
Abstract
INTRODUCTION Almost 281 million people were living in a foreign country in 2022, and more than 100 million were displaced because of war conflicts and human right violations. Vaccination coverage of infectious diseases in migrants from some disadvantaged settings could be lower than reception countries populations, consequently seroprevalence studies and better access to vaccination could contribute to reducing these differences. METHODS A descriptive retrospective cross-sectional study was conducted including migrants, living ≤5 years in the reception country and ≥16 years old, who requested a medical exam between January 1st, 2020 and January 31st, 2021. Seroprevalence assessment was performed, and vaccination was offered to those individuals without immunity to hepatitis B, hepatitis A, varicella, measles, mumps, and rubella. RESULTS A total of 315 migrants were attended during the study period. Immunity protection at arrival was 252/296 (85.1%) for measles, 274/295 (92.9%) for rubella, 257/296 (86.8%) for mumps, 264/295 (89.5%) for varicella, 267/313 (85.3%) for hepatitis A, and 104/300 (34.6%) for hepatitis B. The final immunity protection after full vaccination schedules was 278/296 (93.9%) for measles, 287/295 (97.3%) for rubella, 274/296 (92.6%) for mumps, 276/295 (93.6%) for varicella, 280/313 (89.5%) for hepatitis A, and 139/300 (46.3%) for hepatitis B. CONCLUSIONS The vaccination intervention has increased immunity rates for the studied diseases in the attended migrants in our center, however, such interventions should be maintained to reach local population immunization levels. Moreover, the collaboration between shelter and reference specialized health centers is fundamental to implement such vaccination programs.
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Affiliation(s)
- Carles Rubio Maturana
- Microbiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Univesitat Autònoma de Barcelona, Spain.
| | | | - Maria Casas Claramunt
- EAP d'Alcarràs, ICS Lleida, Spain; Centre Vacunacions Internacional Lleida, ICS Lleida, Spain
| | - Susana Nuria Ayala-Cortés
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Victoria López
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Patricia Martínez-Vallejo
- Microbiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Univesitat Autònoma de Barcelona, Spain
| | - Begoña Treviño
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Elena Sulleiro
- Microbiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Univesitat Autònoma de Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Juliana Esperalba
- Microbiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Univesitat Autònoma de Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Ariadna Rando
- Microbiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Univesitat Autònoma de Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Diana Pou
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Luisa Aznar
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Pau Bosch-Nicolau
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Fernando Salvador
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Inés Oliveira-Souto
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Israel Molina
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Núria Serre-Delcor
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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Hashemi L, Ghasemi M, Bartley A, Fenaughty J, Pirouzi M, Grant C. Migration and infant immunization timeliness in New Zealand: Evidence from the Growing Up in New Zealand study. Vaccine 2024; 42:2229-2238. [PMID: 38472065 DOI: 10.1016/j.vaccine.2024.02.053] [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: 02/10/2023] [Revised: 02/16/2024] [Accepted: 02/17/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Migration has been recognized as an important determinant of child health outcomes including childhood vaccination status. This paper aims to examine the association between parental migration status and a less studied aspect of child immunization outcomes, namely timeliness, within the context of New Zealand (NZ), a country characterized by a substantial proportion of its resident population born overseas. Additionally, the study explored the impact of residential duration on children's immunization timeliness. METHODS The data was taken from a large, representative population-based cohort study in NZ (Growing Up in NZ study). A total of 6156 children and their parents, comprising 2241 foreign-born and 3915 NZ-born mothers and a sub-group of their partners were included in the analysis. The survey data was linked with the National Immunization Register dataset. Timely immunization was defined as receiving two vaccines at each scheduled vaccination point (at six-week, three-month, and five-month, totaling six doses of vaccines) within 30 days of their due date. We examined the associations between parental migration status, maternal residential duration, and child immunization timeliness while controlling for socio-economic variations. The results were presented as adjusted odds ratios (AORs) with 95 % confidence intervals (CIs). RESULTS The findings revealed that after adjustment for socioeconomic differences, children of foreign-born mothers exhibited higher odds of receiving all six studied vaccine doses on time compared to children of native-born mothers (AOR 1.51, 95 %CI:1.27-1.78). Similarly, having a foreign-born father was also significantly associated with timely completion of all six vaccine doses. Children of recent immigrants who had resided in the country for less than five years demonstrated higher odds of timely vaccination of all six vaccine doses compared to children of settled immigrants who had lived in the country for five or more years (AOR 1.65, 95 %CI: 1.25-2.19). CONCLUSION This study revealed a significant pattern in NZ where immigrants exhibited higher rates of timely immunization for their children compared to native-born parents. However, the findings also underscore the importance of providing support to settled immigrants, as their children experienced declines in timely vaccination rates compared to children of recent immigrants and even those born to NZ-born parents.
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Affiliation(s)
- Ladan Hashemi
- Social and Community Health, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Maryam Ghasemi
- Faculty of Counselling, Human Services and Social Work, University of Auckland, Auckland, New Zealand.
| | - Allen Bartley
- Faculty of Counselling, Human Services and Social Work, University of Auckland, Auckland, New Zealand.
| | - John Fenaughty
- Faculty of Counselling, Human Services and Social Work, University of Auckland, Auckland, New Zealand.
| | - Maryam Pirouzi
- Health Systems, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Cameron Grant
- Paediatrics, Child and Youth Health, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
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Requena-Méndez A, Cattaneo P, Bogale RT, Marti-Soler H, Wångdahl A, Buonfrate D, Bisoffi Z, Färnert A. Malaria parasite prevalence among migrants: a systematic review and meta-analysis. Clin Microbiol Infect 2023; 29:1528-1537. [PMID: 37739263 DOI: 10.1016/j.cmi.2023.09.010] [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: 05/15/2023] [Revised: 07/04/2023] [Accepted: 09/14/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Asymptomatic malaria infections are highly prevalent in endemic areas. OBJECTIVES This systematic review aimed to estimate the pooled prevalence of malaria parasites in migrants screened in non-endemic areas. DATA SOURCES MEDLINE-Ovid, EMBASE, Web of Science, Global Health, Lilacs, Cochrane, and MedRxiv. STUDY ELIGIBILITY CRITERIA Cross-sectional studies and observational prospective or retrospective cohort studies conducted in Europe, USA, Canada, Australia, or New Zealand regardless of language or publication status. Studies should include prevalence data on malaria in migrants that were recruited through a systematic screening approach. We excluded studies where people were tested because of malaria symptoms. PARTICIPANTS Migrant individuals exposed to malaria infection ASSESSMENT OF RISK OF BIAS: A standardized and validated appraisal instrument was used for studies reporting prevalence data (Joanna Briggs Institute Manual for Evidence Synthesis). METHODS OF DATA SYNTHESIS Pooled estimates of the parasite prevalence by PCR, microscopy, and rapid diagnostic test (RDT) were calculated with a random-effects model. Heterogeneity was explored by stratification by age, region of origin, period of study, and quality of studies. RESULTS Of 1819 studies retrieved, 23 studies were included with in total 4203 participant PCR data, 3186 microscopy and 4698 RDT data, respectively. Migrants from sub-Saharan Africa had a malaria parasite prevalence of 8.3% (95% CI 5.1-12.2) by PCR, 4.3% (1.5-8.2) by RDT, and 3.1% (0.7-6.8) by microscopy. For migrants from Asia and Latin America, the prevalence with PCR was 0% (0.0-0.08) and 0.4% (0.0-1.8), respectively. Migrants from the Central African Region had the highest PCR prevalence (9.3% [6.0-13.0]), followed by West African migrants (2.0% [0.0-7.7]). Restricting the analysis to sub-Saharan Africa migrants arriving to the host country within the previous year, the PCR-based prevalence was 11.6% (6.9-17.4). CONCLUSION We provide estimates on the malaria parasite prevalence in migrants in non-endemic setting. Despite heterogeneity between settings, these findings can contribute to inform screening strategies and guidelines targeting malaria in migrants.
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Affiliation(s)
- Ana Requena-Méndez
- Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; Migrant Health Research group, Barcelona Institute for Global Health (ISGlobal, University of Barcelona), Barcelona, Spain; CIBERINFEC, (CIBER de Enfermedades Infecciosas), Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Spain.
| | - Paolo Cattaneo
- Department of Infectious Tropical Diseases and Microbiology, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Rebecca T Bogale
- Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Helena Marti-Soler
- Migrant Health Research group, Barcelona Institute for Global Health (ISGlobal, University of Barcelona), Barcelona, Spain
| | - Andreas Wångdahl
- Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Västerås Hospital, Västerås, Sweden
| | - Dora Buonfrate
- Department of Infectious Tropical Diseases and Microbiology, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Zeno Bisoffi
- Department of Infectious Tropical Diseases and Microbiology, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Anna Färnert
- Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
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Marrone R, Mazzi C, Ouattara H, Cammilli M, Pontillo D, Perandin F, Bisoffi Z. Screening for Neglected Tropical Diseases and other infections in African refugees and asylum seekers in Rome and Lazio region, Italy. Travel Med Infect Dis 2023; 56:102649. [PMID: 37820947 DOI: 10.1016/j.tmaid.2023.102649] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/03/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Few reliable data are available on Neglected Tropical Diseases (NTDs) and other infections among African refugees and asylum seekers in Italy. We aimed to estimate the prevalence of NTDs and other infections in a large cohort of African refugees and asylum seekers living in reception centers in Lazio, Italy. MATERIAL AND METHODS This is an observational, prospective prevalence study on infectious diseases in a large population of African refugees and asylum seekers (936 overall) consecutively enrolled for screening purpose at the Infectious and Tropical diseases outpatient clinic of the National Institute of Migrant and Poverty (INMP), Rome from August 2019 to December 2020. RESULTS We found a prevalence of 8.8 % and 31 % for Strongyloides and schistosoma infection, respectively, while the prevalence of human immunodeficiency virus (HIV) infection was 0.7 %, HCV antibodies 2.5%, hepatitis B virus surface antigen 10.8 % and syphilis serological tests 2.9 %. CONCLUSION Strongyloidiasis and schistosomiasis are highly prevalent among African refugees and asylum seekers in Italy, in contrast to communicable diseases (with the exception of hepatitis B). Raising awareness of NTDs among health professionals and implementing guidelines seems to be of paramount importance to prevent these diseases and their sufferers from becoming even more "neglected".
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Affiliation(s)
- R Marrone
- National Institute for Health, Migration and Poverty, 00153 Roma, Italy.
| | - C Mazzi
- Department of Infectious -Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, 37024 Verona, Italy.
| | - H Ouattara
- National Institute for Health, Migration and Poverty, 00153 Roma, Italy.
| | - M Cammilli
- National Institute for Health, Migration and Poverty, 00153 Roma, Italy.
| | - D Pontillo
- Department of Infectious -Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, 37024 Verona, Italy.
| | - F Perandin
- Department of Infectious -Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, 37024 Verona, Italy.
| | - Z Bisoffi
- Department of Infectious -Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, 37024 Verona, Italy.
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Moure Z, Las Revillas FAD, Cantón E, Lara I, Armiñanzas C, Calvo-Montes J. Weil disease in a traveller visiting friends and relatives returning from Cuba to Spain. Travel Med Infect Dis 2023; 54:102621. [PMID: 37487947 DOI: 10.1016/j.tmaid.2023.102621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 07/26/2023]
Affiliation(s)
- Zaira Moure
- Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain.
| | - Francisco Arnáiz-de Las Revillas
- Servicio de Enfermedades Infecciosas, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Spain
| | - Elena Cantón
- Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Isabel Lara
- Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Carlos Armiñanzas
- Servicio de Enfermedades Infecciosas, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Jorge Calvo-Montes
- Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Spain
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Grzegorek K, Kroidl I, Prazeres da Costa C, Rothe C. Spectrum of Helminth Infections in Migrants from Sub-Saharan Africa to Europe: A Literature Review. Am J Trop Med Hyg 2023; 108:1096-1104. [PMID: 37094791 PMCID: PMC10540113 DOI: 10.4269/ajtmh.22-0354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/21/2022] [Indexed: 04/26/2023] Open
Abstract
Sub-Saharan Africa (SSA) is endemic to numerous neglected tropical diseases, including many helminth diseases. With the migration of people from this part of the world to Europe, as has been happening on a large scale since 2015, these diseases are becoming more relevant to European physicians. This work aims to summarize the recent literature on this topic and to raise awareness of helminth diseases afflicting SSA migrants. The databases PubMed, Embase, and MEDLINE were screened for literature published in English and German between January 1, 2015 and December 31, 2020. In total, 74 articles were included in this review. The spectrum of helminth infections in migrants from SSA found in the literature review is broad; current research, however, is particularly focused on infections with Schistosoma spp. and Strongyloides stercoralis. Both diseases are often characterized by a long course, with few or no symptoms, with the risk of long-term organ damage. Successful and reliable screening for schistosomiasis and strongyloidiasis is strongly recommended. However, the current diagnostic methods lack sensitivity and specificity, rendering the diagnosis challenging and reliable assessment of disease prevalence difficult. Novel diagnostic methods and a greater awareness of these diseases are urgently needed.
