1
|
Hsu SL, Fan CK. Emerging and Reemerging Parasitic Diseases in Taiwan: A Retrospective Study of Clinical Case Reports in 2001~2018. Pathogens 2024; 13:383. [PMID: 38787235 PMCID: PMC11124076 DOI: 10.3390/pathogens13050383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/30/2024] [Accepted: 05/02/2024] [Indexed: 05/25/2024] Open
Abstract
Emerging and re-emerging parasitic diseases can cause significant economic burdens at national and global levels. However, governments often underestimate or ignore these diseases, especially in developed countries. This retrospective, case-oriented study analyzed parasitic diseases reported in Taiwan between 2001 and 2018. One hundred and thirty-two eligible clinical profiles of Taiwanese patients obtained from the NCBI, Scopus, Google Scholar, and Web of Science databases and local journals according to age, sex, source of infection, symptoms, risk factors, and geographical regions were analyzed. The analysis results showed that the number/frequency of cases caused by nematodes (46.97%) or protozoa (37.88%) was significantly higher than that of trematodes (9.85%) or cestodes (5.30%) (p < 0.0001). Northern Taiwan (46.97%) had a significantly higher rate than Southern Taiwan (33.33%), Central Taiwan (8.33%), and Eastern Taiwan (5.30%) (p < 0.05). The 15-65 age group (68.94%) had a significantly higher rate than the 65-90 age group (22.73%) and the 0-15 age group (8.33%) (p < 0.0001). Males (70.46%) had a significantly higher number/frequency of cases than females (29.54%) (p < 0.0001). People who acquired the infection through the food/soil route (32.58%) or who had a low immune status (32.58%) had a higher rate than travel-related infections (15.15%) (p < 0.001). The present study showed that emerging/reemerging parasitic infections continue to be of great concern to the lives and health of Taiwanese citizens and, if ignored, will threaten the health of the Taiwanese people; therefore, the delineation of preventive measures by health authorities is urgently warranted.
Collapse
Affiliation(s)
- Shao-Lun Hsu
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan;
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Congenital Aniridia Research, Saarland University, 66421 Homburg, Germany
- Department of Ophthalmology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Chia-Kwung Fan
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan;
- Research Center of International Tropical Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, No. 111, Section 3, Xinglong Road, Wen-Shan District, Taipei 11696, Taiwan
| |
Collapse
|
2
|
Arsuaga M, De Miguel Buckley R, De La Calle-Prieto F, Díaz-Menéndez M. Imported infectious diseases in migrants from Latin America: A retrospective study from a referral centre for tropical diseases in Spain, 2017-2022. Travel Med Infect Dis 2024; 59:102708. [PMID: 38467231 DOI: 10.1016/j.tmaid.2024.102708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/22/2023] [Accepted: 03/03/2024] [Indexed: 03/13/2024]
Abstract
INTRODUCTION Detecting imported diseases by migrants and individuals visiting friends and relatives (VFR) is key in the prevention and management of emergent infectious diseases acquired abroad. METHODS Retrospective descriptive study on migrants and VFR from Central and South America between 2017 and 2022 attended at a National Referral Centre for Tropical Diseases in Madrid, Spain. Demographic characteristics, syndromes and confirmed travel-related diagnoses were obtained from hospital patient medical records. RESULTS 1654 cases were registered, median age of 42 years, 69.1% were female, and 55.2% were migrants. Most cases came from Bolivia (49.6%), followed by Ecuador (12.9%). Health screening while asymptomatic (31.6%) was the main reason for consultation, followed by Chagas disease follow-up (31%). Of those asymptomatic at screening, 47,2% were finally diagnosed of any disease, mainly Chagas disease (19,7%) and strongyloidiasis (10,2%) CONCLUSION: Our study emphasizes the importance of proactive health screening to detect asymptomatic conditions in migrants and VFR, enabling timely intervention and improved health outcomes. By understanding the unique health profiles of immigrant populations, targeted public health interventions can be devised to safeguard the well-being of these vulnerable groups.
