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Tuberculosis and Migrant Pathways in an Urban Setting: A Mixed-Method Case Study on a Treatment Centre in the Lisbon Metropolitan Area, Portugal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073834. [PMID: 35409517 PMCID: PMC8997607 DOI: 10.3390/ijerph19073834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 11/24/2022]
Abstract
Tuberculosis (TB) is an infectious disease associated with poverty. In the European Union TB tends to concentrate in urban settings. In Lisbon, previous studies revealed, the presence of migrant populations from a high endemic country, is one of the risk factors contributing to TB. To better understand TB in foreign-born individuals in the Lisbon Metropolitan Area, a mixed-method case study was undertaken on a TB treatment centre in a high-risk part of urban Portugal. Quantitatively, annual TB cases were analysed from 2008 to 2018, dividing foreign-origin cases into recent migrants and long-term migrants. Qualitatively, we explored recent migrants’ reasons, experiences and perceptions associated with the disease. Our results showed that foreign-born individuals accounted for 45.7% of cases, mainly originated from Angola, Guinea-Bissau, and Cabo Verde. TB in recent migrants increased over the years for Angola and Guinea-Bissau, while for Cabo Verde TB cases were due to migrants residing in Portugal for more than 2 years. Recent migrants’ reasons to travel to Portugal were to study, to live and work, tourism, and seeking better healthcare. Visiting family and friends, historical links and common language were key drivers for the choice of country. Recent migrants and long-term migrants may present distinct background profiles associated with diagnosed TB.
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Woldesemayat EM. Tuberculosis in Migrants is Among the Challenges of Tuberculosis Control in High-Income Countries. Risk Manag Healthc Policy 2021; 14:2965-2970. [PMID: 34285610 PMCID: PMC8285291 DOI: 10.2147/rmhp.s314777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/23/2021] [Indexed: 01/03/2023] Open
Abstract
The incidence of tuberculosis (TB) is high among migrants in high-income countries. The migration process could contribute to the high incidence of TB among them. Achieving TB elimination from these settings will be difficult unless countries address the burden of TB among migrants. The aim of this review was to describe the challenges of international migration on TB control in high-income, low TB incidence countries. Among migrants, there is a high prevalence of risk factors for TB, such as exposure to TB, HIV, malnutrition, substance use, delayed diagnosis, low education, poor health-seeking, the culture, stigma and marginalization. Discriminatory policies of TB care and social barriers such as language, cultural issues and unfriendly health services may also contribute to the high prevalence of TB among them. TB control among migrants in these settings is important as migrants are vulnerable to TB infection and disease, and implementing TB care among them is difficult; it is important to reduce the TB burden in migrants and the community at large and the high risk of multidrug-resistant TB (MDR-TB). TB elimination from high-income countries requires acquiring data and analyzing it to measure the burden, having migrant-sensitive health systems, having policy and legal frameworks and multi-country partnerships and conducting research.
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Arcêncio RA, Berra TZ, Terena NDFM, Rocha MP, Ferraz de Araújo Alecrim T, de Souza Kihara FM, Mascarello KC, Martins Sales CM, Maciel ELN. Spatial clustering and temporal trend analysis of international migrants diagnosed with tuberculosis in Brazil. PLoS One 2021; 16:e0252712. [PMID: 34106968 PMCID: PMC8189475 DOI: 10.1371/journal.pone.0252712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 05/20/2021] [Indexed: 11/18/2022] Open
Abstract
Background Tuberculosis (TB) in migrants is of concern to health authorities worldwide and is even more critical in Brazil, considering the country´s size and long land borders. The aim of the study was to identify critical areas in Brazil for migrants diagnosed with TB and to describe the temporal trend in this phenomenon in recent years. Methods This is an ecological study that used spatial analysis and time series analysis. As the study population, all cases of migrants diagnosed with TB from 2014 to 2019 were included, and Brazilian municipalities were considered as the unit of ecological analysis. The Getis-Ord Gi* technique was applied to identify critical areas, and based on the identified clusters, seasonal-trend decomposition based on loess (STL) and Prais-Winsten autoregression were used, respectively, to trace and classify temporal trend in the analyzed series. In addition, several municipal socioeconomic indicators were selected to verify the association between the identified clusters and social vulnerability. Results 2,471 TB cases were reported in migrants. Gi* analysis showed that areas with spatial association with TB in immigrants coincide with critical areas for TB in the general population (coast of the Southeast and North regions). Four TB clusters were identified in immigrants in the states of Amazonas, Roraima, São Paulo, and Rio de Janeiro, with an upward trend in most of these clusters. The temporal trend in TB in immigrants was classified as increasing in Brazil (+ 60.66% per year [95% CI: 27.21–91.85]) and in the clusters in the states of Amazonas, Roraima, and Rio de Janeiro (+1.01, +2.15, and + 2.90% per year, respectively). The cluster in the state of São Paulo was the only one classified as stationary. The descriptive data on the municipalities belonging to the clusters showed evidence of the association between TB incidence and conditions of social vulnerability. Conclusions The study revealed the critical situation of TB among migrants in the country. Based on the findings, health authorities might focus on actions in regions identified, stablishing an intensive monitoring and following up, ensuring that these cases concluded their treatment and avoiding that they could spread the disease to the other regions or scenarios. The population of migrants are very dynamic, therefore strategies for following up them across Brazil are really urgent to manage the tuberculosis among international migrants in an efficient and proper way.
