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Ayorinde A, Ghosh I, Ali I, Zahair I, Olarewaju O, Singh M, Meehan E, Anjorin SS, Rotheram S, Barr B, McCarthy N, Oyebode O. Health inequalities in infectious diseases: a systematic overview of reviews. BMJ Open 2023; 13:e067429. [PMID: 37015800 PMCID: PMC10083762 DOI: 10.1136/bmjopen-2022-067429] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
OBJECTIVES The aim of this systematic overview of reviews was to synthesise available evidence on inequalities in infectious disease based on three dimensions of inequalities; inclusion health groups, protected characteristics and socioeconomic inequalities. METHODS We searched MEDLINE, Embase, Web of Science and OpenGrey databases in November 2021. We included reviews published from the year 2000 which examined inequalities in the incidence, prevalence or consequences of infectious diseases based on the dimensions of interest. Our search focused on tuberculosis, HIV, sexually transmitted infections, hepatitis C, vaccination and antimicrobial resistance. However, we also included eligible reviews of any other infectious diseases. We appraised the quality of reviews using the Assessment of Multiple Systematic Reviews V.2 (AMSTAR2) checklist. We conducted a narrative data synthesis. RESULTS We included 108 reviews in our synthesis covering all the dimensions of inequalities for most of the infectious disease topics of interest, however the quality and volume of review evidence and consistency of their findings varied. The existing literature reviews provide strong evidence that people in inclusion health groups and lower socioeconomic status are consistently at higher risk of infectious diseases, antimicrobial resistance and incomplete/delayed vaccination. In the protected characteristics dimension, ethnicity, and sexual orientation are important factors contributing to inequalities across the various infectious disease topics included in this overview of reviews. CONCLUSION We identified many reviews that provide evidence of various types of health inequalities in different infectious diseases, vaccination, and antimicrobial resistance. We also highlight areas where reviews may be lacking. The commonalities in the associations and their directions suggest it might be worth targeting interventions for some high risk-groups that may have benefits across multiple infectious disease outcomes rather than operating purely in infectious disease siloes.
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Affiliation(s)
| | - Iman Ghosh
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Ifra Ali
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Iram Zahair
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Olajumoke Olarewaju
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Megha Singh
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Edward Meehan
- School of Public Health and Prevention Medicine, Monash University, Clayton, Victoria, Australia
| | | | - Suzanne Rotheram
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Ben Barr
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Noel McCarthy
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Oyinlola Oyebode
- Wolfson Institute of Population Health, Queen Mary University of London, London, London, UK
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Lee C, Emeto TI, Walsh N. Prevalence of hepatitis B virus amongst refugees, asylum seekers and internally displaced persons in low- and middle-income countries: A systematic review. J Viral Hepat 2023; 30:4-18. [PMID: 36357172 PMCID: PMC10100144 DOI: 10.1111/jvh.13770] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 11/03/2022] [Indexed: 11/12/2022]
Abstract
Hepatitis B, caused by the hepatitis B virus (HBV), is a global public health issue that affects 290 million people worldwide. Most people with hepatitis B are in low- and middle-income countries (LMIC), where health systems and resources are often constrained. Refugees, asylum seekers and internally displaced persons (IDPs) often face barriers in seeking health care and are a priority population at risk of hepatitis B. No systematic review to date has evaluated the prevalence of hepatitis B amongst refugees in in LMIC. We undertook a systematic review of the literature identifying 28 studies addressing this topic. Though few studies on this topic exist, the available evidence suggests a high prevalence amongst refugees in LMIC, with wide variation between and within countries. Possible risk factors contributing to hepatitis B include unsafe injections, low immunization coverage, low awareness, mother-to-child transmission, and limited health services. Further study is needed to better understand the prevalence and risk factors for hepatitis B amongst refugees in LMIC, to inform public health responses. Vulnerable populations such as refugees are an important group to consider in national and global efforts to eliminate hepatitis B.