Collapse
Affiliation(s)
- Marta Arsuaga
- National Referral Unit for Imported Tropical Diseases, Tropical and Travel Medicine Unit, Hospital La Paz- Carlos III, Calle Sinesio Delgado, 10, 28029, Madrid, Spain; CIBERINFEC, Spain.
| | - Rosa De Miguel Buckley
- National Referral Unit for Imported Tropical Diseases, Tropical and Travel Medicine Unit, Hospital La Paz- Carlos III, Calle Sinesio Delgado, 10, 28029, Madrid, Spain; CIBERINFEC, Spain
| | - Fernando De La Calle-Prieto
- National Referral Unit for Imported Tropical Diseases, Tropical and Travel Medicine Unit, Hospital La Paz- Carlos III, Calle Sinesio Delgado, 10, 28029, Madrid, Spain; CIBERINFEC, Spain
| | - Marta Díaz-Menéndez
- National Referral Unit for Imported Tropical Diseases, Tropical and Travel Medicine Unit, Hospital La Paz- Carlos III, Calle Sinesio Delgado, 10, 28029, Madrid, Spain; CIBERINFEC, Spain
| |
Collapse
|
3
|
Marrone R, Mazzi C, Ouattara H, Cammilli M, Pontillo D, Perandin F, Bisoffi Z. Screening for Neglected Tropical Diseases and other infections in African refugees and asylum seekers in Rome and Lazio region, Italy. Travel Med Infect Dis 2023; 56:102649. [PMID: 37820947 DOI: 10.1016/j.tmaid.2023.102649] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/03/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Few reliable data are available on Neglected Tropical Diseases (NTDs) and other infections among African refugees and asylum seekers in Italy. We aimed to estimate the prevalence of NTDs and other infections in a large cohort of African refugees and asylum seekers living in reception centers in Lazio, Italy. MATERIAL AND METHODS This is an observational, prospective prevalence study on infectious diseases in a large population of African refugees and asylum seekers (936 overall) consecutively enrolled for screening purpose at the Infectious and Tropical diseases outpatient clinic of the National Institute of Migrant and Poverty (INMP), Rome from August 2019 to December 2020. RESULTS We found a prevalence of 8.8 % and 31 % for Strongyloides and schistosoma infection, respectively, while the prevalence of human immunodeficiency virus (HIV) infection was 0.7 %, HCV antibodies 2.5%, hepatitis B virus surface antigen 10.8 % and syphilis serological tests 2.9 %. CONCLUSION Strongyloidiasis and schistosomiasis are highly prevalent among African refugees and asylum seekers in Italy, in contrast to communicable diseases (with the exception of hepatitis B). Raising awareness of NTDs among health professionals and implementing guidelines seems to be of paramount importance to prevent these diseases and their sufferers from becoming even more "neglected".
Collapse
Affiliation(s)
- R Marrone
- National Institute for Health, Migration and Poverty, 00153 Roma, Italy.
| | - C Mazzi
- Department of Infectious -Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, 37024 Verona, Italy.
| | - H Ouattara
- National Institute for Health, Migration and Poverty, 00153 Roma, Italy.
| | - M Cammilli
- National Institute for Health, Migration and Poverty, 00153 Roma, Italy.
| | - D Pontillo
- Department of Infectious -Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, 37024 Verona, Italy.
| | - F Perandin
- Department of Infectious -Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, 37024 Verona, Italy.
| | - Z Bisoffi
- Department of Infectious -Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, 37024 Verona, Italy.