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Affiliation(s)
- Katharina Grzegorek
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Inge Kroidl
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
- German Center for Infection Research, Munich, Germany
| | - Clarissa Prazeres da Costa
- German Center for Infection Research, Munich, Germany
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University Munich, Munich, Germany
- Center for Global Health, Technical University Munich, Munich, Germany
| | - Camilla Rothe
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
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Health and Vaccination Status of Unaccompanied Minors After Arrival in a European Border Country: A Cross-sectional Study (2017-2020). Pediatr Infect Dis J 2022; 41:872-877. [PMID: 36102691 DOI: 10.1097/inf.0000000000003670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Unaccompanied and separated children (UASC) are a high-risk group for infectious diseases and information on their vaccination status is scarce. Different approaches are used to screen newly arrived minors in Europe. The aim of this study was to describe the health status and serological protection against different vaccine-preventable diseases among UASC to inform public health decision-making. METHODS Retrospective study of all UASC seen at an international health reference center in Barcelona (Spain) between January 2017 and February 2020. Screening results were analyzed using binary logistic regression with adjustment for symptoms, geographic origin, and time since arrival. RESULTS We studied 289 UASC (88.9% males; median age, 17 years). At least one infection was diagnosed in 136 minors (47.1%). There was a high prevalence of intestinal parasites (22.8%), latent tuberculosis infection (22.5%), and hepatitis B (5.2%), even in asymptomatic individuals, and especially among UASC from sub-Saharan Africa (odds ratio, 2.5; 95% confidence interval, 1.5-4.0, P < 0.001). We did not observe a significant association between clinical symptoms and the presence of infection or differences in the prevalence of different infections according to number of months since arrival. Protection against hepatitis B virus (36%), measles (80%), and varicella (83%) was suboptimal. CONCLUSIONS Our results highlight the importance of screening and vaccination programs for UASC arriving in Europe, especially border countries. Protocols should be adjusted according to geographic origin. Absence of symptoms does not necessarily rule out infection, highlighting the importance of screening in asymptomatic minors. These programs are a public health priority and should not be neglected during the current COVID-19 pandemic.
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Corbacho-Loarte MD, Crespillo-Andújar C, Chamorro-Tojeiro S, Norman F, Pérez-Molina JA, Martín O, Rubio JM, Gullón-Peña B, López-Vélez R, Monge-Maillo B. Screening of imported malaria infection in asymptomatic migrants from Sub-Saharan Africa: A retrospective analysis of a 2010-2019 cohort. Travel Med Infect Dis 2022; 49:102411. [PMID: 35933089 DOI: 10.1016/j.tmaid.2022.102411] [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: 06/17/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Up to 40% of cases of imported malaria in Europe are diagnosed in recently arrived migrants, who generally exhibit asymptomatic or mild symptoms and show low parasitaemia (submicroscopic). The study describes the prevalence of malaria infection among asymptomatic Sub-Saharan African migrants (ASSAM) and compares asymptomatic malaria-infected (AMI) vs non-malaria infected patients. METHODS An observational, comparative, retrospective study was carried out in ASSAM who underwent a medical examination, between 2010 and 2019 at the National Reference Unit for Tropical Diseases (NRU-Trop) in Madrid, Spain. Medical examination and systematic screening protocol for infectious diseases, including screening for malaria infection by Polymerase Chain Reaction (PCR) was performed. RESULTS During the study period, 632 out of 1061 ASSAM were screened for malaria, median age: 24 years (IQR:1-5); median time from arrival to diagnosis: 2 months (IQR:1-5). P. falciparum was the most frequent species: 61 patients (67.8%). Compared to non-malaria infected, AMI subjects had: higher rate of co-infection with S. stercoralis (41.1%VS 22.9%;p < 0.001) and filariae (8.9% VS 2.4%;p = 0.006), lower erythrocyte corpuscular volume (83.6 VS 84.4;p = 0.008) and lower levels of cholesterol (151.0 VS 167.3;p < 0.001). CONCLUSIONS We observed a high prevalence of AMI among ASSAM. This highlights the need to consider routing screening of migrants from endemic areas and to study if such screening could avoid the potential morbidities associated with chronic infection, reduce morbi-mortality of acute malaria and the risk of transmission in host communities.
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Affiliation(s)
- María Dolores Corbacho-Loarte
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - Clara Crespillo-Andújar
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - Sandra Chamorro-Tojeiro
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - Francesca Norman
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - José Antonio Pérez-Molina
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - Oihane Martín
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain; Microbiology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - José Miguel Rubio
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Beatriz Gullón-Peña
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - Rogelio López-Vélez
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - Begoña Monge-Maillo
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain.
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Mohammad Salih DAA, Abbas AK. The Prevalence of Canine Dipylidiasis in Baghdad city, Iraq . THE IRAQI JOURNAL OF VETERINARY MEDICINE 2022. [DOI: 10.30539/ijvm.v46i1.1314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Dipylidiasis is a zoonotic intestinal cestode disease caused by Dipylidium caninum. The objective of this study was to investigate the prevalence of Dipylidium caninum infections in dogs from Baghdad city. The study involved the impact of sexes, age, during nine months (from January to October 2021) on dipylidiasis infection in pet and stray dogs. 108 faecal samples were collected from (54 pets and 54 stray dogs) then examined for the detection of D. caninum egg capsules and eggs using coprological diagnosis (flotation and sedimentation methods) in the laboratory of parasitology / College of Veterinary Medicine, University of Baghdad. The overall infection rate was 14.81% (16/108). The study revealed the infection rate of D. caninum from pets and stray dogs was 9.26% (5/54), and 20.37% (11/54), respectively. Infection rates in stray dogs were high during March, April, and May (12.5% for each month), compared with pet dogs (0%, 6.25%, 6.25%) respectively, while in January, the rate of infection was 0% in both types, significantly (P<0.05) during March. A significant difference was recorded (P<0.01) between the sexes in both dog types, females recorded a higher 25% (3/12) infection rate than males 19.05% (8/42) in stray dogs, compared to the females, 5.9% (1/17) and males, 10.8% (4/37) in pet dogs, respectively. According to the age, a high infection rate was found in stray dog adults (20.51%), while the infection rate was zero (0%) in pet dog puppies, with a significant difference (p < 0.01) between the age groups in both types. The results revealed that stray and pet dogs may play a larger role in the spread of zoonotic dipylidiasis and that public health needs more concerted efforts to educate dog owners and implement control programs to prevent the infective stage maturation by cutting life cycle of intermediate hosts.
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Garcia-Ruiz de Morales A, Morcate C, Isaba-Ares E, Perez-Tanoira R, Perez-Molina JA. High prevalence of malaria in a non-endemic setting among febrile episodes in travellers and migrants coming from endemic areas: a retrospective analysis of a 2013-2018 cohort. Malar J 2021; 20:449. [PMID: 34838010 PMCID: PMC8627073 DOI: 10.1186/s12936-021-03984-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/13/2021] [Indexed: 11/10/2022] Open
Abstract
Background The study aimed to analyse the likelihood of imported malaria in people with a suggestive clinical picture and its distinctive characteristics in a hospital in the south of Madrid, Spain. Methods Observational retrospective study that consisted of a review of all medical files of patients with any malaria test registered at Móstoles University Hospital between April 2013 and April 2018. All suspected malaria cases were confirmed by Plasmodium spp. polymerase chain reaction (PCR). Results Of the 328 patients with suspected malaria (53.7% migrant-travellers; 38.7% visitors; 7.6% travellers), 108 cases were confirmed (101 by Plasmodium falciparum), accounting for a 33% positive sample rate. Sixteen cases were diagnosed only by PCR. Patients with malaria, compared to those without, presented predominantly with fever (84% vs. 65%), were older (34 vs. 24 years), sought medical attention earlier (17d vs. 32d), had a greater number of previous malaria episodes (74% vs. 60%), lower levels of platelets (110,500µL vs. 250,000µL), and higher of bilirubin (0.6 mg/dL vs. 0.5 mg/dL). Severe malaria was present in 13 cases; no deaths were recorded. Malaria diagnosis showed a bimodal distribution with two peaks: June to September and November to January. Conclusions Malaria is still a common diagnosis among febrile patients coming from the tropics specially among migrant travellers. Fever, thrombocytopenia, and/or high bilirubin levels should raise suspicion for this parasitic infection. Prompt diagnosis is crucial to avoid severe cases and deaths. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-021-03984-9.
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Affiliation(s)
- Alejandro Garcia-Ruiz de Morales
- Infectious Diseases Department, National Referral Centre for Tropical Diseases, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBER de Enfermedades Infecciosas, 28034, Madrid, Spain.,Internal Medicine Department, Móstoles University Hospital, Móstoles, Spain
| | - Covadonga Morcate
- Internal Medicine Department, Móstoles University Hospital, Móstoles, Spain
| | - Elena Isaba-Ares
- Internal Medicine Department, Móstoles University Hospital, Móstoles, Spain
| | - Ramon Perez-Tanoira
- Clinical Microbiology Department, Príncipe de Asturias University Hospital, Madrid, Spain.,Biomedicine and Biotechnology Department, Faculty of Medicine, Alcalá de Henares University, Alcalá de Henares, Spain
| | - Jose A Perez-Molina
- Infectious Diseases Department, National Referral Centre for Tropical Diseases, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBER de Enfermedades Infecciosas, 28034, Madrid, Spain.
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11
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[Contributions from a multidisciplinary committee for the prevention of infections in patients with targeted immunosuppressive therapy]. Med Clin (Barc) 2021; 157:489-494. [PMID: 34103165 DOI: 10.1016/j.medcli.2021.03.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/19/2021] [Accepted: 03/21/2021] [Indexed: 12/11/2022]
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12
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Aro T, Kantele A. Hospital admissions of refugees, asylum seekers and undocumented migrants: Ten-year retrospective study. Travel Med Infect Dis 2021; 44:102186. [PMID: 34688889 DOI: 10.1016/j.tmaid.2021.102186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 08/05/2021] [Accepted: 10/18/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The worldwide population of forcibly displaced people has increased over the past decade, approaching 80 million and encompassing more than 30 million refugees and asylum seekers. Research into refugee and migrant health has remained scarce, however. METHODS To investigate the reasons for hospital admissions of refugees, asylum seekers and undocumented migrants, we collected medical data from Helsinki University Hospital (HUH) records 2010-20. RESULTS The study population consisted of 647 patients originally from 54 different countries, mainly Iraq, Syria, and Afghanistan. Among adults, 40.9% of the admissions were related to pregnancy. For minors, the group comprising congenital malformations, deformations, and chromosomal abnormalities accounted for most hospitalizations, followed by diseases of the digestive or nervous system. Every fifth patient (19.3%) was admitted because of an infection: adults mostly for urinary tract infection (16.3%), pneumonia (14.1%), and tuberculosis (9.8%), and minors for acute gastroenteritis (15.2%). Infectious reason was more frequent within two months after immigration than later. CONCLUSIONS Our data reveal a unique admission profile for forced migrants: in addition to infectious diseases, a particularly high rate of obstetric diagnoses was recorded, the two ranking as the most common reasons for hospitalization.
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Affiliation(s)
- Tuomas Aro
- Department of Infectious Diseases, University of Helsinki and Helsinki University Hospital, Finland; Meilahti Infectious Diseases and Vaccine Research Center, MeiVac, Inflammation Center, University of Helsinki and Helsinki University Hospital, Finland
| | - Anu Kantele
- Department of Infectious Diseases, University of Helsinki and Helsinki University Hospital, Finland; Meilahti Infectious Diseases and Vaccine Research Center, MeiVac, Inflammation Center, University of Helsinki and Helsinki University Hospital, Finland.