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Affiliation(s)
- Ricardo Alexandre Arcêncio
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto School of Nursing, Ribeirão Preto, São Paulo, Brazil
- * E-mail:
| | - Thaís Zamboni Berra
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto School of Nursing, Ribeirão Preto, São Paulo, Brazil
| | | | - Matheus Piumbini Rocha
- Epidemiology Laboratory, Health Sciences Center, Universidade Federal do Espírito Santo, Vitoria, Brazil
| | | | | | - Keila Cristina Mascarello
- Department of Health Sciences, Centro Universitário Norte do Espírito Santo, Universidade Federal do Espírito Santo, Vitoria, Brazil
| | | | - Ethel Leonor Noia Maciel
- Epidemiology Laboratory, Health Sciences Center, Universidade Federal do Espírito Santo, Vitoria, Brazil
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Yu D, Li X, Gong J, Li J, Xie F, Hu J. Left-sided portal hypertension caused by peripancreatic lymph node tuberculosis misdiagnosed as pancreatic cancer: a case report and literature review. BMC Gastroenterol 2020; 20:276. [PMID: 32811429 PMCID: PMC7436982 DOI: 10.1186/s12876-020-01420-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/11/2020] [Indexed: 02/06/2023] Open
Abstract
Background Left-sided portal hypertension (LSPH) is an extremely rare clinical syndrome, and it is the only form of curable portal hypertension. It is primarily caused by pancreatic disease, and is associated with complications that cause spleen vein compression. Specific symptoms are often lacking, rendering it difficult to diagnose. Splenectomy is the main treatment for cases complicated by variceal bleeding, and the effects of treatment primarily depend on the condition of the primary disease. Case presentation The patient was a 29-year-old woman who was admitted to the hospital for repeated hematemesis and black stool. She had been misdiagnosed with pancreatic cancer 7 years prior. Combined imaging and endoscopic examination indicated varicose gastric fundus veins, a pancreatic mass, and enlarged peripancreatic lymph nodes. Laboratory investigations revealed reduced erythrocyte, platelet, and leukocyte counts, the interferon gamma release assay was positive, and liver function was normal. Abdominal exploration, splenectomy, varicose vein dissection, and lesion resection were performed via laparotomy. Postoperative biopsy analysis confirmed the diagnosis of lymph node tuberculosis. Based on the above-described factors, LSPH caused by peripancreatic lymph node tuberculosis was a diagnosed. Conclusions Herein we describe the first reported case of LSPH caused by peripancreatic lymph node tuberculosis. When left portal hypertension occurs simultaneously, peripancreatic lymph node tuberculosis is often misdiagnosed as pancreatic cancer. Further studies are necessary to develop a more favorable diagnostic method for pancreas masses and more advantageous therapy for LSPH, especially in cases caused by mechanical compression.
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Affiliation(s)
- Dajun Yu
- Department of General Surgery, Wushan County People's Hospital of Chongqing, Wushan, Chongqing, 404700, China
| | - Xiaolan Li
- Department of General Surgery, Wushan County People's Hospital of Chongqing, Wushan, Chongqing, 404700, China
| | - Jianping Gong
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China
| | - Jinzheng Li
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China
| | - Fei Xie
- Department of Hepatobiliary Surgery, The First People's Hospital of Neijiang, Neijiang, 64100, Sichuan, China
| | - Jiejun Hu
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China.
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Mondoni M, Centanni S, Sotgiu G. New perspectives on difficult-to-treat tuberculosis based on old therapeutic approaches. Int J Infect Dis 2020; 92S:S91-S99. [PMID: 32114204 DOI: 10.1016/j.ijid.2020.02.039] [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] [Received: 01/25/2020] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 12/11/2022] Open
Abstract
Tuberculosis (TB) is an important clinical and public health issue worldwide. Despite improved treatment success rates following the introduction of antibiotics in daily clinical practice, the expected decline in incidence has been hampered by HIV epidemics and multi- and extensively drug-resistant TB. During the pre-antibiotic era, TB therapies were mainly based on improving hygiene conditions, strengthening the immune system, and targeting the rest of the affected lungs with invasive techniques. Detailed knowledge of old non-pharmacological therapies might support physicians and researchers in the identification of new solutions for difficult-to-treat patients. We performed a narrative literature review on the main old therapeutic options prescribed for patients with TB. The main recommendations and contraindications of sanatorium therapies (i.e., bed rest, fresh air, sunlight) and pulmonary collapse techniques are reviewed, evaluating their physiological basis and their impact on patient outcomes. We report studies describing new interventional pulmonary and surgical techniques and assess new perspectives based on old medical and surgical treatments, whose potential implementation could help complicated patients.