| |
Collapse
|
4
|
Ghazy RM, Hammad EM, Hall MA, Mahboob A, Zeina S, Elbanna EH, Fadl N, Abdelmoneim SA, ElMakhzangy R, Hammad HM, Suliman AH, Atia HHA, Rao N, Abosheaishaa H, Elrewany E, Hassaan MA, Hammouda EA, Hussein M. How can imported monkeypox break the borders? A rapid systematic review. Comp Immunol Microbiol Infect Dis 2023; 92:101923. [PMID: 36521366 PMCID: PMC9716240 DOI: 10.1016/j.cimid.2022.101923] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 11/20/2022] [Accepted: 11/25/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Monkeypox was designated as an emerging illness in 2018 by the World Health Organization Research and Development Blueprint, necessitating expedited research, development, and public health action. In this review, we aim to shed the light on the imported cases of monkeypox in attempt to prevent the further spread of the disease. Methodology An electronic search in the relevant database (Web of Science, PubMed Medline, PubMed Central, Google scholar, and Embase) was conducted to identify eligible articles. In addition to searching the grey literature, manual searching was carried out using the reference chain approach. RESULTS A total of 1886 articles were retrieved using the search strategy with 21 studies included in the systematic review. A total of 113 cases of imported monkeypox were confirmed worldwide. Nineteen patients mentioned a travel history from Nigeria, thirty-eight infected cases had travel destinations from Europe, fifty-four cases traveled from European countries such as; Spain, France, and the Netherlands, one case from Portugal, and another one from the United Kingdom (UK). All reported clades of the virus were West African clade. Nine studies showed the source of infection was sexual contact, especially with male partners. Six studies mentioned the cause of infection was contact with an individual with monkeypox symptoms. Two studies considered cases due to acquired nosocomial infection. Ingestion of barbecued bushmeat was the source of infection in three studies and rodent carcasses were the source of infection in the other two studies. CONCLUSION The development of functioning surveillance systems and point-of-entry screening is essential for worldwide health security. This necessitates ongoing training of front-line health professionals to ensure that imported monkeypox is properly diagnosed and managed. In addition, implementing effective health communication about monkeypox prevention and control is mandatory to help individuals to make informed decisions to protect their own and their communities' health.
Collapse
Affiliation(s)
- Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public health, Alexandria University, Egypt.
| | | | - Mohamed Ashraf Hall
- Alexandria Dental Research Center, Egyptian Ministry of Health and Population, Egypt.
| | - Amira Mahboob
- Occupational health and industrial medicine department, high institute of public health, Alexandria university, Egypt.
| | - Sally Zeina
- Department of Clinical Research, Maamora Chest Hospital, Ministry of Health and Population, Egypt.
| | - Eman H Elbanna
- Health Management, Planning and Policy Department, High Institute of Public health, Alexandria University, Egypt.
| | - Noha Fadl
- Family Health Department, High Institute of Public health, Alexandria University, Egypt.
| | - Shaimaa Abdelaziz Abdelmoneim
- Clinical Research Administration, Alexandria Directorate of Health Affairs, Egyptian Ministry of Health and Population, Egypt.
| | - Rony ElMakhzangy
- Family Health Department, High Institute of Public health, Alexandria University, Egypt.
| | | | | | | | - Naman Rao
- Henry M. Goldman School of Dental Medicine, Boston University, USA.
| | | | - Ehab Elrewany
- Tropical Health Department, High Institute of Public health, Alexandria University, Egypt.
| | - Mahmoud A Hassaan
- Institute of Graduate Studies & Research, Alexandria University Egypt, Egypt.
| | - Esraa Abdellatif Hammouda
- Head of clinical research department, El-Raml pediatric hospital, Ministry of health and population, Egypt.
| | - Mai Hussein
- Alexandria Dental Research Center, Egyptian Ministry of Health and Population, Egypt; Clinical Research Administration, Alexandria Directorate of Health Affairs, Egyptian Ministry of Health and Population, Egypt; Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
5
|
Arias-Alpízar K, Sánchez-Cano A, Prat-Trunas J, Sulleiro E, Bosch-Nicolau P, Salvador F, Oliveira I, Molina I, Sánchez-Montalvá A, Baldrich E. Magnetic Bead Handling Using a Paper-Based Device for Quantitative Point-of-Care Testing. BIOSENSORS 2022; 12:680. [PMID: 36140066 PMCID: PMC9496280 DOI: 10.3390/bios12090680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/18/2022] [Accepted: 08/20/2022] [Indexed: 06/16/2023]
Abstract
Microfluidic paper-based analytical devices (μPADs) have been extensively proposed as ideal tools for point-of-care (POC) testing with minimal user training and technical requirements. However, most μPADs use dried bioreagents, which complicate production, reduce device reproducibility and stability, and require transport and storage under temperature and humidity-controlled conditions. In this work, we propose a μPAD produced using an affordable craft-cutter and stored at room temperature, which is used to partially automate a single-step colorimetric magneto-immunoassay. As a proof-of-concept, the μPAD has been applied to the quantitative detection of Plasmodium falciparum lactate dehydrogenase (Pf-LDH), a biomarker of malaria infection. In this system, detection is based on a single-step magneto-immunoassay that consists of a single 5-min incubation of the lysed blood sample with immuno-modified magnetic beads (MB), detection antibody, and an enzymatic signal amplifier (Poly-HRP). This mixture is then transferred to a single-piece paper device where, after on-chip MB magnetic concentration and washing, signal generation is achieved by adding a chromogenic enzyme substrate. The colorimetric readout is achieved by the naked eye or using a smartphone camera and free software for image analysis. This μPAD afforded quantitative Pf-LDH detection in <15 min, with a detection limit of 6.25 ng mL−1 when the result was interpreted by the naked eye and 1.4 ng mL−1 when analysed using the smartphone imaging system. Moreover, the study of a battery of clinical samples revealed concentrations of Pf-LDH that correlated with those provided by the reference ELISA and with better sensitivity than a commercial rapid diagnostic test (RDT). These results demonstrate that magneto-immunoassays can be partly automated by employing a μPAD, achieving a level of handling that approaches the requirements of POC testing.