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Affiliation(s)
- Caroline Lee
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.,University of New South Wales, Kensington, New South Wales, Australia
| | - Theophilus I Emeto
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.,World Health Organization Collaborating Center for Vector-Borne and Neglected Tropical Diseases, James Cook University, Townsville, Queensland, Australia.,Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia
| | - Nick Walsh
- Monash University, Clayton, Victoria, Australia
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James PB, Renzaho AMN, Mwanri L, Miller I, Wardle J, Gatwiri K, Lauche R. The prevalence of anxiety, depression, and post-traumatic stress disorder among African migrants: A systematic review and meta-analysis. Psychiatry Res 2022; 317:114899. [PMID: 36252417 DOI: 10.1016/j.psychres.2022.114899] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/05/2022] [Accepted: 10/08/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Evidence exists reporting a high mental health burden among migrants globally. However, there is no global estimate of mental ill-health among African migrants despite their adverse pre-migration environments. This systematic review and meta-analysis summarise the current scholarship regarding the prevalence of anxiety, depression and Post-traumatic Stress Disorder (PTSD) in the global African migrant population. METHODS We searched six databases (Medline (EBSCOHost), PsycINFO (EBSCOHost), Web of Science, PubMed, Scopus and Cumulative Index to Nursing and Allied Health (CINAHL) from 1st January 2000 to 31st August 2021. We screened retrieved articles using strict inclusion and exclusion criteria. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal tools. Random-effects meta-analyses were employed using DerSimonian and Laird estimator based on inverse variance weights. The I2 statistic was used to measure heterogeneity. RESULTS Our search retrieved 1091 articles, of which 46 were included representing a total of 28,367 African migrants. The weighted mean age of African migrants was 32.98 years, and nearly half were male (n= 12852, 45.31%). Among the included studies, almost nine out of ten (n=41, 89.1%) were cross-sectional studies. The pooled prevalence of anxiety, depression and PTSD was 34.60%;95%CI (26.30-43.00), 33.20%;95%CI (27.70-38.37) and 37.9%;95%CI (23.5- 52.4) respectively. Significant heterogeneity (I2 >98%) existed in the prevalence estimates for anxiety, depression, and PTSD. Sub-group analyses indicate a significantly higher prevalence of anxiety and depression but PTSD for studies conducted in Africa than outside Africa. Similarly, higher prevalence rates for anxiety, depression, and PTSD were seen in studies that used a screening tool than in those that used a diagnostic tool, although a significant difference was observed for depression only. CONCLUSION Despite significant heterogeneity among included studies, our systematic review and meta-analysis show a high prevalence of anxiety, depression, and PTSD among African migrants. Our findings underscore the need to develop and implement serious, culturally appropriate mental health interventions that address post-migration stressors that increase their risk of mental ill-health and successful integration into host communities.
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Affiliation(s)
- Peter Bai James
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW 2480, Australia; Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - Andre M N Renzaho
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Lillian Mwanri
- Research Centre for Public Health Policy, Torrens University Australia, Adelaide, SA 5000, Australia
| | - Ian Miller
- Sport and Exercise Science, Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia
| | - Jon Wardle
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW 2480, Australia
| | - Kathomi Gatwiri
- Centre for Children & Young People, Faculty of Health, Southern Cross University, Gold Coast, Australia
| | - Romy Lauche
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW 2480, Australia
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El-Ghitany EM, Ashour A, Fekry MM, Elrewany E, Farghaly AG, Omran EA. Seroprevalence of Hepatitis A, B and C Among a Sample of Refugees in Egypt: An Exploratory Survey. J Epidemiol Glob Health 2022; 12:430-440. [PMID: 36107333 PMCID: PMC9723078 DOI: 10.1007/s44197-022-00060-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/29/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Estimating the prevalence of infectious diseases, including viral hepatitis, among refugees is important for evaluating their health needs and predicting the burden on the health system of the host country. This study aimed at estimating the seroprevalence of viral hepatitis among refugees in Egypt. METHODS This cross-sectional study involved a heterogeneous group of 501 refugees. Enzyme-linked immunosorbent assays were used to detect IgG antibodies against hepatitis A virus (HAV), B virus (HBV) surface antigen (anti-HBsAg), C virus (HCV), and HBV surface antigen (HBsAg). RESULTS Anti-HAV was the most prevalent marker (n = 482, 96.2%), followed by anti-HBs (n = 142, 28.3%) and HBsAg (n = 21, 4.2%), while only four refugees (0.8%) had positive anti-HCV IgG. Anti-HBs was higher in males (p < 0.05). Older refugees and non-working subjects had significantly higher seropositive rates of anti-HAV (p = 0.051 and p = 0.023, respectively), while students and those below 15 years of age had higher rates of anti-HBs (p < 0.05). Positive HBsAg results were associated with history of hepatitis (p < 0.001). Obese participants were more likely to be positive for HBsAg (p = 0.025) and anti-HBs (p < 0.05). Sudanese refugees had significantly higher rates of anti-HAV antibodies (p = 0.049), while Yemini refugees had significantly higher rates for HBsAg (p = 0.019) positivity. Residents of Dakahlia had significantly higher rates of anti-HAV (p = 0.008) and anti-HBs (p < 0.05). None of the studied risk factors was significantly associated with anti-HCV. CONCLUSION Refugees in Egypt have poor immunity against HBV with intermediate to high HBV and low HCV prevalence rates. Despite that 65% of refugees received the HAV vaccine, almost all had IgG anti-HAV, denoting previous infection.