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Affiliation(s)
- Michele Mondoni
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Stefano Centanni
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.
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Abd El Ghany M, Fouz N, Hill-Cawthorne GA. Human Movement and Transmission of Antimicrobial-Resistant Bacteria. THE HANDBOOK OF ENVIRONMENTAL CHEMISTRY 2020:311-344. [DOI: 10.1007/698_2020_560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Cannas A, Butera O, Gualano G, Parracino MP, Venditti C, Mazzarelli A, Palmieri F, Girardi E, Di Caro A. Multidrug-Resistant Tuberculosis In A Referral Center In Rome: 2011- 2016. Infect Drug Resist 2019; 12:3275-3281. [PMID: 31695446 PMCID: PMC6805241 DOI: 10.2147/idr.s218744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 08/12/2019] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Multidrug-resistant tuberculosis (MDR-TB) is a major burden to public health in low incidence countries in Europe. The aim of this study was to attempt to have a better insight into the trends of MDR-TB in the metropolitan area of Rome, within the Italian and the foreign-born population, based on microbiological and demographic data. PATIENTS AND METHODS We performed a prospective study, collecting microbiological data based on phenotypic drug-resistant testing (DST) of TB strains consecutively isolated in a referral hospital in Rome, the capital city of a low TB incidence country, over a 6-year period, and correlated them to the geographical origin of patients. This study was carried out in a referral hospital for patients with drug-resistant TB from the whole region. RESULTS Drug-resistance data from 926 patients with a microbiological diagnosis of TB from 2011 to 2016 show a 5.5% rate of MDR-TB, mostly occurring in patients born in a single East European country, that has a high incidence of MDR-TB. The strains isolated from these patients frequently carry additional resistances, leading to an increased risk of developing extensively drug-resistant (XDR) TB. CONCLUSION In the great metropolitan area of Rome, MDR-TB more frequently occurs in patients who were born in a single country from Eastern Europe known to have high rates of MDR-TB and long-time residents in Italy. Recent immigrants from non-European countries do not appear to contribute to the rates of MDR-TB reported in this article. This knowledge of local TB trends could help improve the measures of surveillance and prevention of disease.
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Affiliation(s)
- A Cannas
- Microbiology and Bio-Repository Unit, National Institute for Infectious Diseases “L. Spallanzani” IRCCS, Rome, Italy
| | - O Butera
- Microbiology and Bio-Repository Unit, National Institute for Infectious Diseases “L. Spallanzani” IRCCS, Rome, Italy
| | - G Gualano
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases “L. Spallanzani” IRCCS, Rome, Italy
| | - MP Parracino
- Clinical Epidemiology Unit, National Institute for Infectious Diseases “L. Spallanzani” IRCCS, Rome, Italy
| | - C Venditti
- Microbiology and Bio-Repository Unit, National Institute for Infectious Diseases “L. Spallanzani” IRCCS, Rome, Italy
| | - A Mazzarelli
- Microbiology and Bio-Repository Unit, National Institute for Infectious Diseases “L. Spallanzani” IRCCS, Rome, Italy
| | - F Palmieri
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases “L. Spallanzani” IRCCS, Rome, Italy
| | - E Girardi
- Clinical Epidemiology Unit, National Institute for Infectious Diseases “L. Spallanzani” IRCCS, Rome, Italy
| | - A Di Caro
- Microbiology and Bio-Repository Unit, National Institute for Infectious Diseases “L. Spallanzani” IRCCS, Rome, Italy
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Séraphin MN, Hsu H, Chapman HJ, de Andrade Bezerra JL, Johnston L, Yang Y, Lauzardo M. Timing of treatment interruption among latently infected tuberculosis cases treated with a nine-month course of daily isoniazid: findings from a time to event analysis. BMC Public Health 2019; 19:1214. [PMID: 31481046 PMCID: PMC6724263 DOI: 10.1186/s12889-019-7524-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 08/21/2019] [Indexed: 12/05/2022] Open
Abstract
Background Treatment of latent tuberculosis infection (LTBI) in high-risk groups is an effective strategy for TB control and elimination in low incidence settings. A nine-month course of daily isoniazid (INH) has been the longest prescribed therapy; however, completion rates are suboptimal. We need data to guide TB program outreach efforts to optimize LTBI treatment completion rates. Methods We pooled seven (2009–2015) years of LTBI treatment outcome data. We computed the probability of INH treatment disruption over time by patient demographic and clinical risk factors. We used log-rank tests and Cox proportional hazards models to assess the risk factors for treatment disruption. Results We analyzed data from 12,495 persons with complete data on INH treatment initiation. Pediatric cases (0–17 years), recent contacts of active TB patients, and non-U.S.-born adults living in the United States ≤5 years represented 25.2, 13.0, and 59.2% of the study population, respectively. Overall, 48.4% failed to complete therapy. The median treatment duration was 306 days (95% CI: 297, 315). A significant drop in adherence could be observed around day 30 of treatment initiation. Indeed, by day 30 of treatment, 17.0% (95% CI: 16.4, 17.7) of patients had defaulted on therapy. Pediatric patients (HR = 0.83, 95% CI: 0.78, 0.89), recent contacts (HR = 0.74, 95% CI: 0.68, 0.81), patients with diabetes (HR = 0.77, 95% CI: 0.60, 0.98), and patients with HIV (HR = 0.39, 95% CI: 0.30, 0.51) had a lower risk of treatment default. However, black patients (HR = 1.57, 95% CI: 1.44, 1.70), Hispanic patients (HR = 1.54, 95% CI: 1.43, 1.66), and non-U.S.-born persons living in the United States ≤5 years (HR = 1.25, 95% CI: 1.18, 1.32) were significantly more likely to default on therapy. Conclusions In this analysis of INH treatment outcome, we see high levels of treatment discontinuation. On average, patients defaulted on their prescribed nine-month daily INH therapy within 30 days of initiating treatment, and those at increased risk of progression to active disease were most likely to do so. We highlight the need to introduce patient-centered programs to increase treatment adherence in this population. Electronic supplementary material The online version of this article (10.1186/s12889-019-7524-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marie Nancy Séraphin
- Division of Infectious Diseases and Global Medicine, Department of Medicine, University of Florida, 2055 Mowry Road, Suite 250, Gainesville, FL, 32611, USA. .,Emerging Pathogens Institute, University of Florida, 2055 Mowry Road, Gainesville, FL, 32610, USA.