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Khatami A, Bahadory S, Ghorbani S, Saadati H, Zarei M, Soleimani A, Zibaei M. Two rivals or colleagues in the liver? Hepatit B virus and Schistosoma mansoni co-infections: A systematic review and meta-analysis. Microb Pathog 2021; 154:104828. [PMID: 33744336 DOI: 10.1016/j.micpath.2021.104828] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/21/2021] [Accepted: 02/28/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Globally, hepatitis B and schistosomiasis (Mansoni) together affect about 300 million people; which cause hepatic disorders worldwide. Given that little is known about co-infections with hepatitis B and schistosoma mansoni, the present study investigates these two health problems alone and together and their possible correlation. METHODS A search was conducted for reports published between January 1990 and October 2020 by using Embase, Scopus, PubMed, Web of Science databases; Out of a total of 20 studies, 14 cross-sectional studies (6329 people) and 6 case-control studies (2138 individual) were reviewed. The pooled prevalence of hepatitis B virus (HBV), S.mansoni infections, and their co-infections; heterogeneity and the Odds Ratio (OR) were evaluated by Stata 11.2. FINDINGS Among the included studies in the inclusion criteria, the pooled prevalence of hepatitis B, S. mansoni was 34% (95% CI, 0.23-0.46), 41% (95% CI, 0.24-0.59) and their co-infections was 18% (95% CI, 0.11-0.25) by regions. The hepatitis B and S. mansoni correlation was significant in populations with schistosoma compared to control group (OR, 2.12; 95% CI, 1.36-3.30). COMMENTARY Our results showed that in addition to the high global prevalence of hepatitis B- S. mansoni (co) infections in the included studies, there is a significant association between them, especially in people suffering from schistosoma. These results highlight the importance of integrated interventions measurements against coexistence of parasitic and viral diseases. We know that more research studies need to be done in this field and global monitoring should be considered for the co-infection of these two important complications.
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Affiliation(s)
- Alireza Khatami
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran; Department of Virology, Faculty of Medicine, Iran University of Medical Science, Tehran, Iran; School of Medicine, Alborz University of Medical Sciences, Iran
| | - Saeed Bahadory
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran; Department of Parasitology and Mycology, School of Medicine, Alborz University of Medical Sciences, Iran
| | - Saied Ghorbani
- Department of Virology, Faculty of Medicine, Iran University of Medical Science, Tehran, Iran
| | - Hassan Saadati
- Department of Epidemiology and Biostatistics, School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Mohammad Zarei
- John B. Little Center for Radiation Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Alireza Soleimani
- Department of Infectious Diseases, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammad Zibaei
- Department of Parasitology and Mycology, School of Medicine, Alborz University of Medical Sciences, Iran; Evidence-based Phytotherapy and Complementary Medicine Research Center, Alborz University of Medical Sciences, Karaj, Iran.
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Sato S. Plasmodium-a brief introduction to the parasites causing human malaria and their basic biology. J Physiol Anthropol 2021; 40:1. [PMID: 33413683 PMCID: PMC7792015 DOI: 10.1186/s40101-020-00251-9] [Citation(s) in RCA: 92] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/21/2020] [Indexed: 02/07/2023] Open
Abstract
Malaria is one of the most devastating infectious diseases of humans. It is problematic clinically and economically as it prevails in poorer countries and regions, strongly hindering socioeconomic development. The causative agents of malaria are unicellular protozoan parasites belonging to the genus Plasmodium. These parasites infect not only humans but also other vertebrates, from reptiles and birds to mammals. To date, over 200 species of Plasmodium have been formally described, and each species infects a certain range of hosts. Plasmodium species that naturally infect humans and cause malaria in large areas of the world are limited to five—P. falciparum, P. vivax, P. malariae, P. ovale and P. knowlesi. The first four are specific for humans, while P. knowlesi is naturally maintained in macaque monkeys and causes zoonotic malaria widely in South East Asia. Transmission of Plasmodium species between vertebrate hosts depends on an insect vector, which is usually the mosquito. The vector is not just a carrier but the definitive host, where sexual reproduction of Plasmodium species occurs, and the parasite’s development in the insect is essential for transmission to the next vertebrate host. The range of insect species that can support the critical development of Plasmodium depends on the individual parasite species, but all five Plasmodium species causing malaria in humans are transmitted exclusively by anopheline mosquitoes. Plasmodium species have remarkable genetic flexibility which lets them adapt to alterations in the environment, giving them the potential to quickly develop resistance to therapeutics such as antimalarials and to change host specificity. In this article, selected topics involving the Plasmodium species that cause malaria in humans are reviewed.
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Affiliation(s)
- Shigeharu Sato
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Jalan UMS, 88400 Kota Kinabalu, Sabah, Malaysia. .,Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Jalan UMS, 88400, Kota Kinabalu, Sabah, Malaysia.
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Alarcón Linares ME, Torres Cantero A, Subirá C, Ramírez Rubio O, Crespo J, Lazarus JV, Requena-Méndez A. Geographic analysis and estimation of hepatitis C cases in migrant populations living in Spain: is a country-based screening strategy appropriate? REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2020; 111:615-625. [PMID: 31317761 DOI: 10.17235/reed.2019.6117/2018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Spain needs to increase the number of new known cases in order to achieve the goal of eliminating hepatitis C virus (HCV) by 2030. The aim of this study was to estimate the number of HCV cases among the migrant population in Spain and propose different scenarios for micro-elimination strategies, targeting the most relevant migrant groups. METHODOLOGY this epidemiological and demographic cross-sectional descriptive study employed a systematic approach to estimate the number of migrants infected by HCV in Spain. Estimates are based on demographic data and details the size of the foreign-born population living in every Spanish province and the anti-HVC+ prevalence rates in their respective countries of origin. RESULTS in Spain, there are 100,268 estimated cases of anti-HCV+ among the total adult migrant population who live in the country. The estimated cases of anti-HCV+ among migrants from moderate-high endemic countries with a prevalence of ≥ 2%, > 3%, > 4% and > 5% are 48,979, 48,029, 24,176 and 15,646, respectively. The anti-HCV+ endemic countries (≥ 2%) that contribute to the highest number of estimated cases in Spain are Romania, Italy, Pakistan, Ukraine, Senegal, Russia and Nigeria. The autonomous communities with the highest prevalence and number of estimated anti-HCV+ cases among migrant population are Catalonia, Valencian Community, Madrid and Andalusia, respectively. CONCLUSION these data show the need to establish HCV screening strategies for the migrant population in Spain and, particularly, in the most affected areas. The strategy should target those migrant communities with a higher prevalence and a higher number of estimated cases, such as people from Eastern Europe, Sub-Saharan Africa and Pakistan.
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Affiliation(s)
| | | | - Carme Subirá
- Barcelona Institute for Global Health, (ISGlobal-CRESIB, Hospital Clínic-Universitat de Barcelona, SPAIN
| | - Oriana Ramírez Rubio
- Barcelona Institute for Global Health, (ISGlobal-CRESIB, Hospital Clínic-Universitat de Barcelona, SPAIN
| | - Javier Crespo
- Servicio de Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Santander., SPAIN
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health, (ISGlobal-CRESIB, Hospital Clínic-Universitat de Barcelona, SPAIN
| | - Ana Requena-Méndez
- Barcelona Institute for Global Health, (ISGlobal-CRESIB, Hospital Clínic-Universitat de Barcelona, SPAIN
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Puente S, Lago M, Subirats M, Sanz-Esteban I, Arsuaga M, Vicente B, Alonso-Sardon M, Belhassen-Garcia M, Muro A. Imported Mansonella perstans infection in Spain. Infect Dis Poverty 2020; 9:105. [PMID: 32703283 PMCID: PMC7376953 DOI: 10.1186/s40249-020-00729-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/15/2020] [Indexed: 01/05/2023] Open
Abstract
Background Mansonella perstans infection can be considered one of the most neglected tropical infectious diseases. Very few studies have reported on the clinical picture caused by infection with this nematode. Therefore, our study was aimed to describe the clinical patterns and treatment of imported M. perstans infection by migrants from Africa. Methods The present study evaluated a large cohort of migrants who have been diagnosed, examined and treated for imported M. perstans infection at a Spanish reference center (Hospital Carlos III Tropical Medicine Unit, Madrid, Spain) over a 19-year period. Most patients voluntarily attend the emergency unit or are referred from primary care or general hospitals in Madrid. Chi-square test was used to compare the association between categorical variables. The continuous variables were compared by Student’s t-test or the Mann–Whitney test. The corresponding regression models were used for multivariate analysis. Results Five hundred three cases of migrants from tropical and subtropical areas with M. perstans infection were identified. Two hundred sixty-four patients were female (52.5%). The mean age (± SD) was 44.6 ± 18.2 years (range: 16–93 years). The mean time (± SD) between the arrival in Spain and the first consultation was 8.6 ± 18.0 months. The major origin of the patients was Equatorial Guinea (97.6%). Regarding the clinical picture, 257 patients were asymptomatic (54.7%) and 228 were symptomatic (45.3%); 190 patients had pruritus (37.8%), 50 (9.9%) had arthralgia, 18 patients had Calabar-like swelling (3.6%), and 15 (3%) had abdominal pain. Four hundred forty-two (87.9%) migrants had hyper-IgE, and 340 (67.6%) had eosinophilia. One hundred ninety-five patients had coinfections with other filarial nematodes (38.8%), and 308 migrants had only M. perstans infection (61.2%). Four hundred thirty-seven cases (86.9%) had been treated with anti-filarial drugs; 292 cases were treated with one anti-filarial drug, and 145 cases were treated with combined anti-filarial therapy. Additionally, 20 (4%) cases received steroids and 38 (7.6%) cases received antihistamines. Conclusions A long series of M. perstans infections is presented in sub-Saharan immigrants whose data indicate that it should be included in the differential diagnosis in patients with pruritus or analytical alterations such as eosinophilia or hyper-IgE presentation, and they also have a high number of coinfections with other microorganisms whose treatment needs to be protocolized.
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Affiliation(s)
- Sabino Puente
- Unidad de Medicina Tropical, Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, Spain
| | - Mar Lago
- Unidad de Medicina Tropical, Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, Spain
| | | | | | - Marta Arsuaga
- Unidad de Medicina Tropical, Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, Spain
| | - Belén Vicente
- Laboratorio de Inmunología Parasitaria y Molecular, CIETUS, IBSAL, Facultad de Farmacia, Universidad de Salamanca, 37007, Salamanca, Spain
| | - Montserrat Alonso-Sardon
- Área de Medicina Preventiva y Salud Pública, IBSAL, CIETUS, Universidad de Salamanca, Salamanca, Spain
| | - Moncef Belhassen-Garcia
- Servicio de Medicina Interna, Sección de Enfermedades Infecciosas, CAUSA, IBSAL, CIETUS, Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain.
| | - Antonio Muro
- Laboratorio de Inmunología Parasitaria y Molecular, CIETUS, IBSAL, Facultad de Farmacia, Universidad de Salamanca, 37007, Salamanca, Spain
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Boga JA, Casado L, Fernández-Suarez J, Moran N, Rodríguez-Perez M, Martínez-Sela M, Pérez A, Garcia-Perez A, Menendez C, Santos S, Rodriguez-Guardado A. Screening Program for Imported Diseases in Immigrant Women: Analysis and Implications from a Gender-Oriented Perspective. Am J Trop Med Hyg 2020; 103:480-484. [PMID: 32342844 DOI: 10.4269/ajtmh.19-0687] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The female immigrant population is especially vulnerable to imported diseases. We describe the results of a prospective screening program for imported diseases performed in immigrant female patients. The protocol included tests for HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), Treponema pallidum, Trypanosoma cruzi, Strongyloides stercoralis and Schistosoma spp., intestinal parasites, malaria, and the detection of microfilaremia, according to the patient's origin. Six hundred eleven patients were studied. The most frequent imported diseases were intestinal parasitosis (39.4%), followed by syphilis (14.6%), HIV infection (9%), chronic HCV (5%), and HBV (3.3%). Most of the cases of HIV (78%) and HBV (85%) were diagnosed in patients aged between 16 and 45 years. Hepatitis C virus appeared mostly in patients in the 46- to 65-year range (P = 0.001; odds ratio [OD]: 3.667 [1.741-7.724]) or older than 65 years (P = 0.0001; OR: 26.350 [7.509-92.463]). Syphilis was diagnosed more frequently in patients older than 46 years (P = 0.0001; OR: 4.273 [2.649-6.893]). Multivariate analysis confirmed a greater presence of HCV infection (P = 0.049) and syphilis (P = 0.0001) in patients aged between 46 and 65 years. In 15.4% of patients, screening did not find any pathology. These data show a high prevalence of imported diseases in the female immigrant population, which may have serious consequences in terms of morbimortality and vertical transmission. Our results encourage the establishment of policies of active screening both in women of childbearing age and within the specific pregnancy screening programs.