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Affiliation(s)
- Engy Mohamed El-Ghitany
- grid.7155.60000 0001 2260 6941Department of Tropical Health, High Institute of Public Health, Alexandria University, 165 El-Horreya Avenue–El-Ibrahimia, Alexandria, Egypt
| | - Ayat Ashour
- grid.7155.60000 0001 2260 6941Department of Family Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Marwa M. Fekry
- grid.7155.60000 0001 2260 6941Department of Microbiology, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Ehab Elrewany
- grid.7155.60000 0001 2260 6941Department of Tropical Health, High Institute of Public Health, Alexandria University, 165 El-Horreya Avenue–El-Ibrahimia, Alexandria, Egypt
| | - Azza Galal Farghaly
- grid.7155.60000 0001 2260 6941Department of Tropical Health, High Institute of Public Health, Alexandria University, 165 El-Horreya Avenue–El-Ibrahimia, Alexandria, Egypt
| | - Eman A. Omran
- grid.7155.60000 0001 2260 6941Department of Microbiology, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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Agbata EN, Buitrago-Garcia D, Nunez-Gonzalez S, Hashmi SS, Pottie K, Alonso-Coello P, Arevalo-Rodriguez I. Quality assessment of systematic reviews on international migrant healthcare interventions: a systematic review. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01390-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Bourouache M, Mimouni R, Ait Alla A, Hamadi F, El Boulani A, Bihadassen B, Laktib A, Moustaoui F, Aghrouch M. Occurrence and removal of intestinal parasites in two wastewater treatment plants in the south of Morocco. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2021; 19:1425-1434. [PMID: 34900277 PMCID: PMC8617139 DOI: 10.1007/s40201-021-00697-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 06/21/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Agadir city plans to reuse treated wastewater on a large scale to irrigate these green spaces. This study aims to evaluate the risk of intestinal parasites, to which human and animal populations are exposed during the reuse of treated wastewaters. METHODS Over 21 months, wastewater samples were collected in Bensergao and Mzar wastewater treatment plants, in Agadir city, southern Morocco. The occurrences and removal of intestinal parasites were inspected using the modified Bailenger method. RESULTS The biodiversity of helminths is higher than protozoa, while the protozoa cysts are more abundant and more prevalent. Generally, the highest parasitic loads were recorded during the hot season. For raw waters, the average concentration of protozoa cysts was 173.33 ± 70.81 cysts per L for Bensergao plant and 179.33 ± 129.22 cysts per L for Mzar plant. However, the helminths average concentration was 48.70 ± 39.91 eggs/larvae per L for Bensergao plant and 51.10 ± 31.76 eggs/larvae per L for Mzar plant. The purified water of the Mzar plant does not contain parasites, unlike the Bensergao plant where a small numbers of parasites were detected, included 2.33 ± 1.53 cysts per L for protozoa and 0.45 ± 0.58 eggs/larvae per L for helminths. CONCLUSIONS Considering parasitological risks, the purified waters of Bensergao plant cannot be used without risks to the public health and environment. In contrast, the purified waters and the purified waters disinfected by ultraviolet radiation from the Mzar plant can be used safely to water the green spaces of Agadir city.
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Affiliation(s)
- M. Bourouache
- Laboratory of Microbial Biotechnology and Plant Protection, Faculty of Sciences, Ibn Zohr University, Agadir, BP 8106, Morocco
| | - R. Mimouni
- Laboratory of Microbial Biotechnology and Plant Protection, Faculty of Sciences, Ibn Zohr University, Agadir, BP 8106, Morocco
| | - A. Ait Alla
- Laboratory of Microbial Biotechnology and Plant Protection, Faculty of Sciences, Ibn Zohr University, Agadir, BP 8106, Morocco
| | - F. Hamadi
- Laboratory of Microbial Biotechnology and Plant Protection, Faculty of Sciences, Ibn Zohr University, Agadir, BP 8106, Morocco
| | - A. El Boulani
- Laboratory of Microbial Biotechnology and Plant Protection, Faculty of Sciences, Ibn Zohr University, Agadir, BP 8106, Morocco
| | - B. Bihadassen
- Laboratory of Microbial Biotechnology and Plant Protection, Faculty of Sciences, Ibn Zohr University, Agadir, BP 8106, Morocco
| | - A. Laktib
- Laboratory of Microbial Biotechnology and Plant Protection, Faculty of Sciences, Ibn Zohr University, Agadir, BP 8106, Morocco
| | - F. Moustaoui
- Medical Analysis Laboratory, Hassan II Regional Hospital, Agadir, 80000 Morocco
| | - M. Aghrouch
- Medical Analysis Laboratory, Hassan II Regional Hospital, Agadir, 80000 Morocco