| | - HsiaoChu Hsu
- Division of Infectious Diseases and Global Medicine, Department of Medicine, University of Florida, 2055 Mowry Road, Suite 250, Gainesville, FL, 32611, USA.,Emerging Pathogens Institute, University of Florida, 2055 Mowry Road, Gainesville, FL, 32610, USA
| | - Helena J Chapman
- Division of Infectious Diseases and Global Medicine, Department of Medicine, University of Florida, 2055 Mowry Road, Suite 250, Gainesville, FL, 32611, USA.,Emerging Pathogens Institute, University of Florida, 2055 Mowry Road, Gainesville, FL, 32610, USA
| | - Joanne L de Andrade Bezerra
- Division of Infectious Diseases and Global Medicine, Department of Medicine, University of Florida, 2055 Mowry Road, Suite 250, Gainesville, FL, 32611, USA.,Emerging Pathogens Institute, University of Florida, 2055 Mowry Road, Gainesville, FL, 32610, USA
| | - Lori Johnston
- Bureau of Communicable Diseases, Tuberculosis Control Section, Florida Department of Health, 4052 Bald Cypress Way, Tallahassee, FL, 32399, USA
| | - Yang Yang
- Emerging Pathogens Institute, University of Florida, 2055 Mowry Road, Gainesville, FL, 32610, USA.,Department of Biostatistics, College of Public Health and Health Professions, University of Florida, 2055 Mowry Road, suite 250, Gainesville, FL, 32610, USA
| | - Michael Lauzardo
- Division of Infectious Diseases and Global Medicine, Department of Medicine, University of Florida, 2055 Mowry Road, Suite 250, Gainesville, FL, 32611, USA.,Emerging Pathogens Institute, University of Florida, 2055 Mowry Road, Gainesville, FL, 32610, USA
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Villa S, Codecasa LR, Faccini M, Pontello MM, Ferrarese M, Castellotti PF, Senatore S, Lamberti A, Mazzola E, Perno CF, Campisi D, Saporiti M, Raviglione MC. Tuberculosis among asylum seekers in Milan, Italy: epidemiological analysis and evaluation of interventions. Eur Respir J 2019; 54:13993003.00896-2019. [DOI: 10.1183/13993003.00896-2019] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 07/25/2019] [Indexed: 12/13/2022]
Abstract
In countries of the European Union, tuberculosis (TB) mainly affects marginalised people, including asylum seekers. Migratory flows from high-incidence countries to Italy have increased up to 2017, posing challenges to the national health system. This study sought to assess TB and latent TB infection (LTBI) prevalence among asylum seekers in Milan during the biennium 2016–2017 and to evaluate interventions in place.A two-level active surveillance and screening system was developed for both TB and LTBI. Asylum seekers underwent an initial screening with a tuberculin skin test (TST) and a questionnaire at the receiving sites. At the Regional TB Reference Centre, those with a positive result underwent chest radiography. People aged <35 years with negative chest radiography results underwent further testing by interferon-γ release assay. If results of the assay were positive, LTBI treatment was offered. TB and LTBI prevalence were compared with literature data.A total of 5324 asylum seekers, mostly young (10–39 years; 98%), male (84%) and from sub-Saharan Africa (69%), were enrolled in the study. 69 active TB cases were diagnosed and 863 LTBI-positive individuals were detected. TB prevalence was high (1236 per 100 000 population) and LTBI prevalence was 28%. Despite losses (41%) during the transition from initial screening sites and the diagnostic centre, a good TB cure rate (84%) and optimal LTBI treatment completion (94%) were achieved.Our study shows that TB incidence is high among asylum seekers in Milan and that well-coordinated screening measures are critical for early diagnosis and treatment. It also proves that rolling out successful at-scale interventions for both prophylaxis and disease management is feasible.