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Affiliation(s)
- José A Boga
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Microbiology Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Luis Casado
- Internal Medicine, Hospital de Cruz Roja, Gijón, Spain
| | - Jonathan Fernández-Suarez
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Microbiology Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Noelia Moran
- Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Mercedes Rodríguez-Perez
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Microbiology Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - María Martínez-Sela
- Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Ana Pérez
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Microbiology Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Candela Menendez
- Department of Internal Medicine, Fundación Hospital de Aviles, Aviles, Spain
| | - Sagrario Santos
- Infectious Diseases Unit, Hospital Universitario de Cabueñes, Gijón, Spain
| | - Azucena Rodriguez-Guardado
- Infectious Diseases Unit, Hospital Universitario de Cabueñes, Gijón, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
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Salvador F, Treviño B, Bosch-Nicolau P, Serre-Delcor N, Sánchez-Montalvá A, Oliveira I, Sulleiro E, Aznar ML, Pou D, Sao-Avilés A, Molina I. Strongyloidiasis screening in migrants living in Spain: systematic review and meta-analysis. Trop Med Int Health 2020; 25:281-290. [PMID: 31758828 DOI: 10.1111/tmi.13352] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To provide information regarding the prevalence of strongyloidiasis among migrants coming from Strongyloides stercoralis-endemic areas who reside in Spain. METHODS Systematic review of the literature and meta-analysis of studies showing prevalence of S. stercoralis infection among migrants from Latin America, Africa, Eastern Europe, Asia and Oceania who reside in Spain. We included articles published until 30 April 2019 without language restriction. The keywords used for the search included 'Strongyloides stercoralis', 'strongyloidiasis', 'Spain', 'screening' and 'migrants'. RESULTS Twenty-four studies were included in the review and meta-analysis, comprising 12 386 screened people. Eleven studies (7020 patients) evaluated the presence of S. stercoralis infection only through investigation of larvae in faeces, showing an overall prevalence of 1% (95%CI 1-1%). Thirteen studies (5366 patients) used a serological test, showing an overall prevalence of 14% (95%CI 11-17%). Strongyloidiasis seroprevalence was 20% (95%CI 15-24%) among migrants from sub-Saharan Africa, 14% (95%CI 10-18%) among those from Latin America and 8% (95%CI 5-11%) among migrants from North Africa. CONCLUSIONS Migrants coming from strongyloidiasis-endemic areas living in Spain had a high S. stercoralis infection prevalence, particularly those from sub-Saharan Africa and Latin America. This population should be screened using serology as the most sensitive test for S. stercoralis infection. This could be easily implemented at primary care level.
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Affiliation(s)
- Fernando Salvador
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Begoña Treviño
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Pau Bosch-Nicolau
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Núria Serre-Delcor
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Inés Oliveira
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Elena Sulleiro
- Department of Microbiology, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Mª Luisa Aznar
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Diana Pou
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Augusto Sao-Avilés
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Israel Molina
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
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Schmutzhard E, Pfausler B. [Imported infections of the central nervous system : Migration and travel neurology]. DER NERVENARZT 2020; 91:161-169. [PMID: 32016511 DOI: 10.1007/s00115-019-00865-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The numbers of migrants, refugees and asylum seekers reached an unprecedented high in Europe in 2015 and 2016 but in 2019 they are back to the average numbers of the last 30 years. In contrast, frequencies of international and intercontinental travelers have continuously increased over the past decades and will continue to do so in the coming years. In 2018 more than 1.35 billion incoming travelers were reported worldwide by international organizations. Detailed knowledge of the epidemiology, transmission types, risk behavior and clinical presentation of acute and chronic central nervous system (CNS) infections enables timely diagnosis and initiation of potentially life-saving emergency treatment. Acute infections of the CNS, e.g. cerebral Plasmodium falciparum malaria or arboviral encephalitis, are seen most frequently and almost exclusively in travelers returning from tropical countries, whereas chronic CNS infections, e.g. tuberculous meningitis or neurocysticercosis, are typically seen in migrants and refugees. Beside CNS infections genetic diseases, environment-associated, nutrition-related, metabolic or cerebrovascular diseases also need to be considered when discussing differential diagnostic possibilities.
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Affiliation(s)
- Erich Schmutzhard
- Universitätsklinik für Neurologie, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich.
| | - Bettina Pfausler
- Universitätsklinik für Neurologie, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich
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Norman FF, Comeche B, Chamorro S, López-Vélez R. Overcoming challenges in the diagnosis and treatment of parasitic infectious diseases in migrants. Expert Rev Anti Infect Ther 2020; 18:127-143. [PMID: 31914335 DOI: 10.1080/14787210.2020.1713099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Introduction: Recent increases in population movements have created novel health challenges in many areas of the World, and health policies have been adapted accordingly in several countries. However, screening guidelines for infectious diseases are not standardized and generally do not include comprehensive screening for parasitic infections.Areas covered: Malaria, Chagas disease, leishmaniasis, amebiasis, filariases, strongyloidiasis, and schistosomiasis are reviewed, focusing on the challenges posed for their diagnosis and management in vulnerable populations such as migrants. The methodology included literature searches in public databases such as PubMed.gov and Google Scholar and search of the US National Library of Medicine online database of privately and publicly funded clinical studies (ClinicalTrials.gov) until November 2019.Expert opinion: Parasitic infections which may remain asymptomatic for prolonged periods, leading to chronic infection and complications, and/or may be transmitted in non-endemic areas are ideal candidates for screening. Proposed strategies to improve diagnosis in vulnerable groups such as migrants include facilitating access to healthcare in a multi-dimensional manner considering location, individual characteristics, and timing. Limitations and availability of specific diagnostic techniques should be addressed and focus on drug and vaccine development for these neglected infections should be prioritized through collaborative initiatives with public disclosure of results.
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Affiliation(s)
- Francesca F Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Belen Comeche
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Sandra Chamorro
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Rogelio López-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
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Kaur H, Singh L, Chibale K, Singh K. Structure elaboration of isoniazid: synthesis, in silico molecular docking and antimycobacterial activity of isoniazid–pyrimidine conjugates. Mol Divers 2019; 24:949-955. [DOI: 10.1007/s11030-019-10004-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/11/2019] [Indexed: 12/11/2022]
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Buonfrate D, Gobbi F, Marchese V, Postiglione C, Badona Monteiro G, Giorli G, Napoletano G, Bisoffi Z. Extended screening for infectious diseases among newly-arrived asylum seekers from Africa and Asia, Verona province, Italy, April 2014 to June 2015. ACTA ACUST UNITED AC 2019; 23. [PMID: 29692316 PMCID: PMC5915973 DOI: 10.2807/1560-7917.es.2018.23.16.17-00527] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Management of health issues presented by newly-arrived migrants is often limited to communicable diseases even though other health issues may be more prevalent. We report the results of infectious disease screening proposed to 462 recently-arrived asylum seekers over 14 years of age in Verona province between April 2014 and June 2015. Methods: Screening for latent tuberculosis (TB) was performed via tuberculin skin test (TST) and/or QuantiFERON-TB Gold in-tube assay and/or chest X-ray. An ELISA was used to screen for syphilis. Stool microscopy was used to screen for helminthic infections, and serology was also used for strongyloidiasis and schistosomiasis. Screening for the latter also included urine filtration and microscopy. Results: Most individuals came from sub-Saharan Africa (77.5%), with others coming from Asia (21.0%) and North Africa (1.5%). The prevalence of viral diseases/markers of human immunodeficiency virus (HIV) infection was 1.3%, HCV infection was 0.85% and hepatitis B virus surface antigen was 11.6%. Serological tests for syphilis were positive in 3.7% of individuals. Of 125 individuals screened for TB via the TST, 44.8% were positive and of 118 screened via the assay, 44.0% were positive. Of 458 individuals tested for strongyloidiasis, 91 (19.9%) were positive, and 76 of 358 (21.2%) individuals from sub-Saharan Africa were positive for schistosomiasis. Conclusions: The screening of viral diseases is questionable because of low prevalence and/or long-term, expensive treatments. For opposing reasons, helminthic infections are probably worth to be targeted by screening strategies in asylum seekers of selected countries of origin.
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Affiliation(s)
- Dora Buonfrate
- Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy
| | - Federico Gobbi
- Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy
| | - Valentina Marchese
- University Department of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy.,Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy
| | - Chiara Postiglione
- Prevention Department, Unità Locale Socio Sanitaria (ULSS) 9, Verona, Italy
| | | | - Giovanni Giorli
- Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy
| | | | - Zeno Bisoffi
- Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy
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Henriquez-Camacho C, Serre N, Norman F, Sánchez-Montalvá A, Torrús D, Goikoetxea AJ, Herrero-Martínez JM, Ruiz-Giardín JM, Treviño B, Monge-Maillo B, Molina I, Rodríguez A, García M, López-Vélez R, Pérez-Molina JA. Clinicoepidemiological characteristics of viral hepatitis in migrants and travellers of the +Redivi network. Travel Med Infect Dis 2019; 29:51-57. [PMID: 30738196 DOI: 10.1016/j.tmaid.2019.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 01/28/2019] [Accepted: 02/05/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Continuous growth of mobile populations has influenced the global epidemiology of infectious diseases, including chronic and acute viral hepatitis. METHOD A prospective observational multicentre study was performed in a Spanish network of imported infections. Viral hepatitis cases from January 2009 to September 2017 were included. RESULTS Of 14,546 records, 723 (4.97%) had imported viral hepatitis, including 48 (6.64%) acute cases and 675 (93.36%) chronic cases. Of the 48 acute cases, 31 were travellers and immigrants returning from visiting friends or relatives (VFR), while 19 (61%) were acute Hepatitis A or Hepatitis B. Only 18.2% of VFR immigrants and 35% of travellers received pre-travel advice. Acute hepatitis was more frequent in VFR immigrants (AOR 2.59, CI95% 1.20-5.60) and travellers (AOR 2.83, CI95% 1.46-5.50) than immigrants. Of the 675 Chronic cases, 570 were immigrants, and 439 (77%) had chronic Hepatitis B. Chronic hepatitis was more frequent in immigrants (AOR 20.22, CI95% 11.64-35.13) and VFR immigrants (AOR 11.12, CI95% 6.20-19.94) than travellers. CONCLUSIONS Chronic viral hepatitis was typical of immigrants, acute viral hepatitis was common among travellers, and VFR immigrants had mixed risk. Improving pre-travel consultation and screening of immigrants may contribute to preventing new cases of viral hepatitis and avoiding community transmission.
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Affiliation(s)
- Cesar Henriquez-Camacho
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain
| | - Núria Serre
- Unitat Medicina Tropical I Salut Internacional Vall d´Hebron-Drassanes, PROSICS, Av de Drassanes 17-21, 08001, Barcelona, Spain
| | - Francesca Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases, Vall d´Hebron University Hospital, Universitat Autonoma de Barcelona, PROSICS Barcelona, Passeig Vall d´Hebron 119-129, 08035, Barcelona, Spain
| | - Diego Torrús
- Alicante University Hospital, Calle Pintor Baeza 11, 03010, Alicante, Spain
| | | | | | | | - Begoña Treviño
- Unitat Medicina Tropical I Salut Internacional Vall d´Hebron-Drassanes, PROSICS, Av de Drassanes 17-21, 08001, Barcelona, Spain
| | - Begoña Monge-Maillo
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain
| | - Israel Molina
- Department of Infectious Diseases, Vall d´Hebron University Hospital, Universitat Autonoma de Barcelona, PROSICS Barcelona, Passeig Vall d´Hebron 119-129, 08035, Barcelona, Spain
| | - Azucena Rodríguez
- Hospital Universitario Central de Asturias, Av. Roma, s/n, 33011, Oviedo Principado de Asturias, Spain
| | - Magdalena García
- Consorcio Hospital General Universitario de Valencia, Avenida Tres Cruces, 2, 46014, Valencia, Spain
| | - Rogelio López-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain
| | - José A Pérez-Molina
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain.
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Maimaitijiang R, He Q, Wu Y, Bouey JZH, Koné A, Liang Y, Hao C, Tu J, Gu J, Hao Y. Assessment of the health status and health service perceptions of international migrants coming to Guangzhou, China, from high-, middle- and low-income countries. Global Health 2019; 15:9. [PMID: 30683119 PMCID: PMC6346560 DOI: 10.1186/s12992-019-0449-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 01/09/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND China, which used to be an export country for migrants, has become a new destination for international migrants due to its rapid economic growth. However, little empirical data is available on the health status of and health service access barriers faced by these international migrants. METHODS Foreigners who visited the Guangzhou Municipal Exit-Entry Administration Office to extend their visas were invited to participate in the study. Quantitative data were collected using electronic questionnaire in 13 languages. The participants were characterised by the income level of their country of origin (high-, middle- and low-income countries (HICs, MICs and LICs, respectively)), and the key factors associated with their health status, medical insurance coverage and perceptions of health services in China were examined. RESULTS Overall, 1146 participants from 119 countries participated in the study, 57.1, 25.1 and 17.8% of whom were from MICs, HICs and LICs, respectively. Over one fifth of the participants experienced health problems while staying in China, and about half had no health insurance. Although the participants from HICs were more likely than those from MICs and LICs to have medical insurance, they were also more likely to have health problems. Furthermore, 43.0, 45.0 and 12.0% of the participants thought that the health services in China were good, fair and poor, respectively. Among the participants, those from HICs were less likely to have positive feedback. CONCLUSIONS Our study is the first to report a quantitative survey of the health status, health insurance coverage, and health service perceptions of a diverse and surging population of international migrants in China. The findings call for more in-depth studies on the challenges presented by the increasing global migration to the health system.