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Lambert JF, Stete K, Balmford J, Bockey A, Kern W, Rieg S, Boeker M, Lange B. Reducing burden from respiratory infections in refugees and immigrants: a systematic review of interventions in OECD, EU, EEA and EU-applicant countries. BMC Infect Dis 2021; 21:872. [PMID: 34445957 PMCID: PMC8390210 DOI: 10.1186/s12879-021-06474-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 07/26/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Respiratory diseases are a major reason for refugees and other immigrants seeking health care in countries of arrival. The burden of respiratory diseases in refugees is exacerbated by sometimes poor living conditions characterised by crowding in mass accommodations and basic living portals. The lack of synthesised evidence and guideline-relevant information to reduce morbidity and mortality from respiratory infections endangers this population. METHODS A systematic review of all controlled and observational studies assessing interventions targeting the treatment, diagnosis and management of respiratory infections in refugees and immigrants in OECD, EU, EEA and EU-applicant countries published between 2000 and 2019 in MEDLINE, CINAHL, PSYNDEX and the Web of Science. RESULTS Nine of 5779 identified unique records met our eligibility criteria. Seven studies reported an increase in vaccine coverage from 2 to 52% after educational multilingual interventions for respiratory-related childhood diseases (4 studies) and for influenza (5 studies). There was limited evidence in one study that hand sanitiser reduced rates of upper respiratory infections and when provided together with face masks also the rates of influenza-like-illness in a hard to reach migrant neighbourhood. In outbreak situations of vaccine-preventable diseases, secondary cases and outbreak hazards were reduced by general vaccination strategies early after arrival but not by serological testing after exposure (1 study). We identified evidence gaps regarding interventions assessing housing standards, reducing burden of bacterial pneumonia and implementation of operational standards in refugee care and reception centres. CONCLUSIONS Multilingual health literacy interventions should be considered to increase uptake of vaccinations in refugees and immigrants. Immediate vaccinations upon arrival at refugee housings may reduce secondary infections and outbreaks. Well-designed controlled studies on housing and operational standards in refugee and immigrant populations early after arrival as well as adequate ways to gain informed consent for early vaccinations in mass housings is required to inform guidelines.
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Affiliation(s)
- Jan-Frederic Lambert
- Division of Infectious Diseases, Department of Medicine II, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg im Breisgau, DE, Germany.
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg im Breisgau, Germany.
| | - Katarina Stete
- Division of Infectious Diseases, Department of Medicine II, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg im Breisgau, DE, Germany
| | - James Balmford
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Annabelle Bockey
- Division of Infectious Diseases, Department of Medicine II, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg im Breisgau, DE, Germany
| | - Winfried Kern
- Division of Infectious Diseases, Department of Medicine II, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg im Breisgau, DE, Germany
| | - Siegbert Rieg
- Division of Infectious Diseases, Department of Medicine II, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg im Breisgau, DE, Germany
| | - Martin Boeker
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Berit Lange
- Division of Infectious Diseases, Department of Medicine II, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg im Breisgau, DE, Germany
- Department of Epidemiology, Helmholtz Centre for Infection Research, Inhoffenstr.7, 38124, Braunschweig, DE, Germany
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Leblanc C, Brun S, Bouchaud O, Izri A, Ok V, Caseris M, Sorge F, Pham LL, Paugam A, Paris L, Jaureguiberry S, Bloch-Queyrat C, Boubaya M, Faye A, Mariani P, de Pontual L. Imported schistosomiasis in Paris region of France: A multicenter study of prevalence and diagnostic methods. Travel Med Infect Dis 2021; 41:102041. [PMID: 33785455 DOI: 10.1016/j.tmaid.2021.102041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 03/18/2021] [Accepted: 03/22/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND There are few data on imported schistosomiasis - especially in children. The objectives of the present study were to estimate the prevalence of imported schistosomiasis in at-risk children in the greater Paris region of France and to compare diagnostic methods. METHOD Children at risk of schistosomiasis who consulted or were hospitalized in four hospitals in the greater Paris region were prospectively included. Clinical and laboratory data were collected. Urine and feces samples were screened for Schistosoma spp. using microscopy, a point-of-care circulating cathodic antigen and a real-time polymerase chain reaction assay. Serum samples were screened using Western blot, ELISA, indirect hemagglutination, and immunochromatographic assays. The diagnosis was characterized as confirmed (positive microscopy analysis) and as suspected (positive ELISA and Western blot assays). The prevalence of schistosomiasis and the tests' performances were estimated using the latent class method. RESULTS A total of 114 children were included. Most of the children were newly arrived migrants from sub-Saharan Africa. The mean age was 13.2 years-old. There were 12 (10.5%) confirmed cases and 13 (11.4%) suspected cases. Half of the confirmed and suspected cases were asymptomatic. The prevalence was 24.3%. The ELISA and the Western blot assays presented the same sensitivity (83%) and specificity (99%). The serum immunochromatographic assay also showed good performance. CONCLUSIONS The high prevalence of imported schistosomiasis among at-risk children in the greater Paris region confirms the need for systematic screening. A serum immunochromatographic assay appears to be one of the most effective screening methods for a low cost.