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Liu L, Zhong Y, Ao S, Wu H. Exploring the Relevance of Green Space and Epidemic Diseases Based on Panel Data in China from 2007 to 2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2551. [PMID: 31319532 PMCID: PMC6679052 DOI: 10.3390/ijerph16142551] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/13/2019] [Accepted: 07/15/2019] [Indexed: 12/12/2022]
Abstract
Urban green space has been proven effective in improving public health in the contemporary background of planetary urbanization. There is a growing body of literature investigating the relationship between non-communicable diseases (NCDs) and green space, whereas seldom has the correlation been explored between green space and epidemics, such as dysentery, tuberculosis, and malaria, which still threaten the worldwide situation of public health. Meanwhile, most studies explored healthy issues with the general green space, public green space, and green space coverage, respectively, among which the different relevance has been rarely explored. This study aimed to examine and compare the relevance between these three kinds of green space and incidences of the three types of epidemic diseases based on the Panel Data Model (PDM) with the time series data of 31 Chinese provinces from 2007 to 2016. The results indicated that there exists different, or even opposite, relevance between various kinds of green space and epidemic diseases, which might be associated with the process of urban sprawl in rapid urbanization in China. This paper provides a reference for re-thinking the indices of green space in building healthier and greener cities.
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Affiliation(s)
- Lingbo Liu
- Department of Urban Planning, School of Urban Design, Wuhan University, Wuhan 430072, China
| | - Yuni Zhong
- Department of Urban Planning, School of Urban Design, Wuhan University, Wuhan 430072, China
| | - Siya Ao
- Department of Graphics and Digital Technology, School of Urban Design, Wuhan University, Wuhan 430072, China.
| | - Hao Wu
- Department of Graphics and Digital Technology, School of Urban Design, Wuhan University, Wuhan 430072, China
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Migliori GB, Centis R, D'Ambrosio L, Silva DR, Rendon A. International collaboration among medical societies is an effective way to boost Latin American production of articles on tuberculosis. ACTA ACUST UNITED AC 2019; 45:e20180420. [PMID: 31038653 PMCID: PMC6733746 DOI: 10.1590/1806-3713/e20180420] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 01/10/2019] [Indexed: 01/02/2023]
Abstract
Objective: Most studies of tuberculosis originate from high-income countries with a low incidence of tuberculosis. A review of the scientific production on tuberculosis in Latin American countries, most of which are low- or middle-income countries (some with high or intermediate tuberculosis incidence rates), would improve the understanding of public health challenges, clinical needs, and research priorities. The aims of this systematic review were to determine what has been published recently in Latin America, to identify the leading authors involved, and to quantify the impact of international collaborations. Methods: We used PubMed to identify relevant manuscripts on pulmonary tuberculosis (PTB), drug-resistant tuberculosis (DR-TB), or multidrug-resistant tuberculosis (MDR-TB), published between 2013 and 2018. We selected only studies conducted in countries with an annual tuberculosis incidence of ≥ 10,000 reported cases and an annual MDR-TB incidence of ≥ 300 estimated cases, including Brazil, Peru, Mexico, Colombia, and Argentina. Articles were stratified by country, type, and topic. Results: We identified as eligible 395 studies on PTB and 188 studies on DR/MDR-TB-of which 96.4% and 96.8%, respectively, were original studies; 35.5% and 32.4%, respectively, had an epidemiological focus; and 52.7% and 36.2%, respectively, were conducted in Brazil. The recent Latin American Thoracic Association/European Respiratory Society/Brazilian Thoracic Association collaborative project boosted the production of high-quality articles on PTB and DR/MDR-TB in Latin America. Conclusions: Most of the recent Latin American studies on tuberculosis were conducted in Brazil, Mexico, or Peru. Collaboration among medical societies facilitates the production of scientific papers on tuberculosis. Such initiatives are in support of the World Health Organization call for intensified research and innovation in tuberculosis.