Collapse
Affiliation(s)
- Kevin Arias-Alpízar
- Diagnostic Nanotools Group, Vall d’Hebron Institut de Recerca (VHIR), 08035 Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - Ana Sánchez-Cano
- Diagnostic Nanotools Group, Vall d’Hebron Institut de Recerca (VHIR), 08035 Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - Judit Prat-Trunas
- Diagnostic Nanotools Group, Vall d’Hebron Institut de Recerca (VHIR), 08035 Barcelona, Spain
| | - Elena Sulleiro
- Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
- International Health Unit Vall d’Hebron-Drassanes, Vall d’Hebron Hospital Universitari, PROSICS Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28028 Madrid, Spain
| | - Pau Bosch-Nicolau
- International Health Unit Vall d’Hebron-Drassanes, Vall d’Hebron Hospital Universitari, PROSICS Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28028 Madrid, Spain
| | - Fernando Salvador
- International Health Unit Vall d’Hebron-Drassanes, Vall d’Hebron Hospital Universitari, PROSICS Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28028 Madrid, Spain
| | - Inés Oliveira
- International Health Unit Vall d’Hebron-Drassanes, Vall d’Hebron Hospital Universitari, PROSICS Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28028 Madrid, Spain
| | - Israel Molina
- International Health Unit Vall d’Hebron-Drassanes, Vall d’Hebron Hospital Universitari, PROSICS Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28028 Madrid, Spain
| | - Adrián Sánchez-Montalvá
- Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
- International Health Unit Vall d’Hebron-Drassanes, Vall d’Hebron Hospital Universitari, PROSICS Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28028 Madrid, Spain
| | - Eva Baldrich
- Diagnostic Nanotools Group, Vall d’Hebron Institut de Recerca (VHIR), 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28028 Madrid, Spain
| |
Collapse
|
6
|
Corbacho-Loarte MD, Crespillo-Andújar C, Chamorro-Tojeiro S, Norman F, Pérez-Molina JA, Martín O, Rubio JM, Gullón-Peña B, López-Vélez R, Monge-Maillo B. Screening of imported malaria infection in asymptomatic migrants from Sub-Saharan Africa: A retrospective analysis of a 2010-2019 cohort. Travel Med Infect Dis 2022; 49:102411. [PMID: 35933089 DOI: 10.1016/j.tmaid.2022.102411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Up to 40% of cases of imported malaria in Europe are diagnosed in recently arrived migrants, who generally exhibit asymptomatic or mild symptoms and show low parasitaemia (submicroscopic). The study describes the prevalence of malaria infection among asymptomatic Sub-Saharan African migrants (ASSAM) and compares asymptomatic malaria-infected (AMI) vs non-malaria infected patients. METHODS An observational, comparative, retrospective study was carried out in ASSAM who underwent a medical examination, between 2010 and 2019 at the National Reference Unit for Tropical Diseases (NRU-Trop) in Madrid, Spain. Medical examination and systematic screening protocol for infectious diseases, including screening for malaria infection by Polymerase Chain Reaction (PCR) was performed. RESULTS During the study period, 632 out of 1061 ASSAM were screened for malaria, median age: 24 years (IQR:1-5); median time from arrival to diagnosis: 2 months (IQR:1-5). P. falciparum was the most frequent species: 61 patients (67.8%). Compared to non-malaria infected, AMI subjects had: higher rate of co-infection with S. stercoralis (41.1%VS 22.9%;p < 0.001) and filariae (8.9% VS 2.4%;p = 0.006), lower erythrocyte corpuscular volume (83.6 VS 84.4;p = 0.008) and lower levels of cholesterol (151.0 VS 167.3;p < 0.001). CONCLUSIONS We observed a high prevalence of AMI among ASSAM. This highlights the need to consider routing screening of migrants from endemic areas and to study if such screening could avoid the potential morbidities associated with chronic infection, reduce morbi-mortality of acute malaria and the risk of transmission in host communities.