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Affiliation(s)
- Claire Leblanc
- Department of Pediatrics, AP-HP University Paris 13, Jean Verdier Hospital, Bondy, France.
| | - Sophie Brun
- Department of Parasitology-Mycology, AP-HP University Paris 13, Avicenne Hospital, Bobigny, France
| | - Olivier Bouchaud
- Department of Infectious and Tropical Diseases, AP-HP University Paris 13, Avicenne Hospital, Bobigny, France
| | - Arezki Izri
- Department of Parasitology-Mycology, AP-HP University Paris 13, Avicenne Hospital, Bobigny, France
| | - Vichita Ok
- Department of Parasitology-Mycology, AP-HP University Paris 13, Avicenne Hospital, Bobigny, France
| | - Marion Caseris
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP University Paris Diderot, Robert Debré Hospital, Paris, France
| | - Fréderic Sorge
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP University Paris Descartes, Necker-Enfants Malades Hospital, Paris, France
| | - Luu-Ly Pham
- Department of Pediatrics, AP-HP University Paris 13, Jean Verdier Hospital, Bondy, France
| | - André Paugam
- Department of Parasitology-Mycology, AP-HP University Paris Descartes, Cochin Hospital, Paris, France
| | - Luc Paris
- Department of Parasitology-Mycology, AP-HP Sorbonne Université, Pitié-Salpétrière Hospital, Paris, France
| | - Stéphane Jaureguiberry
- Department of Infectious and Tropical Diseases, AP-HP University Paris -Sud Saclay, Kremlin Bicêtre Hospital, Le Kremlin Bicêtre, France
| | - Coralie Bloch-Queyrat
- Department of Clinical Research, AP-HP University Paris 13, Avicenne Hospital, Bobigny, France
| | - Marouane Boubaya
- Department of Clinical Research, AP-HP University Paris 13, Avicenne Hospital, Bobigny, France
| | - Albert Faye
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP University Paris Diderot, Robert Debré Hospital, Paris, France
| | - Patricia Mariani
- Department of Microbiology, AP-HP University Paris Diderot, Robert Debré Hospital, Paris, France
| | - Loïc de Pontual
- Department of Pediatrics, AP-HP University Paris 13, Jean Verdier Hospital, Bondy, France
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Tamarozzi F, Ursini T, Hoekstra PT, Silva R, Costa C, Gobbi F, Monteiro GB, Motta L, van Dam GJ, Corstjens PL, van Lieshout L, Buonfrate D. Evaluation of microscopy, serology, circulating anodic antigen (CAA), and eosinophil counts for the follow-up of migrants with chronic schistosomiasis: a prospective cohort study. Parasit Vectors 2021; 14:149. [PMID: 33750443 PMCID: PMC7941883 DOI: 10.1186/s13071-021-04655-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/23/2021] [Indexed: 12/16/2022] Open
Abstract
Background An accurate test for the diagnosis and post-treatment follow-up of patients with schistosomiasis is needed. We assessed the performance of different laboratory parameters, including the up-converting reporter particle technology lateral flow assay to detect circulating anodic antigen (UCP-LF CAA), for the post-treatment follow-up of schistosomiasis in migrants attending a dedicated outpatient clinic in a non-endemic country. Methods Routine anti-Schistosoma serology results and eosinophil counts were obtained of patients with positive urine/stool microscopy and/or PCR (confirmed cases) or only positive serology (possible cases), and at least one follow-up visit at 6 (T6) or 12 (T12) months after praziquantel treatment. All sera samples were tested with the UCP-LF CAA assay. Results Forty-eight patients were included, 23 confirmed and 25 possible cases. The percentage seropositivity and median antibody titers did not change significantly during follow-up. UCP-LF CAA was positive in 86.9% of confirmed and 20% of possible cases. The percentage positivity and median CAA levels decreased significantly post-treatment, with only two patients having positive CAA levels at T12. Conclusions The UCP-LF CAA assay proved useful for the diagnosis of active infection with Schistosoma spp. and highly valuable for post-treatment monitoring in migrants, encouraging the development of a commercial test.![]()
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Affiliation(s)
- Francesca Tamarozzi
- Department of Infectious-Tropical Diseases and Microbiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Sacro Cuore Don Calabria Hospital, Viale Luigi Rizzardi 4, 37024, Negrar di Valpolicella, Verona, Italy
| | - Tamara Ursini
- Department of Infectious-Tropical Diseases and Microbiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Sacro Cuore Don Calabria Hospital, Viale Luigi Rizzardi 4, 37024, Negrar di Valpolicella, Verona, Italy