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Affiliation(s)
- Giovanni Battista Migliori
- . Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri - IRCCS - Tradate, Italia
| | - Rosella Centis
- . Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri - IRCCS - Tradate, Italia
| | | | - Denise Rossato Silva
- . Faculdade de Medicina, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre (RS) Brasil
| | - Adrian Rendon
- . Centro de Investigación, Prevención y Tratamiento de Infecciones Respiratorias - CIPTIR - Hospital Universitario de Monterrey, Universidad Autónoma de Nuevo León -UANL - Monterrey, México
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Diaw MM, Ndiaye M, Riccardi N, Ungaro R, Alagna R, Cirillo DM, Codecasa L, Viscoli C, Nicolini LA, Besozzi G. Implementing TB control in a rural, resource-limited setting: the stop-TB Italia project in Senegal. Multidiscip Respir Med 2018; 13:41. [PMID: 30455883 PMCID: PMC6225657 DOI: 10.1186/s40248-018-0154-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 10/09/2018] [Indexed: 11/10/2022] Open
Abstract
Background Since 2013 StopTB Italia Onlus supports the Senegalese National Tuberculosis Programme by improving diagnostic capability with technological interventions, ameliorating educational programs for health care personnel, rising awareness among civil society and providing economical support for patients during treatment. The purpose of our study was to assess the preliminary results of an interventional cooperation project in a peripheral health care facility in Senegal. Methods An observational, retrospective, pre-post study was conducted to compare Tuberculosis (TB) retention in care and outcome between a one-year period before and a four-year period after. Results Overall, 239 patients with active TB were included, 196 (82%) of whom after the starting of the collaboration project. At diagnosis 35/43(81.4%) vs 151/196 (77%) patients were smear sputum positive before and after the beginning of the project, respectively.At 2 months follow up 23/35 (65.7%) patients in 2012 vs. 139/151 (92%) patients in 2013-2016 had negative control AFB stain (p = 0.249), 4/35 (11.4%) vs 12/151 (8%) patients remained AFB stain positive (p = 0.17), 7/35 (20%) vs 0/151 died before the 2 months follow up (p < 0.0001). TB treatment outcome was more frequently favourable after the beginning of cooperation 29/43 (67.4%) vs. 176/196 (89.8%) patients, (p < 0.0001). Patients' mortality during treatment decreased from 8/43 (18.6%) in 2012 to 11/196 (5.6%) patients in the following years (p = 0.009). Conclusion The implementation of diagnostic procedures, if integrated in a socio-economical intervention, impacts favourably on TB retention in care and treatment outcomes.
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Affiliation(s)
- Mama Moussa Diaw
- Médecin coordonnateur lutte contre la TB, Région médicale de Thiès, Thiès, Sénégal.,Bureau Régional Immunisation et Surveillance Epidemiologique de Thiès, Avenue Malick SY prolongée BP 34A, Thiès, RP Sénégal
| | - Mamoudou Ndiaye
- District Sanitaire de Diofior/Département de Fatick, Diofior, Sénégal
| | - Niccolò Riccardi
- 3Infectious Diseases Clinic, Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
| | - Riccardo Ungaro
- 3Infectious Diseases Clinic, Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
| | - Riccardo Alagna
- 4TB Supranational Reference Laboratory, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Daniela Maria Cirillo
- 4TB Supranational Reference Laboratory, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Luigi Codecasa
- 5Regional TB Reference Centre, Villa Marelli Institute/ASST Niguarda Ca' Granda, Milan, Italy
| | - Claudio Viscoli
- 3Infectious Diseases Clinic, Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
| | - Laura Ambra Nicolini
- 3Infectious Diseases Clinic, Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
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13
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Haemoptysis and fever in a young refugee from Somalia. Int J Infect Dis 2018; 77:57-60. [PMID: 30315989 DOI: 10.1016/j.ijid.2018.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 10/02/2018] [Accepted: 10/04/2018] [Indexed: 12/31/2022] Open
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14
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Sweileh WM, Wickramage K, Pottie K, Hui C, Roberts B, Sawalha AF, Zyoud SH. Bibliometric analysis of global migration health research in peer-reviewed literature (2000-2016). BMC Public Health 2018; 18:777. [PMID: 29925353 PMCID: PMC6011263 DOI: 10.1186/s12889-018-5689-x] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 06/11/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The health of migrants has become an important issue in global health and foreign policy. Assessing the current status of research activity and identifying gaps in global migration health (GMH) is an important step in mapping the evidence-base and on advocating health needs of migrants and mobile populations. The aim of this study was to analyze globally published peer-reviewed literature in GMH. METHODS A bibliometric analysis methodology was used. The Scopus database was used to retrieve documents in peer-reviewed journals in GMH for the study period from 2000 to 2016. A group of experts in GMH developed the needed keywords and validated the final search strategy. RESULTS The number of retrieved documents was 21,457. Approximately one third (6878; 32.1%) of the retrieved documents were published in the last three years of the study period. In total, 5451 (25.4%) documents were about refugees and asylum seekers, while 1328 (6.2%) were about migrant workers, 440 (2.1%) were about international students, 679 (3.2%) were about victims of human trafficking/smuggling, 26 (0.1%) were about patients' mobility across international borders, and the remaining documents were about unspecified categories of migrants. The majority of the retrieved documents (10,086; 47.0%) were in psychosocial and mental health domain, while 2945 (13.7%) documents were in infectious diseases, 6819 (31.8%) documents were in health policy and systems, 2759 (12.8%) documents were in maternal and reproductive health, and 1918 (8.9%) were in non-communicable diseases. The contribution of authors and institutions in Asian countries, Latin America, Africa, Middle East, and Eastern European countries was low. Literature in GMH represents the perspectives of high-income migrant destination countries. CONCLUSION Our heat map of research output shows that despite the ever-growing prominence of human mobility across the globe, and Sustainable Development Goals of leaving no one behind, research output on migrants' health is not consistent with the global migration pattern. A stronger evidence base is needed to enable authorities to make evidence-informed decisions on migration health policy and practice. Research collaboration and networks should be encouraged to prioritize research in GMH.