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Affiliation(s)
- Remina Maimaitijiang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, School of Public Health, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Qiangsheng He
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, School of Public Health, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Yanan Wu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, School of Public Health, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Jennifer Z H Bouey
- Department of International Health, Georgetown University, St. Mary' s Hall, 3700 Reservoir Road, N.W., Washington D.C., 20057, USA
| | - Ahoua Koné
- Department of Global Health, University of Washington, Seattle, WA and Health Alliance International, 1107 NE 45th Street, Suite 350, Seattle, WA, 98105, USA
| | - Yucheng Liang
- Department of Sociology and Center for Social Survey, Sun Yat-sen University, No. 135 Xingang Xi Road, Guangzhou, 510275, People's Republic of China
| | - Chun Hao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, School of Public Health, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, People's Republic of China.,Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, No. 135 Xingang Xi Road, Guangzhou, 510275, People's Republic of China
| | - Jiong Tu
- Department of Sociology and Center for Social Survey, Sun Yat-sen University, No. 135 Xingang Xi Road, Guangzhou, 510275, People's Republic of China
| | - Jing Gu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, School of Public Health, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, People's Republic of China. .,Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, No. 135 Xingang Xi Road, Guangzhou, 510275, People's Republic of China.
| | - Yuantao Hao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, School of Public Health, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, People's Republic of China.,Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, No. 135 Xingang Xi Road, Guangzhou, 510275, People's Republic of China
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Abbas M, Aloudat T, Bartolomei J, Carballo M, Durieux-Paillard S, Gabus L, Jablonka A, Jackson Y, Kaojaroen K, Koch D, Martinez E, Mendelson M, Petrova-Benedict R, Tsiodras S, Christie D, Saam M, Hargreaves S, Pittet D. Migrant and refugee populations: a public health and policy perspective on a continuing global crisis. Antimicrob Resist Infect Control 2018; 7:113. [PMID: 30250735 PMCID: PMC6146746 DOI: 10.1186/s13756-018-0403-4] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 09/07/2018] [Indexed: 02/01/2023] Open
Abstract
The 2015-2017 global migratory crisis saw unprecedented numbers of people on the move and tremendous diversity in terms of age, gender and medical requirements. This article focuses on key emerging public health issues around migrant populations and their interactions with host populations. Basic needs and rights of migrants and refugees are not always respected in regard to article 25 of the Universal Declaration of Human Rights and article 23 of the Refugee Convention. These are populations with varying degrees of vulnerability and needs in terms of protection, security, rights, and access to healthcare. Their health status, initially conditioned by the situation at the point of origin, is often jeopardised by adverse conditions along migratory paths and in intermediate and final destination countries. Due to their condition, forcibly displaced migrants and refugees face a triple burden of non-communicable diseases, infectious diseases, and mental health issues. There are specific challenges regarding chronic infectious and neglected tropical diseases, for which awareness in host countries is imperative. Health risks in terms of susceptibility to, and dissemination of, infectious diseases are not unidirectional. The response, including the humanitarian effort, whose aim is to guarantee access to basic needs (food, water and sanitation, healthcare), is gripped with numerous challenges. Evaluation of current policy shows insufficiency regarding the provision of basic needs to migrant populations, even in the countries that do the most. Governments around the world need to rise to the occasion and adopt policies that guarantee universal health coverage, for migrants and refugees, as well as host populations, in accordance with the UN Sustainable Development Goals. An expert consultation was carried out in the form of a pre-conference workshop during the 4th International Conference on Prevention and Infection Control (ICPIC) in Geneva, Switzerland, on 20 June 2017, the United Nations World Refugee Day.
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Affiliation(s)
- Mohamed Abbas
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, Faculty of Medicine, University of Geneva Hospitals, Geneva, Switzerland
| | | | - Javier Bartolomei
- CAPPI Servette, Department of Mental Health and Psychiatry, Geneva University Hospitals, Genève, Switzerland
| | - Manuel Carballo
- International Centre for Migration, Health and Development, Geneva, Switzerland
| | - Sophie Durieux-Paillard
- Programme Santé Migrants, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
| | | | - Alexandra Jablonka
- Department of Clinical Immunology and Rheumatology, Hannover Medical School, Hannover, Germany
- German Center for Infection Research (DZIF), PARTNER Site Hannover-Braunschweig, Hannover, Germany
| | - Yves Jackson
- Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Institute of Global Health, Geneva University, Geneva, Switzerland
| | - Kanokporn Kaojaroen
- Department of Service Delivery & Safety, World Health Organization, Geneva, Switzerland
| | - Daniel Koch
- Division of Communicable Diseases, Federal Office of Public Health, Bern, Switzerland
| | - Esperanza Martinez
- Health Unit, International Committee of the Red Cross (ICRC), Geneva, Switzerland
| | - Marc Mendelson
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Roumyana Petrova-Benedict
- International Organization for Migration (IOM), Migration Health Division (MHD), Regional office (RO), Brussels, Belgium
| | - Sotirios Tsiodras
- 4th Department of Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Hellenic Centre for Disease Control & Prevention, Athens, Greece
| | - Derek Christie
- Division of environmental health, Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Mirko Saam
- Communication in Science, Geneva, Switzerland
| | - Sally Hargreaves
- Section of Infectious Diseases and Immunity, Department of Medicine, Imperial College London, Hammersmith Hospital, London, W12 0HS UK
- The Institute for Infection and Immunity, St George’s, University of London, London, WC1E 7HU UK
| | - Didier Pittet
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, Faculty of Medicine, University of Geneva Hospitals, Geneva, Switzerland
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Eosinophilie bei pulmonalen Infektionen. DER PNEUMOLOGE 2018; 15:322-332. [PMID: 32288711 PMCID: PMC7101533 DOI: 10.1007/s10405-018-0197-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Neben Allergien, Autoimmunerkrankungen, Vaskulitiden, Dermatosen, Malignomen und Medikamentennebenwirkungen können sowohl parasitäre als auch nichtparasitäre Infektionen Ursachen für eine Eosinophilie sein. Bei Tropenrückkehrern stellen parasitäre Infektionen die häufigste Ursache für eine Eosinophilie dar. Dabei kann das jeweilige Ausmaß der Eosinophilie Rückschlüsse auf die Art des Erregers liefern. Zur Abklärung der Eosinophilie nach Tropenaufenthalt sollten primär dreimalige Stuhluntersuchungen auf Wurmeier und zusätzlich ggf. Serologien bezüglich Helminthen veranlasst werden. Komplettiert wird die Diagnostik durch eine Thorax-Röntgenaufnahme, eine Sonographie des Oberbauchs und ein Elektrokardiogramm (EKG). In den letzten Jahren werden in spezialisierten Laboren molekulare Techniken (Multiplex-Polymerasekettenreaktion, PCR) für die Diagnostik von Wurmeiern und intestinalen Parasiten im Stuhl eingesetzt, die eine deutlich höhere Sensitivität als die klassischen Stuhlnachweismethoden haben. Nichtparasitäre Infektionen, die zu einer relevanten Blut- oder lediglich pulmonalen Eosinophilie (bronchoalveoläre Lavage, BAL) führen, umfassen die Kryptokokkose sowie endemische Systemmykosen (Kokzidioidomykose, sehr selten bei Histoplasmose) und Schimmelpilzinfektionen (Aspergillus fumigatus, Mucor spp.).
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27
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Martín-Díaz A, Rubio JM, Herrero-Martínez JM, Lizasoain M, Ruiz-Giardin JM, Jaqueti J, Cuadros J, Rojo-Marcos G, Martín-Rabadán P, Calderón M, Campelo C, Velasco M, Pérez-Ayala A. Study of the diagnostic accuracy of microbiological techniques in the diagnosis of malaria in the immigrant population in Madrid. Malar J 2018; 17:314. [PMID: 30157862 PMCID: PMC6116490 DOI: 10.1186/s12936-018-2459-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 08/17/2018] [Indexed: 11/16/2022] Open
Abstract
Background Malaria is currently the most important human parasitic disease in the world responsible for high morbidity and mortality. Appropriate diagnostic methods are essential for early detection. Microscopy examination remains the gold standard, although molecular techniques have higher sensitivity and are very useful in cases of low parasitaemia and mixed infections. The objective of this study was to evaluate a new commercial molecular diagnostic technique. Methods A prospective, observational, multicentre study was performed between January 2015 and April 2017. All participants were immigrants from malaria-endemic areas, who were divided into two groups: asymptomatic group and symptomatic. Samples from both groups were evaluated by a rapid diagnostic test (ImmunoQuick® Malaria + 4 RDT), microscopy examination, and two commercial molecular malaria tests (FTD Malaria and FTD Malaria Differentiation), then compared against an in-house reference PCR technique. Results In all, 250 patients were included: 164 (65.6%) in the asymptomatic group, and 86 (34.4%) in the symptomatic group. There were seven cases of asymptomatic parasitaemia (prevalence = 2.8%) that were detected only by molecular methods. In the symptomatic group, there were seven cases of submicroscopic malaria. The main species detected was Plasmodium falciparum (96.6%). The commercial molecular technique had higher sensitivity than the other methods (S = 96%) and a high rate of concordance with the in-house reference PCR technique (Kappa score = 0.93). Conclusions The molecular techniques, although slower than microscopy, have adequate diagnostic accuracy and are very useful for the detection of P. falciparum in cases with low parasitaemia.
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Affiliation(s)
- Ariadna Martín-Díaz
- Department of Clinical Microbiology, Hospital Universitario 12 de Octubre, Avenida de Córdoba, s/n, 28041, Madrid, Spain
| | - José Miguel Rubio
- Malaria & Emerging Parasitic Diseases Laboratory, Parasitology Department, National Microbiology Centre, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Manolo Lizasoain
- Internal Medicine and Infectious Diseases Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | - Juan Cuadros
- University Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | | | | | | | | | - María Velasco
- University Hospital Fundación Alcorcón, Madrid, Spain
| | - Ana Pérez-Ayala
- Department of Clinical Microbiology, Hospital Universitario 12 de Octubre, Avenida de Córdoba, s/n, 28041, Madrid, Spain.
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28
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Padovese V, Franco G, Valenzano M, Pecoraro L, Cammilli M, Petrelli A. Skin cancer risk assessment in dark skinned immigrants: the role of social determinants and ethnicity. ETHNICITY & HEALTH 2018; 23:649-658. [PMID: 28277022 DOI: 10.1080/13557858.2017.1294657] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Dark-skinned people have a lower incidence rate of skin cancer, in particular melanoma, which is detected at more advanced stages leading to poorer prognoses and long-term outcomes compared to whites. The gap in survival is due to some difficulty in melanoma detection, lack of attention from doctors and awareness by patients. This study aims to assess skin cancer risk awareness in dark-skinned immigrants and to determine the influence of socioeconomic factors and ethnic origin on behaviors. DESIGN This is a cross-sectional health facility based study carried out in a 12-month period. A semi-structured questionnaire to assess skin cancer risk awareness and a dermatological examination was offered to dark-skinned immigrants consecutively attending the dermatology department of the National Institute for Health, Migration and Poverty in Rome. RESULTS 147 dark-skinned immigrants were enrolled, of which 54.4% were males, coming from Africa (53.1%). They were mainly young, aged 18-34 (56.5%). The level of education and length of stay in Italy was significantly related to the awareness about skin cancer: people with a high educational level (OR: 8.1 95% CI: 3.2-23.4) or immigrated more than 4 years before the interview (OR: 2.1 95% CI: 1.0-4.4) have a greater knowledge about skin cancer. CONCLUSIONS Education level is the strongest predictive factor of skin cancer awareness, whereas cultural behaviours and personal experience of sunburns are the main factors determining sunlight avoidance. Health promotion programs targeting immigrants must consider cultural differences related to ethnicity and country of origin, and adopt a transcultural approach.