| | - Pytsje T Hoekstra
- Department of Parasitology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Ronaldo Silva
- Department of Infectious-Tropical Diseases and Microbiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Sacro Cuore Don Calabria Hospital, Viale Luigi Rizzardi 4, 37024, Negrar di Valpolicella, Verona, Italy
| | - Cecilia Costa
- Dipartimento medico di malattie infettive, Ospedale Maggiore della Carità, Novara, Italy
| | - Federico Gobbi
- Department of Infectious-Tropical Diseases and Microbiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Sacro Cuore Don Calabria Hospital, Viale Luigi Rizzardi 4, 37024, Negrar di Valpolicella, Verona, Italy
| | - Gerardo B Monteiro
- Department of Infectious-Tropical Diseases and Microbiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Sacro Cuore Don Calabria Hospital, Viale Luigi Rizzardi 4, 37024, Negrar di Valpolicella, Verona, Italy
| | - Leonardo Motta
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Govert J van Dam
- Department of Parasitology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Paul L Corstjens
- Cell and Chemical Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Lisette van Lieshout
- Department of Parasitology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Dora Buonfrate
- Department of Infectious-Tropical Diseases and Microbiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Sacro Cuore Don Calabria Hospital, Viale Luigi Rizzardi 4, 37024, Negrar di Valpolicella, Verona, Italy.
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Beltrame A, Barabino G, Wei Y, Clapasson A, Orza P, Perandin F, Piubelli C, Monteiro GB, Longoni SS, Rodari P, Duranti S, Silva R, Fittipaldo VA, Bisoffi Z. Leprosy in Refugees and Migrants in Italy and a Literature Review of Cases Reported in Europe between 2009 and 2018. Microorganisms 2020; 8:microorganisms8081113. [PMID: 32722218 PMCID: PMC7463815 DOI: 10.3390/microorganisms8081113] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/18/2020] [Accepted: 07/23/2020] [Indexed: 02/06/2023] Open
Abstract
Leprosy is a chronic neglected infectious disease that affects over 200,000 people each year and causes disabilities in more than four million people in Asia, Africa, and Latin America. The disease can appear with a wide spectrum of clinical forms, and therefore the clinical suspicion is often difficult. Refugees and migrants from endemic countries affected by leprosy can remain undiagnosed in Europe due to the unpreparedness of clinicians. We retrospectively describe the characteristics of 55 refugees/migrants with a diagnosis of leprosy established in Italy from 2009 to 2018. Continents of origin were Africa (42%), Asia (40%), and South and Central America (18%). The symptoms reported were skin lesions (91%), neuropathy (71%), edema (7%), eye involvement (6%), fever (6%), arthritis (4%), and lymphadenopathy (4%). Seven patients (13%) had irreversible complications. Overall, 35% were relapses and 66% multibacillary leprosy. Furthermore, we conducted a review of 17 case reports or case series and five nationwide reports, published in the same decade, describing 280 migrant patients with leprosy in Europe. In Europe, leprosy is a rare chronic infectious disease, but it has not completely disappeared. Diagnosis and treatment of leprosy in refugees and migrants from endemic countries are a challenge. European guidelines for this neglected disease in this high-risk population would be beneficial.
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Affiliation(s)
- Anna Beltrame
- Department of Infectious, Tropical Diseases and Microbiology, I.R.C.C.S. Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024 Negrar di Valpolicella, Italy; (P.O.); (F.P.); (C.P.); (G.B.M.); (S.S.L.); (P.R.); (S.D.); (R.S.); (Z.B.)
- Correspondence: ; Tel.: +39-045-601-4748
| | - Gianfranco Barabino
- Dermatological Clinic, National Reference Center for Hansen’s Disease, Ospedale Policlinico San Martino, Sistema Sanitario Regione Liguria, Istituto di Ricovero e Cura a Carattere Scientifico per l’Oncologia, Largo Rosanna Benzi 10, 16132 Genoa, Italy; (G.B.); (Y.W.); (A.C.)
| | - Yiran Wei
- Dermatological Clinic, National Reference Center for Hansen’s Disease, Ospedale Policlinico San Martino, Sistema Sanitario Regione Liguria, Istituto di Ricovero e Cura a Carattere Scientifico per l’Oncologia, Largo Rosanna Benzi 10, 16132 Genoa, Italy; (G.B.); (Y.W.); (A.C.)