Collapse
Affiliation(s)
- María Dolores Corbacho-Loarte
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - Clara Crespillo-Andújar
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - Sandra Chamorro-Tojeiro
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - Francesca Norman
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - José Antonio Pérez-Molina
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - Oihane Martín
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain; Microbiology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - José Miguel Rubio
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Beatriz Gullón-Peña
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - Rogelio López-Vélez
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - Begoña Monge-Maillo
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain.
| |
Collapse
|
7
|
Abstract
The twenty-first century has witnessed a wave of severe infectious disease outbreaks, not least the COVID-19 pandemic, which has had a devastating impact on lives and livelihoods around the globe. The 2003 severe acute respiratory syndrome coronavirus outbreak, the 2009 swine flu pandemic, the 2012 Middle East respiratory syndrome coronavirus outbreak, the 2013-2016 Ebola virus disease epidemic in West Africa and the 2015 Zika virus disease epidemic all resulted in substantial morbidity and mortality while spreading across borders to infect people in multiple countries. At the same time, the past few decades have ushered in an unprecedented era of technological, demographic and climatic change: airline flights have doubled since 2000, since 2007 more people live in urban areas than rural areas, population numbers continue to climb and climate change presents an escalating threat to society. In this Review, we consider the extent to which these recent global changes have increased the risk of infectious disease outbreaks, even as improved sanitation and access to health care have resulted in considerable progress worldwide.
Collapse
|
8
|
Risk of Trypanosoma cruzi infection among travellers visiting friends and relatives to continental Latin America. PLoS Negl Trop Dis 2021; 15:e0009528. [PMID: 34214087 PMCID: PMC8281994 DOI: 10.1371/journal.pntd.0009528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 07/15/2021] [Accepted: 06/01/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Chagas disease (CD) is regarded as a possible risk for travellers to endemic areas of continental Latin America (LA). The aim of the study is to determine the risk of Trypanosoma cruzi (TC) infection among travellers to CD endemic areas and to identify risk factors for acquiring TC infection. METHODS/PRINCIPAL FINDING We designed a multicenter cross-sectional study among travellers in Spain (Badalona, Barcelona and Madrid). All available adults with laboratory confirmed proof of absence of TC infection from January 2012 to December 2015 were contacted. Participants referring a trip to LA after the negative TC screening were offered to participate. We performed a standardized questionnaire of travel related factors and measurement of TC antibodies in serum. A total of 971 participants with baseline negative TC serology were selected from the microbiology records. After excluding participants not meeting inclusion criteria, eighty participants were selected. Sixty three (78.8%) were female, and the median age was 38 (IQR 34-47) years. The reason to travel was visiting friends and relatives in 98.8% of the participants. The median duration of travel was 40 (IQR 30-60) days, with 4911 participants-day of exposure. Seventy seven cases (96.25%) participants had two negative TC serology tests after the travel, two cases (2.5%) had discordant serology results (considered false positive results) and one case was infected before travelling to LA. According to our data, the upper limit of the 95% confidence interval of the incidence rate of TC acquisition in travellers is 0.8 per 1000 participant-days. CONCLUSIONS/SIGNIFICANCE Among 79 non-CD travellers to TC endemic areas, we found no cases of newly acquired TC infection. The incidence rate of TC acquisition in travellers to endemic countries is less than or equal to 0.8 per 1000 traveller-days.