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Affiliation(s)
- Valeska Padovese
- a Department of Dermatology , National Institute for Health, Migration and Poverty (INMP) , Rome , Italy
| | - Gennaro Franco
- a Department of Dermatology , National Institute for Health, Migration and Poverty (INMP) , Rome , Italy
| | - Mariacarla Valenzano
- a Department of Dermatology , National Institute for Health, Migration and Poverty (INMP) , Rome , Italy
| | - Laura Pecoraro
- a Department of Dermatology , National Institute for Health, Migration and Poverty (INMP) , Rome , Italy
| | - Marina Cammilli
- a Department of Dermatology , National Institute for Health, Migration and Poverty (INMP) , Rome , Italy
| | - Alessio Petrelli
- a Department of Dermatology , National Institute for Health, Migration and Poverty (INMP) , Rome , Italy
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29
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Martín-Dávila P, Norman F, Fortún-Abete J, Píris M, Lovatti R, Rubio JM, Martinez-Pérez A, Graus J, Ta G, Villarubia J, Mahillo B, López-Vélez R. Donor-derived multiorgan transmission of mixed P. malariae and P. ovale infection: Impact of globalization on post-transplant infections. Transpl Infect Dis 2018; 20:e12938. [PMID: 29863799 DOI: 10.1111/tid.12938] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/12/2018] [Accepted: 05/23/2018] [Indexed: 12/18/2022]
Abstract
A 57-year-old man was admitted with fever and thrombocytopenia 1 month after renal transplantation. He had never received a blood transfusion or travelled outside Spain. A peripheral blood smear revealed Plasmodium malariae and P. ovale parasites, diagnosis confirmed later by malaria PCR. The donor, from Equatorial Guinea, had negative thick and thin blood smears and rapid malaria antigen test prior to organ donation. Peripheral blood malaria PCR was not performed during donor screening. The second renal recipient and the liver recipient were evaluated and were found to be asymptomatic. Thick and thin films and rapid malaria diagnostic tests were negative for both patients and blood for malaria PCR was sent to the referral laboratory. The index patient was treated with oral chloroquine diphosphate, with a favorable outcome and was considered cured. Malaria PCR was negative for the other renal recipient and positive for P. malariae and P. ovale curtisi for the liver transplant patient. Both were treated with oral chloroquine and the liver recipient also completed treatment with primaquine phosphate. This reported case of multiorgan transmission of mixed malaria infection highlights the importance of PCR-based tests for Plasmodium in the screening of donors from endemic areas.
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Affiliation(s)
- Pilar Martín-Dávila
- Infectious Diseases Department, Transplant Infection Unit, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Francesca Norman
- Infectious Diseases Department, National Referral Unit for Tropical Diseases, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Jesus Fortún-Abete
- Infectious Diseases Department, Transplant Infection Unit, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Miguel Píris
- Hematology Department, Cytopathology Unit, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Ruben Lovatti
- Microbiology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Jose Miguel Rubio
- Malaria & Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Javier Graus
- Gastroenterology Department, Liver Transplant Unit, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Gema Ta
- Malaria & Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III, Madrid, Spain
| | - Jesus Villarubia
- Infectious Diseases Department, National Referral Unit for Tropical Diseases, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | | | - Rogelio López-Vélez
- Infectious Diseases Department, National Referral Unit for Tropical Diseases, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
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Lazarus JV, Bromberg DJ, Del Amo J, Norgaard O, García-Samaniego J, Casellas A, Calleja JL, Requena-Méndez A. Hepatitis C prevalence among the migrant population in Spain: A systematic review and meta-analysis. Enferm Infecc Microbiol Clin 2018; 37:222-230. [PMID: 29759423 DOI: 10.1016/j.eimc.2018.04.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 04/11/2018] [Accepted: 04/11/2018] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Spain, which has one of the largest migrant populations in Europe, has committed to eliminating the hepatitis C virus (HCV). The aim of this study was to estimate the prevalence of HCV among migrant groups in Spain, a country of 46 million people, with an estimated HCV-antibody prevalence of 1.7%. METHODS Studies on HCV and migration in Spain were identified by systematically searching three databases from the first records to 30 November 2017, and consulting experts at the Ministry of Health and in the 17 Spanish autonomous communities. A meta-analysis was conducted to determine pooled HCV prevalence for the general migrant population. Prevalences were also calculated for high-risk migrant populations and populations who had undergone hospital screening, stratified by region of origin. RESULTS Out of 243 studies identified, 26 met the eligibility criteria. The meta-analysis of the general migrant population found HCV antibody prevalence to be 1.6%. Migrants originating from European countries, including those at high or moderate risk for HCV, had the highest pooled prevalence (7.1%). In the general migrant population, prevalence was highest among sub-Saharan African migrants (3.1%) and lowest among Latin American migrants (0.2%). CONCLUSION Based on the limited available data, the prevalence among the general migrant population was found to be the same as the general Spanish population. Further research is needed to more accurately determine HCV prevalence for the overall migrant population and specific migrant subpopulations with a higher risk in the country as a whole and in each of Spain's 17 autonomous communities.
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Affiliation(s)
- Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Daniel J Bromberg
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Julia Del Amo
- National Centre of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Aina Casellas
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | | | - Ana Requena-Méndez
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain.
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Serre-Delcor N, Ascaso C, Soriano-Arandes A, Collazos-Sanchez F, Treviño-Maruri B, Sulleiro E, Pou-Ciruelo D, Bocanegra-Garcia C, Molina-Romero I. Health Status of Asylum Seekers, Spain. Am J Trop Med Hyg 2018; 98:300-307. [PMID: 29165223 DOI: 10.4269/ajtmh.17-0438] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
The rising rate of conflicts and the unsafe situation caused by reasons of ethnicity, religion, gender, sexual orientation, political opinion, or nationality entail an increase in the number of migratory movements. The goal of this article is to describe the health status of asylum seekers visited in an international health center. We conducted a retrospective study of the asylum seekers visited between July 2013 and June 2016. A total of 303 cases were included. The median age was 28.0 years (interquartile range [IQR]: 21-35), and 203 (67.0%) were men. Of the total, 128 cases (42.2%) were from Asia, 82 (27.1%) from Eastern Europe, 42 (13.9%) from sub-Saharan Africa, 34 (11.2%) from America, and 17 (5.6%) from Maghreb. The majority, 287 (94.7%), were asymptomatic. Seventy of the 303 (23.1%) cases were diagnosed with at least one infection, this being more prevalent in men; migrants from sub-Saharan Africa; and in those who took a land-maritime migratory route. Eight of the 303 (2.6%) cases were referred to the transcultural psychiatric department. Two important challenges of the study were the communication barriers and the legal or social situation that condition the psychological symptoms. In 48 of the 303 (15.8%) cases, there was diagnosed a noncommunicable diseases. The process of care was completed by 82.5%; although 21.9% completed the vaccination for hepatitis B. The asylum seekers in this study were in general healthy young men, although special attention was given to infectious diseases with certain geoepidemiological backgrounds. Unstable living arrangements, linguistic, and cultural barriers could account for the failure of the course of care.
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Affiliation(s)
- Núria Serre-Delcor
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, PROSICS, Hospital Universitari Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain
| | - Carlos Ascaso
- Department of Basic Clinical Practice, Institut de Investigacions biomédiques August Pi i Sunyer, Barcelona, Spain
| | - Antoni Soriano-Arandes
- Pediatric Infectious Diseases Unit, PROSICS, Hospital Universitari Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain
| | - Francisco Collazos-Sanchez
- Department of Psychiatric, PROSICS, Hospital Universitari Vall d'Hebron, CIBERSAM, Institut Català de la Salut, Barcelona, Spain and Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Begoña Treviño-Maruri
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, PROSICS, Hospital Universitari Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain
| | - Elena Sulleiro
- Department of Microbiology, PROSICS, Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain
| | - Diana Pou-Ciruelo
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, PROSICS, Hospital Universitari Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain
| | - Cristina Bocanegra-Garcia
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, PROSICS, Hospital Universitari Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain
| | - Israel Molina-Romero
- Department of Infectious Diseases, PROSICS, Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain
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Adeel AA. Schistosomiasis in International Refugees and Migrant Populations. CURRENT TROPICAL MEDICINE REPORTS 2017. [DOI: 10.1007/s40475-017-0128-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Zeng X, Yiu WC, Cheung KH, Yip HY, Nong W, He P, Yuan D, Rollinson D, Qiu JW, Fung MC, Wu Z, Hui JHL. Distribution and current infection status of Biomphalaria straminea in Hong Kong. Parasit Vectors 2017; 10:351. [PMID: 28743308 PMCID: PMC5526268 DOI: 10.1186/s13071-017-2285-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 07/12/2017] [Indexed: 03/11/2023] Open
Abstract
Background Schistosomiasis, also generally known as snail fever, is a parasitic disease caused by trematode flatworms of the genus Schistosoma. In Hong Kong and mainland China, the freshwater snail Biomphalaria straminea has been introduced and has the potential to transmit intestinal schistosomiasis caused by S. mansoni, a parasite of man which has a wide distribution in Africa and parts of the New World, especially Brazil. The first identification of B. straminea in Hong Kong dates back to the 1970s, and its geographical distribution, phylogenetic relationships, and infection status have not been updated for more than 30 years. Thus, this study aims to reveal the distribution and current infection status of B. straminea in contemporary Hong Kong. Methods Snails were collected from different parts of Hong Kong from July 2016 to January 2017. Both anatomical and molecular methods were applied to identify B. straminea. Cytochrome c oxidase subunit 1 (cox1), internal transcribed spacer 1 (ITS1), 5.8S rDNA, internal transcribed spacer 2 (ITS2), and 16S ribosomal DNA (rDNA) were sequenced from individual snails and analyzed. To detect the presence of S. mansoni, both biopsy and PCR analyses were carried out. Results Using both anatomical and molecular analyses, this study demonstrated the existence of black- and red-coloured shell B. straminea in different districts in the New Territories in Hong Kong, including places close to the mainland China border. None of the B. straminea (n = 87) investigated were found to be infected with S. mansoni when tested by biopsy and PCR. The Hong Kong B. straminea are genetically indistinguishable, based on the chosen molecular markers (cox1, ITS1-5.8S-ITS2, and 16S rDNA), and are similar to those obtained in mainland China and South America. Conclusion Biomphalaria straminea is now well established in freshwater habitats in Hong Kong. No evidence of infection with S. mansoni has been found. Surveillance should be continued to monitor and better understand this schistosomiasis intermediate host in mainland China and Hong Kong. Electronic supplementary material The online version of this article (doi:10.1186/s13071-017-2285-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xin Zeng
- School of Life Science, State Key Laboratory of Agrobiotechnology, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China.,Department of Parasitology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong Province, People's Republic of China.,Key Laboratory of Tropical Disease Control (SYSU), Ministry of Education, Guangzhou, Guangdong Province, People's Republic of China
| | - Wing Chung Yiu
- School of Life Science, State Key Laboratory of Agrobiotechnology, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China
| | - Kwan Ho Cheung
- School of Life Science, State Key Laboratory of Agrobiotechnology, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China
| | - Ho Yin Yip
- School of Life Science, State Key Laboratory of Agrobiotechnology, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China
| | - Wenyan Nong
- School of Life Science, State Key Laboratory of Agrobiotechnology, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China
| | - Ping He
- Department of Parasitology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong Province, People's Republic of China.,Key Laboratory of Tropical Disease Control (SYSU), Ministry of Education, Guangzhou, Guangdong Province, People's Republic of China
| | - Dongjuan Yuan
- Department of Parasitology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong Province, People's Republic of China.,Key Laboratory of Tropical Disease Control (SYSU), Ministry of Education, Guangzhou, Guangdong Province, People's Republic of China
| | - David Rollinson
- Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, Cromwell Road, London, SW7 5BD, UK
| | - Jian-Wen Qiu
- Department of Biology, Hong Kong Baptist University, Hong Kong, Special Administrative Region, People's Republic of China
| | - Ming Chiu Fung
- School of Life Science, State Key Laboratory of Agrobiotechnology, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China.,Key Laboratory of Tropical Disease Control (SYSU), Ministry of Education, Guangzhou, Guangdong Province, People's Republic of China
| | - Zhongdao Wu
- Department of Parasitology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong Province, People's Republic of China. .,Key Laboratory of Tropical Disease Control (SYSU), Ministry of Education, Guangzhou, Guangdong Province, People's Republic of China.
| | - Jerome Ho Lam Hui
- School of Life Science, State Key Laboratory of Agrobiotechnology, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China.