| | - Andrea Clapasson
- Dermatological Clinic, National Reference Center for Hansen’s Disease, Ospedale Policlinico San Martino, Sistema Sanitario Regione Liguria, Istituto di Ricovero e Cura a Carattere Scientifico per l’Oncologia, Largo Rosanna Benzi 10, 16132 Genoa, Italy; (G.B.); (Y.W.); (A.C.)
| | - Pierantonio Orza
- Department of Infectious, Tropical Diseases and Microbiology, I.R.C.C.S. Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024 Negrar di Valpolicella, Italy; (P.O.); (F.P.); (C.P.); (G.B.M.); (S.S.L.); (P.R.); (S.D.); (R.S.); (Z.B.)
| | - Francesca Perandin
- Department of Infectious, Tropical Diseases and Microbiology, I.R.C.C.S. Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024 Negrar di Valpolicella, Italy; (P.O.); (F.P.); (C.P.); (G.B.M.); (S.S.L.); (P.R.); (S.D.); (R.S.); (Z.B.)
| | - Chiara Piubelli
- Department of Infectious, Tropical Diseases and Microbiology, I.R.C.C.S. Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024 Negrar di Valpolicella, Italy; (P.O.); (F.P.); (C.P.); (G.B.M.); (S.S.L.); (P.R.); (S.D.); (R.S.); (Z.B.)
| | - Geraldo Badona Monteiro
- Department of Infectious, Tropical Diseases and Microbiology, I.R.C.C.S. Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024 Negrar di Valpolicella, Italy; (P.O.); (F.P.); (C.P.); (G.B.M.); (S.S.L.); (P.R.); (S.D.); (R.S.); (Z.B.)
| | - Silvia Stefania Longoni
- Department of Infectious, Tropical Diseases and Microbiology, I.R.C.C.S. Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024 Negrar di Valpolicella, Italy; (P.O.); (F.P.); (C.P.); (G.B.M.); (S.S.L.); (P.R.); (S.D.); (R.S.); (Z.B.)
| | - Paola Rodari
- Department of Infectious, Tropical Diseases and Microbiology, I.R.C.C.S. Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024 Negrar di Valpolicella, Italy; (P.O.); (F.P.); (C.P.); (G.B.M.); (S.S.L.); (P.R.); (S.D.); (R.S.); (Z.B.)
| | - Silvia Duranti
- Department of Infectious, Tropical Diseases and Microbiology, I.R.C.C.S. Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024 Negrar di Valpolicella, Italy; (P.O.); (F.P.); (C.P.); (G.B.M.); (S.S.L.); (P.R.); (S.D.); (R.S.); (Z.B.)
| | - Ronaldo Silva
- Department of Infectious, Tropical Diseases and Microbiology, I.R.C.C.S. Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024 Negrar di Valpolicella, Italy; (P.O.); (F.P.); (C.P.); (G.B.M.); (S.S.L.); (P.R.); (S.D.); (R.S.); (Z.B.)
| | - Veronica Andrea Fittipaldo
- Oncology Department, Mario Negri Institute for Pharmacological Research I.R.C.C.S., Via Giuseppe La Masa 19, 20156 Milano, Italy;
| | - Zeno Bisoffi
- Department of Infectious, Tropical Diseases and Microbiology, I.R.C.C.S. Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024 Negrar di Valpolicella, Italy; (P.O.); (F.P.); (C.P.); (G.B.M.); (S.S.L.); (P.R.); (S.D.); (R.S.); (Z.B.)
- Department of Diagnostic and Public Health, University of Verona, P.le L. A. Scuro 10, 37134 Verona, Italy
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Marchese V, Beltrame A, Angheben A, Marocco S, Gaeta GB, Bisoffi Z. The impact of schistosomiasis co-infection in the presentation of viral hepatitis B in migrants: An observational study in non-endemic area. Travel Med Infect Dis 2019; 35:101467. [PMID: 31449881 DOI: 10.1016/j.tmaid.2019.101467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 06/30/2019] [Accepted: 08/22/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND In Europe, the prevalence rates of schistosomiasis and HBV infection in migrants from sub-Saharan Africa are high. The co-infection schistosomiasis-HBV has been scarcely studied. METHODS This is a retrospective study assessing differences in clinical presentation, laboratory and ultrasound findings in a cohort of migrants admitted at the Department of Infectious - Tropical Diseases and Microbiology IRCCS Sacro Cuore Don Calabria Hospital of Negrar (Northeast Italy) with schistosomiasis, HBV infection or both. RESULTS Of the 227 migrants, 175 (77.1%) with a diagnosis of schistosomiasis were classified as SCHISTO group, 35 (15.4%) with schistosomiasis and hepatitis B were classified as SCHISTO/HBV group, and 17 (7.5%) patients with a diagnosis of HBV infection were classified as HBV group. S. mansoni was found in 47 patients, classified in MANSONI (38/175, 21.7%) or MANSONI/HBV (9/35, 25.7%) group depending on HBsAg status. Mean transaminases and APRI index values were higher in SCHISTO/HBV compared to SCHISTO group (p < 0.01). AST differed between MANSONI/HBV and MANSONI group (p = 0.038). No differences were found between SCHISTO/HBV and HBV group. Eosinophil count and total IgE differed only between MANSONI/HBV and HBV group (p = 0,049). CONCLUSIONS Schistosomiasis seems not to increase the liver damage in people with HBV infection. Conversely, finding elevated transaminases in patients with schistosomiasis should alert for presence of HBV.