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Affiliation(s)
- Waleed M. Sweileh
- College of Medicine and Health Science, An-Najah National University, Nablus, Palestine
| | - Kolitha Wickramage
- International Organization for Migration, UN Migration Agency, Migration Health Division, Geneva, Switzerland
| | - Kevin Pottie
- Faculty of Medicine, University of Ottawa, Ottawa, CA Canada
| | - Charles Hui
- Faculty of Medicine, University of Ottawa, Ottawa, CA Canada
| | - Bayard Roberts
- London School of Hygiene and Tropical Medicine, London, UK
| | - Ansam F. Sawalha
- College of Medicine and Health Science, An-Najah National University, Nablus, Palestine
| | - Saed H. Zyoud
- College of Medicine and Health Science, An-Najah National University, Nablus, Palestine
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15
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Rendon A, Centis R, Zellweger JP, Solovic I, Torres-Duque C, Robalo Cordeiro C, de Queiroz Mello F, Manissero D, Sotgiu G. Migration, TB control and elimination: Whom to screen and treat. Pulmonology 2018; 24:99-105. [DOI: 10.1016/j.rppnen.2017.11.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 11/27/2017] [Indexed: 01/09/2023] Open
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16
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Olaru ID, Van Den Broucke S, Rosser AJ, Salzer HJF, Woltmann G, Bottieau E, Lange C. Pulmonary Diseases in Refugees and Migrants in Europe. Respiration 2018; 95:273-286. [PMID: 29414830 DOI: 10.1159/000486451] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 12/20/2017] [Indexed: 12/18/2022] Open
Abstract
More than 2 million people fleeing conflict, persecution, and poverty applied for asylum between 2015 and 2016 in the European Union. Due to this, medical practitioners in recipient countries may be facing a broader spectrum of conditions and unusual presentations not previously encountered, including a wide range of infections with pulmonary involvement. Tuberculosis is known to be more common in migrants and has been covered broadly in other publications. The scope of this review was to provide an overview of exotic infections with pulmonary involvement that could be encountered in refugees and migrants and to briefly describe their epidemiology, diagnosis, and management. As refugees and migrants travel from numerous countries and continents, it is important to be aware of the various organisms that might cause disease according to the country of origin. Some of these diseases are very rare and geographically restricted to certain regions, while others have a more cosmopolitan distribution. Also, the spectrum of severity of these infections can vary from very benign to severe and even life-threatening. We will also describe infectious and noninfectious complications that can be associated with HIV infection as some migrants might originate from high HIV prevalence countries in sub-Saharan Africa. As the diagnosis and treatment of these diseases can be challenging in certain situations, patients with suspected infection might require referral to specialized centers with experience in their management. Additionally, a brief description of noncommunicable pulmonary diseases will be provided.
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Affiliation(s)
- Ioana D Olaru
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Andrew J Rosser
- Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Helmut J F Salzer
- Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany
| | - Gerrit Woltmann
- Respiratory Biomedical Research Centre, Institute for Lung Health, Department of Infection Immunity and Inflammation, University of Leicester, Leicester, United Kingdom
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Christoph Lange
- Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany.,International Health/Infectious Diseases, University of Lübeck, Lübeck, Germany.,Department of Medicine, Karolinska Institute, Stockholm, Sweden
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17
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Riccardi N, Giannini B, Borghesi ML, Taramasso L, Cattaneo E, Cenderello G, Toscanini F, Giacomini M, Pontali E, Cassola G, Viscoli C, Di Biagio A. Time to change the single-centre approach to management of patients with tuberculosis: a novel network platform with automatic data import and data sharing. ERJ Open Res 2018; 4:00108-2017. [PMID: 29410957 PMCID: PMC5795190 DOI: 10.1183/23120541.00108-2017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 12/07/2017] [Indexed: 12/22/2022] Open
Abstract
Time to change the single-centre approach to TB http://ow.ly/lCeM30hBcbB.