Collapse
|
9
|
Characterization of an outbreak of malaria in a non-endemic zone on the coastal region of Ecuador. ACTA ACUST UNITED AC 2021; 41:100-112. [PMID: 34111343 PMCID: PMC8320780 DOI: 10.7705/biomedica.5816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Indexed: 11/21/2022]
Abstract
Introduction: Malar¡a ¡s a vector-borne d¡sease w¡dely d¡str¡buted ¡n the Amazon reg¡on and the coastal area of northern Ecuador. Its ep¡dem¡ology ¡nvolves related factors such as human settlements, vector reproduct¡on s¡tes, mob¡l¡ty, product¡ve act¡v¡ty, and the response capac¡ty of health systems, among others. Objective: To describe malaria transm¡ss¡on by Plasmodium vivax ¡n a non-endem¡c area of Ecuador by analyz¡ng the ep¡dem¡olog¡cal and entomolog¡cal factors ¡nvolved. Materials and methods: We conducted the epidemiological study of the cases reported ¡n the Sal¡nas canton and the character¡zat¡on of vector breed¡ng s¡tes through captures of larvae and adult mosqu¡toes by human capture of rest¡ng mosqu¡toes. Results: We detected 21 cases of malar¡a w¡th local transm¡ss¡on related to the presence of ¡n¡t¡al cases ¡n Venezuelan rrrigrant pat¡ents and ¡dentified Anopheles albimanus as the predom¡nant vector ¡n natural breed¡ng s¡tes such as estuar¡es, wells, and water channels. Conclusions: We detected an outbreak of malar¡a tr¡ggered by ¡mported cases from Venezuela. Cl¡mat¡c, soc¡al, env¡ronmental, and ecolog¡cal cond¡t¡ons have favored the development of the vector maintaining the transm¡ss¡on cycle. Strateg¡es to control ¡mported malar¡a should be mult¡ple ¡nclud¡ng early case detect¡on and control of product¡ve breed¡ng s¡tes to avo¡d local transm¡ss¡on.
Collapse
|
10
|
Salvador F, Treviño B, Bosch-Nicolau P, Serre-Delcor N, Sánchez-Montalvá A, Oliveira I, Sulleiro E, Aznar ML, Pou D, Sao-Avilés A, Molina I. Strongyloidiasis screening in migrants living in Spain: systematic review and meta-analysis. Trop Med Int Health 2020; 25:281-290. [PMID: 31758828 DOI: 10.1111/tmi.13352] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To provide information regarding the prevalence of strongyloidiasis among migrants coming from Strongyloides stercoralis-endemic areas who reside in Spain. METHODS Systematic review of the literature and meta-analysis of studies showing prevalence of S. stercoralis infection among migrants from Latin America, Africa, Eastern Europe, Asia and Oceania who reside in Spain. We included articles published until 30 April 2019 without language restriction. The keywords used for the search included 'Strongyloides stercoralis', 'strongyloidiasis', 'Spain', 'screening' and 'migrants'. RESULTS Twenty-four studies were included in the review and meta-analysis, comprising 12 386 screened people. Eleven studies (7020 patients) evaluated the presence of S. stercoralis infection only through investigation of larvae in faeces, showing an overall prevalence of 1% (95%CI 1-1%). Thirteen studies (5366 patients) used a serological test, showing an overall prevalence of 14% (95%CI 11-17%). Strongyloidiasis seroprevalence was 20% (95%CI 15-24%) among migrants from sub-Saharan Africa, 14% (95%CI 10-18%) among those from Latin America and 8% (95%CI 5-11%) among migrants from North Africa. CONCLUSIONS Migrants coming from strongyloidiasis-endemic areas living in Spain had a high S. stercoralis infection prevalence, particularly those from sub-Saharan Africa and Latin America. This population should be screened using serology as the most sensitive test for S. stercoralis infection. This could be easily implemented at primary care level.