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Beltrame A, Guerriero M, Angheben A, Gobbi F, Requena-Mendez A, Zammarchi L, Formenti F, Perandin F, Buonfrate D, Bisoffi Z. Accuracy of parasitological and immunological tests for the screening of human schistosomiasis in immigrants and refugees from African countries: An approach with Latent Class Analysis. PLoS Negl Trop Dis 2017; 11:e0005593. [PMID: 28582412 PMCID: PMC5472324 DOI: 10.1371/journal.pntd.0005593] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 06/15/2017] [Accepted: 04/24/2017] [Indexed: 12/17/2022] Open
Abstract
Background Schistosomiasis is a neglected infection affecting millions of people, mostly living in sub-Saharan Africa. Morbidity and mortality due to chronic infection are relevant, although schistosomiasis is often clinically silent. Different diagnostic tests have been implemented in order to improve screening and diagnosis, that traditionally rely on parasitological tests with low sensitivity. Aim of this study was to evaluate the accuracy of different tests for the screening of schistosomiasis in African migrants, in a non endemic setting. Methodology/Principal findings A retrospective study was conducted on 373 patients screened at the Centre for Tropical Diseases (CTD) in Negrar, Verona, Italy. Biological samples were tested with: stool/urine microscopy, Circulating Cathodic Antigen (CCA) dipstick test, ELISA, Western blot, immune-chromatographic test (ICT). Test accuracy and predictive values of the immunological tests were assessed primarily on the basis of the results of microscopy (primary reference standard): ICT and WB resulted the test with highest sensitivity (94% and 92%, respectively), with a high NPV (98%). CCA showed the highest specificity (93%), but low sensitivity (48%). The analysis was conducted also using a composite reference standard, CRS (patients classified as infected in case of positive microscopy and/or at least 2 concordant positive immunological tests) and Latent Class Analysis (LCA). The latter two models demonstrated excellent agreement (Cohen’s kappa: 0.92) for the classification of the results. In fact, they both confirmed ICT as the test with the highest sensitivity (96%) and NPV (97%), moreover PPV was reasonably good (78% and 72% according to CRS and LCA, respectively). ELISA resulted the most specific immunological test (over 99%). The ICT appears to be a suitable screening test, even when used alone. Conclusions The rapid test ICT was the most sensitive test, with the potential of being used as a single screening test for African migrants. Schistosomiasis is probably the most important of the neglected tropical diseases (NTD) caused by helminthes (worms). It is acquired bathing in freshwater in endemic areas. The life cycle is complex and involves freshwater snails. Schistosomiasis, caused by Schistosoma mansoni, S. haematobium and less frequently by other species, affects more than 200 million people, mostly in Africa, and may chronically cause irreversible damage of the liver (S. mansoni) or of the kidneys and the urinary tract, including cancer of the bladder (S. haematobium). As in chronic infections eggs of both species are often missed by microscopy of faeces and urine, with this retrospective study we evaluate the accuracy of different, alternative diagnostic tests, for the screening of schistosomiasis in African migrants and asylum seekers, of whom many thousands reach the Italian coast every year proceding from the most endemic areas. The most interesting finding of our study is that a rapid diagnostic test for antibody detection in blood, easy to use as a point-of-care tool, resulted the most sensitive of the five tests evaluated, and thus is very promising as a screening tool even when used without any additional test.
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Affiliation(s)
- Anna Beltrame
- Centre for Tropical Diseases, Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy
| | | | - Andrea Angheben
- Centre for Tropical Diseases, Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy
| | - Federico Gobbi
- Centre for Tropical Diseases, Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy
| | - Ana Requena-Mendez
- Barcelona Institute for Global Health, ISGlobal-CRESIB, Universitat de Barcelona, Barcelona, Spain
| | - Lorenzo Zammarchi
- Infectious and Tropical Diseases Department, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - Fabio Formenti
- Centre for Tropical Diseases, Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy
| | - Francesca Perandin
- Centre for Tropical Diseases, Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy
| | - Dora Buonfrate
- Centre for Tropical Diseases, Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy
- * E-mail:
| | - Zeno Bisoffi
- Centre for Tropical Diseases, Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy
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Castelli F, Sulis G. Migration and infectious diseases. Clin Microbiol Infect 2017; 23:283-289. [PMID: 28336382 DOI: 10.1016/j.cmi.2017.03.012] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 02/17/2017] [Accepted: 03/14/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND Infectious diseases still represent an important cause of morbidity and mortality among foreign-born individuals. The rising migration flows towards Europe throughout the last few years are raising renewed concerns about management issues and the potential associated risk for the native population. AIMS To discuss the health implications and challenges related to the four phases of migration, from first arrival to stable resettlement. SOURCES Scientific literature and relevant statistical reports. CONTENT Although infectious diseases are not a health priority at first arrival, a syndromic screening to identify the most common communicable conditions (pulmonary tuberculosis above all) should be promptly conducted. Reception centres where asylum seekers are gathered after arrival may be crowded, so favouring epidemic outbreaks, sometimes caused by incomplete vaccine coverage for preventable diseases. After resettlement, the prevalence of some chronic infections such as human immunodeficiency virus, viral hepatitis or tuberculosis largely reflects the epidemiological pattern in the country of origin, with poor living conditions being an additional driver. Once resettled, migrants usually travel back to their country of origin without seeking pre-travel advice, which results in a high incidence of malaria and other infections. IMPLICATIONS Although infectious diseases among migrants are known to have a negligible impact on European epidemiology, screening programmes need to be implemented and adapted to the different stages of the migratory process to better understand the trends and set priorities for action. Appropriate access to care regardless of the legal status is crucial to improve the health status and prevent the spread of contagious conditions.
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Affiliation(s)
- F Castelli
- University Department of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy; UNESCO Chair 'Training and empowering human resources for health development in resource-limited countries', University of Brescia, Brescia, Italy.
| | - G Sulis
- University Department of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy
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Seroprevalence of five neglected parasitic diseases among immigrants accessing five infectious and tropical diseases units in Italy: a cross-sectional study. Clin Microbiol Infect 2017; 23:335.e1-335.e5. [PMID: 28259548 DOI: 10.1016/j.cmi.2017.02.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 02/06/2017] [Accepted: 02/15/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This multicentre cross-sectional study aims to estimate the prevalence of five neglected tropical diseases (Chagas disease, filariasis, schistosomiasis, strongyloidiasis and toxocariasis) among immigrants accessing health care facilities in five Italian cities (Bologna, Brescia, Florence, Rome, Verona). METHODS Individuals underwent a different set of serological tests, according to country of origin and presence of eosinophilia. Seropositive patients were treated and further followed up. RESULTS A total of 930 adult immigrants were enrolled: 477 men (51.3%), 445 women (47.9%), eight transgender (0.8%); median age was 37.81 years (range 18-80 years). Most of them had come from the African continent (405/930, 43.5%), the rest from East Europe, South America and Asia, and 9.6% (89/930) were diagnosed with at least one of the infections under study. Seroprevalence of each specific infection varied from 3.9% (7/180) for Chagas disease to 9.7% (11/113) for toxocariasis. Seropositive people were more likely to be 35-40 years old and male, and to come from South East Asia, sub-Saharan Africa or South America. CONCLUSIONS The results of our study confirm that neglected tropical diseases represent a substantial health problem among immigrants and highlight the need to address this emerging public health issue.
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Mipatrini D, Stefanelli P, Severoni S, Rezza G. Vaccinations in migrants and refugees: a challenge for European health systems. A systematic review of current scientific evidence. Pathog Glob Health 2017; 111:59-68. [PMID: 28165878 DOI: 10.1080/20477724.2017.1281374] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The decline of immunization rates in countries of origin of migrants and refugees, along with risky conditions during the journey to Europe, may threaten migrants' health. We performed a systematic review of the scientific literature in order to assess the frequency of vaccine preventable diseases, and vaccination coverage among migrants and refugees in Europe. To this end, Medline and Cochrane databases were considered. After the screening and the selection process, 58 papers were included in the review. We focused on the following vaccine-preventable diseases: hepatitis B, measles, rubella, mumps, tetanus, poliomyelitis, pertussis, diphtheria, meningitis, and varicella. The results were presented as a qualitative synthesis. In summary, several studies highlighted that migrants and refugees have lower immunization rates compared to European-born individuals. Firstly, this is due to low vaccination coverage in the country of origin. Then, several problems may limit migrants' access to vaccination in Europe: (i) migrants are used to move around the continent, and many vaccines require multiple doses at regular times; (ii) information on the immunization status of migrants is often lacking; (iii) hosting countries face severe economic crises; (iv) migrants often refuse registration with medical authorities for fear of legal consequences and (v) the lack of coordination among public health authorities of neighboring countries may determine either duplications or lack of vaccine administration. Possible strategies to overcome these problems include tailoring immunization services on the specific needs of the target population, developing strong communication campaigns, developing vaccination registers, and promoting collaboration among public health authorities of European Countries.
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Affiliation(s)
- Daniele Mipatrini
- a Department of Public Health and Infectious Diseases , Sapienza University , Rome , Italy
| | - Paola Stefanelli
- b Department of Infectious Diseases , Istituto Superiore di Sanità , Rome , Italy
| | - Santino Severoni
- c Division of Policy and Governance for Health and Well-being European Office for Investment for Health and Development , WHO European Office , Copenhagen , Denmark
| | - Giovanni Rezza
- b Department of Infectious Diseases , Istituto Superiore di Sanità , Rome , Italy
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Abu-Madi MA, Behnke JM, Ismail A, Boughattas S. Assessing the burden of intestinal parasites affecting newly arrived immigrants in Qatar. Parasit Vectors 2016; 9:619. [PMID: 27903290 PMCID: PMC5131437 DOI: 10.1186/s13071-016-1906-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 11/22/2016] [Indexed: 11/30/2022] Open
Abstract
Background In the last decades, the enormous influx of immigrants to industrialized countries has led to outbreaks of parasitic diseases, with enteric infections being amongst the most frequently encountered. In its strategy to control such infection, Qatar has established the Pre-Employment Certificate (PEC) program which requires medical inspection before arrival in Qatar and which is mandatory for immigrant workers travelling to the country. To assess the reliability of the PEC, we conducted a survey of intestinal parasites, based on examination of stool samples provided by immigrant workers (n = 2,486) recently arrived in Qatar. Results Overall prevalence of helminths was 7.0% and that of protozoa was 11.7%. Prevalence of combined helminths was highest among the western Asians and the highest prevalence of combined protozoan parasites was among workers from North to Saharan Africa. Analysis of temporal changes showed an increasing trend of protozoan infections over the investigated 3 years. A major contribution to this temporal change in prevalence came from Blastocystis hominis as well as from other protozoan species: Giardia duodenalis and Endolimax nana. Analysis of the temporal trend in species richness of the protozoan species showed a significant increase in the mean number of species harboured per subject across this period. Conclusion The increase of protozoan infections over recent years raises some concerns. It suggests that screening protocols for applicants for visas/work permits needs to be revised giving more careful attention to the intestinal protozoan infections that potential immigrants may harbor.
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Affiliation(s)
- Marawan A Abu-Madi
- Department of Biomedical Science, College of Health Sciences, Biomedical Research Center, Qatar University, P.O. Box 2713, Doha, Qatar.
| | - Jerzy M Behnke
- School of Life Sciences, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Ahmed Ismail
- Medical Commission, Ministry of Public Health, P.O. Box 42, Doha, Qatar
| | - Sonia Boughattas
- Department of Biomedical Science, College of Health Sciences, Biomedical Research Center, Qatar University, P.O. Box 2713, Doha, Qatar
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Prevalence of chronic infections and susceptibility to measles and varicella-zoster virus in Latin American immigrants. Infect Dis Poverty 2016; 5:41. [PMID: 27164954 PMCID: PMC4863343 DOI: 10.1186/s40249-016-0136-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 04/20/2016] [Indexed: 01/15/2023] Open
Abstract
Background Large numbers of Latin American immigrants recently arrived in Western Europe. Curative and preventive programmes need to take account of their risk of suffering and transmitting imported chronic infections and of their susceptibility to cosmopolitan infections. We aimed to assess the prevalence and co-occurrence of imported chronic infections among Latin American immigrants, and their susceptibility to highly prevalent cosmopolitan infections. Methods Adult participants were recruited in the community and in a primary health centre in Geneva in 2008. Serological tests were performed on stored sera for HIV, HBV, syphilis, Strongyloides stercoralis, Trypanosoma cruzi, varicella and measles. We considered only chronic active infections in the analysis. Results and discussion The 1 012 participants, aged 37.2 (SD 11.3) years, were mostly female (82.5 %) and Bolivians (48 %). Overall, 209 (20.7 %) had at least one and 27 (2.7 %) two or more chronic infections. T. cruzi (12.8 %) and S. stercoralis (8.4 %) were the most prevalent chronic active infections compared to syphilis (0.4 %), HBV (0.4 %) and HIV (1.4 %). Concomitant infections affected 28.2 and 18.5 % of T. cruzi and S. stercoralis infected cases. Bolivian origin (aOR: 13.6; 95 % CI: 3.2–57.9) was associated with risk of multiple infections. Susceptibilities for VZV and measles were 0.7 and 1.4 %, respectively. Latin American immigrants are at risk of complications and possible reactivation of chronic parasitic infections but have overall low risks of chronic viral and syphilitic active infections. Conclusions Systematic screening for chronic active parasitic infections is therefore necessary especially among Bolivians. The high protection rate against measles and VZV doesn’t require specific preventive interventions. Electronic supplementary material The online version of this article (doi:10.1186/s40249-016-0136-7) contains supplementary material, which is available to authorized users.