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Affiliation(s)
- Niccolò Riccardi
- University of Genoa, Genoa, Italy.,Dept of Infectious Diseases, Ospedale Policlinico San Martino, Genoa, Italy
| | - Barbara Giannini
- Dept of Informatics, Bioengineering, Robotics and System Engineering (DIBRIS), University of Genoa, Genoa, Italy
| | - Maria Lucia Borghesi
- University of Genoa, Genoa, Italy.,Dept of Infectious Diseases, Ospedale Policlinico San Martino, Genoa, Italy
| | - Lucia Taramasso
- University of Genoa, Genoa, Italy.,Dept of Infectious Diseases, Ospedale Policlinico San Martino, Genoa, Italy
| | - Elena Cattaneo
- University of Genoa, Genoa, Italy.,Dept of Infectious Diseases, Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Federica Toscanini
- Clinic of Infectious Diseases, Ospedale Policlinico San Martino, Genoa, Italy
| | - Mauro Giacomini
- Dept of Informatics, Bioengineering, Robotics and System Engineering (DIBRIS), University of Genoa, Genoa, Italy.,Infectious Diseases, Ospedali Galliera, Genoa, Italy.,Clinic of Infectious Diseases, Ospedale Policlinico San Martino, Genoa, Italy.,Healthropy, Savona, Italy
| | | | | | - Claudio Viscoli
- University of Genoa, Genoa, Italy.,Dept of Infectious Diseases, Ospedale Policlinico San Martino, Genoa, Italy.,Clinic of Infectious Diseases, Ospedale Policlinico San Martino, Genoa, Italy
| | - Antonio Di Biagio
- Clinic of Infectious Diseases, Ospedale Policlinico San Martino, Genoa, Italy
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18
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Ankrah AO, Glaudemans AWJM, Maes A, Van de Wiele C, Dierckx RAJO, Vorster M, Sathekge MM. Tuberculosis. Semin Nucl Med 2017; 48:108-130. [PMID: 29452616 DOI: 10.1053/j.semnuclmed.2017.10.005] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Tuberculosis (TB) is currently the world's leading cause of infectious mortality. Imaging plays an important role in the management of this disease. The complex immune response of the human body to Mycobacterium tuberculosis results in a wide array of clinical manifestations, making clinical and radiological diagnosis challenging. 18F-FDG-PET/CT is very sensitive in the early detection of TB in most parts of the body; however, the lack of specificity is a major limitation. 18F-FDG-PET/CT images the whole body and provides a pre-therapeutic metabolic map of the infection, enabling clinicians to accurately assess the burden of disease. It enables the most appropriate site of biopsy to be selected, stages the infection, and detects disease in previously unknown sites. 18F-FDG-PET/CT has recently been shown to be able to identify a subset of patients with latent TB infection who have subclinical disease. Lung inflammation as detected by 18F-FDG-PET/CT has shown promising signs that it may be a useful predictor of progression from latent to active infection. A number of studies have identified imaging features that might improve the specificity of 18F-FDG-PET/CT at some sites of extrapulmonary TB. Other PET tracers have also been investigated for their use in TB, with some promising results. The potential role and future perspectives of PET/CT in imaging TB is considered. Literature abounds on the very important role of 18F-FDG-PET/CT in assessing therapy response in TB. The use of 18F-FDG for monitoring response to treatment is addressed in a separate review.
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Affiliation(s)
- Alfred O Ankrah
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, South Africa; Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Alex Maes
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, South Africa; Department of Nuclear Medicine, AZ Groeninge, Kortrijk, Belgium; Department of Morphology and Medical Imaging, University Hospital Leuven, Leuven, Belgium
| | - Christophe Van de Wiele
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, South Africa; Department of Nuclear Medicine and Radiology, University of Ghent, Ghent, Belgium
| | - Rudi A J O Dierckx
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
| | - Mariza Vorster
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, South Africa
| | - Mike M Sathekge
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, South Africa.
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Maltezou HC, Elhadad D, Glikman D. Monitoring and managing antibiotic resistance in refugee children. Expert Rev Anti Infect Ther 2017; 15:1015-1025. [PMID: 29027495 DOI: 10.1080/14787210.2017.1392853] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The past decade the Middle East and Southeastern Europe have witnessed an enormous movement of refugees due to the Syrian war and conflicts in Asia and Africa. Although carriage of and infections with multi-drug resistant (MDR) pathogens in refugees have been reported, pediatric data are scarce. Areas covered: MDR bacterial carriage and infections, and MDR-tuberculosis (TB) in refugee children from 2010. Expert commentary: High MDR carriage rates in refugee children are attributed to high pre-civil war MDR rates, war-damaged infrastructure and healthcare systems, and poor hygiene conditions. Currently there are no international guidelines about MDR screening in refugee children. Given the medical importance of MDRs, challenging therapeutics and risk of importation in non/low-endemic countries, we recommend routine screening and contact isolation upon hospitalization of refugees. TB, including MDR-TB, is highly-endemic in many Asian and African countries, however, current data in refugee children are lacking. TB Screening in refugees is widely implemented but there is no consensus on methods and target populations. Coordinated TB detection and treatment, use of rapid molecular tests and drug-susceptibility testing, better access to healthcare, cross border TB care collaboration, and protection from deportation while on treatment should be integrated parts of TB control and prevention.
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Affiliation(s)
- Helena C Maltezou
- a Department for Interventions in Health Care Facilities , Hellenic Center for Disease Control and Prevention , Athens , Greece
| | - Dana Elhadad
- b The Faculty of Medicine in the Galilee , Bar-Ilan University , Safed , Israel
| | - Daniel Glikman
- b The Faculty of Medicine in the Galilee , Bar-Ilan University , Safed , Israel.,c Pediatric Infectious Diseases Unit , Galilee Medical Center , Nahariya , Israel
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20
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Migrant health—a cause for concern? Clin Microbiol Infect 2017; 23:281-282. [DOI: 10.1016/j.cmi.2017.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 04/15/2017] [Indexed: 12/30/2022]
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