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Affiliation(s)
- Valentina Marchese
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024, Negrar, Italy; University Department of Infectious and Tropical Diseases & WHO Collaborating Centre for TB/HIV and TB Elimination, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Anna Beltrame
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024, Negrar, Italy.
| | - Andrea Angheben
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024, Negrar, Italy
| | - Stefania Marocco
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024, Negrar, Italy
| | - Giovanni Battista Gaeta
- Chair of Infectious Diseases, Campania University "Luigi Vanvitelli", Policlinico Via Pansini 5, 8031, Naples, Italy
| | - Zeno Bisoffi
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024, Negrar, Italy; Department of Diagnostics and Public Health, University of Verona, Piazzale L.A. Scuro, 37134, Verona, Italy
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Abstract
The increasing number of refugees, migrants and international travelers influences the surgical spectrum of abdominal diseases. The aim of this review is to familiarize surgeons with specific diseases which are endemic in the patients' countries of origin and are likely to be diagnosed with increasing incidence in Germany. Low levels of hygiene in the countries of origin or refugee camps is associated with a high incidence of numerous infections, such as helminth infections, typhoid fever or amoebiasis, which if untreated can cause surgical emergencies. Historically, some of them were common in Germany but have been more or less eradicated because of the high socioeconomic standard. Echinococcosis and Chagas disease are frequently treated surgically while schistosomiasis can mimic intestinal cancer. Abdominal tuberculosis presents in a variety of abdominal pathologies and frequently causes diagnostic uncertainty. Sigmoid volvulus has a very low incidence among Europeans, but is one of the most common abdominal surgical conditions of adults in endemic countries. The number of patients who eventually undergo surgery for these conditions might be relatively low; however, surgeons must be aware of them and consider them as differential diagnoses in refugees and migrants with acute or chronic abdominal symptoms.
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Affiliation(s)
- T J Wilhelm
- Chirurgische Klinik, Universitätsklinikum Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.
| | - S Post
- Chirurgische Klinik, Universitätsklinikum Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
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Alberer M, Malinowski S, Sanftenberg L, Schelling J. Notifiable infectious diseases in refugees and asylum seekers: experience from a major reception center in Munich, Germany. Infection 2018; 46:375-383. [PMID: 29616458 DOI: 10.1007/s15010-018-1134-4] [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: 10/11/2017] [Accepted: 03/16/2018] [Indexed: 01/05/2023]
Abstract
PURPOSE In 2016, the number of refugees worldwide reached 65.6 million. So far, only limited data are available on the health status of refugees and asylum seekers (RAs). Especially, notifiable infectious diseases (NIDs) carry the risk of outbreaks in communal accommodations hosting RAs. METHODS We conducted a monocentric retrolective cross-sectional study including 15,137 RAs treated in a special health care unit for RAs located in the major reception center in Munich from November 2014 to October 2016. Altogether 811 RAs with NIDs according to sections 6 and 7 of the German Infection Protection Act or with other infections relevant in the setting of a communal accommodation (RIDs) could be identified. RESULTS The gender and age distribution was generally comparable to that of refugees in Germany. However, patients from East Africa and Nigeria were significantly overrepresented. NIDs/RIDs were dominated by cases of tuberculosis, hepatitis B, and vaccine-preventable and parasitic diseases. Significant risk factors included country of origin (COI) and age for hepatitis B, age for hepatitis C, gender and age for HIV, and COI, gender and age for tuberculosis and ectoparasitosis. Calculated prevalences of hepatitis B, hepatitis C, and HIV were mostly below those of the COI. Incidences of tuberculosis were mostly strongly elevated. CONCLUSIONS COI, gender, and age have an impact on the occurrence of NIDs/RIDs. Early vaccinations and improved hygiene could be effective in preventing NIDs/RIDs in communal accommodations. Screening, prompt therapy, and infection protection measures are necessary to prevent the transmission of diseases.
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Affiliation(s)
- Martin Alberer
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the Ludwig-Maximilians-University (LMU), Munich, Germany.
| | - Svea Malinowski
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Linda Sanftenberg
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Jörg Schelling
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Munich, Germany
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