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Abstract
The United States of America (USA) has the largest international population of any nation in the world. Immigrants from Latin American countries, where intestinal parasites are endemic, comprise more than half of this population. This study aims to determine the prevalence of strongyloidiasis, a potentially deadly parasitic infection, in foreign-born individuals. We conducted a cross-sectional study in Washington, DC, to determine the seroprevalence of Strongyloides stercoralis infection using an NIE-ELISA IgG antibody assay. Multi-parallel quantitative real-time polymerase chain reaction (qPCR) was performed in stool samples of NIE-ELISA-positive patients to investigate possible polyparasitism. The NIE-ELISA assay detected an S. stercoralis prevalence of 4.2% in a group of 119 volunteers. Combining NIE-ELISA and qPCR detected a parasite prevalence of 5.0%. Our results underscore the relevance of systematic testing for gastrointestinal parasites in individuals from endemic regions. It also makes a case for a survey in the USA to identify immigrants' risk for strongyloidiasis and other gastrointestinal parasitic infections.
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Serre-Delcor N, Treviño B, Monge B, Salvador F, Torrus D, Gutiérrez-Gutiérrez B, López-Vélez R, Soriano-Arandes A, Sulleiro E, Goikoetxea J, Pérez-Molina JA. Eosinophilia prevalence and related factors in travel and immigrants of the network +REDIVI. Enferm Infecc Microbiol Clin 2016; 35:617-623. [PMID: 27032297 DOI: 10.1016/j.eimc.2016.02.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 02/19/2016] [Accepted: 02/19/2016] [Indexed: 11/27/2022]
Abstract
The population movements during the last decades have resulted in a progressively increasing interest in certain infectious diseases. Eosinophilia is a common finding in immigrants and travellers. One of the most common causes of eosinophilia is helminth infection, and some intestinal protozoa. The aim of this paper is to describe the epidemiological characteristics of cases with eosinophilia and its association with the presence of parasites in the REDIVI data network. This is a multicentre prospective observational study that includes patients diagnosed with eosinophilia registered in the cooperative network for the study of infectious diseases in travellers and immigrants (+REDIVI) from January 2009 to December 2012. A total of 5,255 episodes were recorded in the network during the study period, and eosinophilia was observed in 8.1-31.3% of cases (depending on the immigration group). There were 60.2% men, with a median age of 31years. There were 72.4% immigrants, and 81.2% were asymptomatic. The most commonly identified parasites were S.stercoralis (34.4%), Schistosoma sp. (11.0%), and hookworm (8.6%). The relationship between eosinophilia and parasite infection was significant for all helminths (except for cutaneous larva migrans). The symptoms and duration of the journey did not significantly determine the presence of eosinophilia. In the case of eosinophilia in a person who has lived in helminth endemic areas, it is advisable to carry out targeted studies to diagnose the infection, regardless of immigration type, length of stay, or the presence of symptoms.
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Affiliation(s)
- Núria Serre-Delcor
- Unitat de Salut Internacional i Medicina Tropical Vall d'Hebron-Drassanes, PROSICS, Barcelona, España.
| | - Begoña Treviño
- Unitat de Salut Internacional i Medicina Tropical Vall d'Hebron-Drassanes, PROSICS, Barcelona, España
| | - Begoña Monge
- Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid, España
| | - Fernando Salvador
- Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d'Hebron, PROSICS, Barcelona, España
| | - Diego Torrus
- Hospital General Universitario de Alicante, Alicante, España
| | | | - Rogelio López-Vélez
- Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid, España
| | - Antoni Soriano-Arandes
- Unitat de Salut Internacional i Medicina Tropical Vall d'Hebron-Drassanes, PROSICS, Barcelona, España
| | - Elena Sulleiro
- Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d'Hebron, PROSICS, Barcelona, España
| | | | - Jose A Pérez-Molina
- Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid, España
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Smith J. Thinking beyond borders: reconceptualising migration to better meet the needs of people in transit. Int J Public Health 2016; 61:521-2. [DOI: 10.1007/s00038-016-0814-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 03/21/2016] [Indexed: 11/24/2022] Open
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Abu-Madi MA, Behnke JM, Boughattas S, Al-Thani A, Doiphode SH, Deshmukh A. Helminth infections among long-term-residents and settled immigrants in Qatar in the decade from 2005 to 2014: temporal trends and varying prevalence among subjects from different regional origins. Parasit Vectors 2016; 9:153. [PMID: 26984202 PMCID: PMC4793708 DOI: 10.1186/s13071-016-1433-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 03/05/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Travel and migration from developing regions, where tropical diseases are common, to more developed industrialised nations can contribute to the introduction and subsequent spread of infections. With its rapidly expanding economy, Qatar has attracted vast numbers of immigrant workers in the last two decades, often from countries with poor socio-economic levels. Many used to arrive with patent intestinal parasitic infections. METHODS We analysed the prevalence of helminth infections in a dataset of 29,286 records of subjects referred for stool examination at the Hamad Medical Corporation over the course of a decade (2005 to 2014, inclusive). RESULTS Overall prevalence of combined helminth infections was low (1.86 %) but there were significant temporal trends, age and sex effects and those arising from the region of origin of the subjects. The most common helminths were hookworms (overall prevalence 1.22 %), which accounted for 70.1 % of cases, and therefore patterns for combined helminth infections were largely driven by hookworms. In both cases, and also in Trichuris trichiura and Ascaris lumbricoides, prevalence peaked in 2008, since when prevalence has been steadily falling. Helminth infections were largely concentrated among subjects from five Asian countries (Nepal, Bangladesh, Sri Lanka, India and Pakistan), and there was a highly biased prevalence in favour of male subjects in all cases. Prevalence of all three nematodes peaked in age class 7 (mean age 25.5 years, range = 20-29) and there were significant interactions between region of origin, sex of subjects and prevalence of hookworms. CONCLUSION These results offer optimism that prevalence will continue to decline in the years ahead, especially if control is targeted at those most at risk of carrying infections.
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Affiliation(s)
- Marawan A Abu-Madi
- Department of Biomedical Sciences, College of Health Science, Biomedical Research Center, Qatar University, P.O. Box 2713, Doha, Qatar.
| | - Jerzy M Behnke
- School of Life Sciences, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Sonia Boughattas
- Department of Biomedical Sciences, College of Health Science, Biomedical Research Center, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Asma Al-Thani
- Department of Biomedical Sciences, College of Health Science, Biomedical Research Center, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Sanjay H Doiphode
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Qatar, P.O. Box 3050, Doha, Qatar
| | - Anand Deshmukh
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Qatar, P.O. Box 3050, Doha, Qatar
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Serre Delcor N, Maruri BT, Arandes AS, Guiu IC, Essadik HO, Soley ME, Romero IM, Ascaso C. Infectious Diseases in Sub-Saharan Immigrants to Spain. Am J Trop Med Hyg 2016; 94:750-6. [PMID: 26880782 DOI: 10.4269/ajtmh.15-0583] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 12/08/2015] [Indexed: 12/17/2022] Open
Abstract
Immigrants may be carriers of infectious diseases because of the prevalence of these diseases in their country of origin, exposure during migration, or conditions during resettlement, with this prevalence being particularly high in sub-Saharan Africans. We performed a retrospective review of 180 sub-Saharan immigrants screened for infectious diseases at an International Health Center from January 2009 to December 2012. At least one pathogenic infectious disease was diagnosed in 72.8% patients: 60.6% latent tuberculosis infection, 36.8% intestinal parasites (intestinal protozoa or helminths), 28.1% helminths, 14.8% hepatitis B surface antigen positive, 1.2% anti-hepatitis C virus positive, 1.2% human immunodeficiency virus-positive, and 1.2% malaria. Coinfections were present in 28.4%. There was significant association between eosinophilia (absolute count or percentage) or hyper-IgE and the presence of helminths (P< 0.001). Relative eosinophilia and hyper-IgE were better indicators of helminth infection than absolute eosinophilia, particularly for schistosomiasis and strongyloidiasis. We found a high prevalence of infectious diseases in sub-Saharan immigrants, which could lead to severe health problems (in the absence of prompt treatment), representing a high cost to the public health system and possible transmission in the host country. Accurate screening and tailored protocols for infectious diseases are recommended in sub-Saharan immigrants.
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Affiliation(s)
- Núria Serre Delcor
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| | - Begoña Treviño Maruri
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| | - Antoni Soriano Arandes
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| | - Isabel Claveria Guiu
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| | - Hakima Ouaarab Essadik
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| | - Mateu Espasa Soley
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| | - Israel Molina Romero
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| | - Carlos Ascaso
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
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Pérez-Molina JA, Álvarez-Martínez MJ, Molina I. Medical care for refugees: A question of ethics and public health. Enferm Infecc Microbiol Clin 2016; 34:79-82. [PMID: 26811213 PMCID: PMC7103281 DOI: 10.1016/j.eimc.2015.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 12/30/2015] [Indexed: 01/05/2023]
Affiliation(s)
- José Antonio Pérez-Molina
- CSUR de Medicina Tropical, Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.
| | | | - Israel Molina
- Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d'Hebron, PROSICS, Barcelona, Spain
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Helminthosis and eosinophilia in Spain (1990-2015). Enferm Infecc Microbiol Clin 2016; 36:120-136. [PMID: 26827134 DOI: 10.1016/j.eimc.2015.11.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 11/29/2015] [Accepted: 11/30/2015] [Indexed: 12/16/2022]
Abstract
The finding of blood eosinophilia in a patient is a relatively frequent reason to refer him/her to a Clinical Department of Infectious Diseases. The doctor usually intends to rule out a parasitic disease in the autochthonous population, travelers or immigrants. It is uncommon for an eosinophilia to be produced by protozoa infection, whereas helminth parasites are more frequently associated with an increase of eosinophil counts in the infected patient. Eosinophilia can be the only abnormal finding, or it could be part of more complex clinical manifestations suffered by the patient. Furthermore, many, but not all, helminth infections are associated with eosinophilia, and the eosinophil level (low, high) differs according to parasite stages, helminth species, and worm co-infections. The purpose of the present article is to carry out a systematic review of cases and case series on helminth infections and eosinophilia reported in Spain from 1990 to 2015, making a distinction between autochthonous and imported (immigrants and travelers) cases, and studying their relationship with immunodepression situations.
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Pérez-Arellano JL, Carranza-Rodriguez C. [Population screening strategies in recent immigrant to Spain]. Enferm Infecc Microbiol Clin 2015; 34:45-52. [PMID: 26655674 DOI: 10.1016/j.eimc.2015.11.001] [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: 11/01/2015] [Revised: 11/05/2015] [Accepted: 11/06/2015] [Indexed: 11/27/2022]
Abstract
The definition of terms that delimites the content of this paper are initially displayed. Subsequently, the main sources of information about the disease screening in immigrants and the entities considered susceptible of screening are showed. In a later section we review the diagnostic methodology used, separately considering the history, physical examination, the usual complementary tests and specific studies of both infectious and noninfectious diseases. Finally, with the limitations of the data available a proposal of a protocol for screening of diseases in recent immigrant is performed.
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Affiliation(s)
- José-Luis Pérez-Arellano
- Departamento de Ciencias Médicas y Quirúrgicas, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España; Unidad de Enfermedades Infecciosas y Medicina Tropical, Hospital Universitario Insular de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España.
| | - Cristina Carranza-Rodriguez
- Departamento de Ciencias Médicas y Quirúrgicas, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España; Unidad de Enfermedades Infecciosas y Medicina Tropical, Hospital Universitario Insular de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España
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49
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Immigration, helminths and eosinophilia: A complex triad. Travel Med Infect Dis 2015; 13:283-4. [PMID: 26119540 DOI: 10.1016/j.tmaid.2015.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 06/04/2015] [Indexed: 12/11/2022]
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