Collapse
Affiliation(s)
- Fernando Salvador
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Begoña Treviño
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Pau Bosch-Nicolau
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Núria Serre-Delcor
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Inés Oliveira
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Elena Sulleiro
- Department of Microbiology, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Mª Luisa Aznar
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Diana Pou
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Augusto Sao-Avilés
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Israel Molina
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| |
Collapse
|
11
|
Norman FF, Comeche B, Chamorro S, López-Vélez R. Overcoming challenges in the diagnosis and treatment of parasitic infectious diseases in migrants. Expert Rev Anti Infect Ther 2020; 18:127-143. [PMID: 31914335 DOI: 10.1080/14787210.2020.1713099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Introduction: Recent increases in population movements have created novel health challenges in many areas of the World, and health policies have been adapted accordingly in several countries. However, screening guidelines for infectious diseases are not standardized and generally do not include comprehensive screening for parasitic infections.Areas covered: Malaria, Chagas disease, leishmaniasis, amebiasis, filariases, strongyloidiasis, and schistosomiasis are reviewed, focusing on the challenges posed for their diagnosis and management in vulnerable populations such as migrants. The methodology included literature searches in public databases such as PubMed.gov and Google Scholar and search of the US National Library of Medicine online database of privately and publicly funded clinical studies (ClinicalTrials.gov) until November 2019.Expert opinion: Parasitic infections which may remain asymptomatic for prolonged periods, leading to chronic infection and complications, and/or may be transmitted in non-endemic areas are ideal candidates for screening. Proposed strategies to improve diagnosis in vulnerable groups such as migrants include facilitating access to healthcare in a multi-dimensional manner considering location, individual characteristics, and timing. Limitations and availability of specific diagnostic techniques should be addressed and focus on drug and vaccine development for these neglected infections should be prioritized through collaborative initiatives with public disclosure of results.
Collapse
Affiliation(s)
- Francesca F Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Belen Comeche
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Sandra Chamorro
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Rogelio López-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| |
Collapse
|
12
|
Henriquez-Camacho C, Serre N, Norman F, Sánchez-Montalvá A, Torrús D, Goikoetxea AJ, Herrero-Martínez JM, Ruiz-Giardín JM, Treviño B, Monge-Maillo B, Molina I, Rodríguez A, García M, López-Vélez R, Pérez-Molina JA. Clinicoepidemiological characteristics of viral hepatitis in migrants and travellers of the +Redivi network. Travel Med Infect Dis 2019; 29:51-57. [PMID: 30738196 DOI: 10.1016/j.tmaid.2019.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 01/28/2019] [Accepted: 02/05/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Continuous growth of mobile populations has influenced the global epidemiology of infectious diseases, including chronic and acute viral hepatitis. METHOD A prospective observational multicentre study was performed in a Spanish network of imported infections. Viral hepatitis cases from January 2009 to September 2017 were included. RESULTS Of 14,546 records, 723 (4.97%) had imported viral hepatitis, including 48 (6.64%) acute cases and 675 (93.36%) chronic cases. Of the 48 acute cases, 31 were travellers and immigrants returning from visiting friends or relatives (VFR), while 19 (61%) were acute Hepatitis A or Hepatitis B. Only 18.2% of VFR immigrants and 35% of travellers received pre-travel advice. Acute hepatitis was more frequent in VFR immigrants (AOR 2.59, CI95% 1.20-5.60) and travellers (AOR 2.83, CI95% 1.46-5.50) than immigrants. Of the 675 Chronic cases, 570 were immigrants, and 439 (77%) had chronic Hepatitis B. Chronic hepatitis was more frequent in immigrants (AOR 20.22, CI95% 11.64-35.13) and VFR immigrants (AOR 11.12, CI95% 6.20-19.94) than travellers. CONCLUSIONS Chronic viral hepatitis was typical of immigrants, acute viral hepatitis was common among travellers, and VFR immigrants had mixed risk. Improving pre-travel consultation and screening of immigrants may contribute to preventing new cases of viral hepatitis and avoiding community transmission.
Collapse
Affiliation(s)
- Cesar Henriquez-Camacho
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain
| | - Núria Serre
- Unitat Medicina Tropical I Salut Internacional Vall d´Hebron-Drassanes, PROSICS, Av de Drassanes 17-21, 08001, Barcelona, Spain
| | - Francesca Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases, Vall d´Hebron University Hospital, Universitat Autonoma de Barcelona, PROSICS Barcelona, Passeig Vall d´Hebron 119-129, 08035, Barcelona, Spain
| | - Diego Torrús
- Alicante University Hospital, Calle Pintor Baeza 11, 03010, Alicante, Spain
| | | | | | | | - Begoña Treviño
- Unitat Medicina Tropical I Salut Internacional Vall d´Hebron-Drassanes, PROSICS, Av de Drassanes 17-21, 08001, Barcelona, Spain
| | - Begoña Monge-Maillo
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain
| | - Israel Molina
- Department of Infectious Diseases, Vall d´Hebron University Hospital, Universitat Autonoma de Barcelona, PROSICS Barcelona, Passeig Vall d´Hebron 119-129, 08035, Barcelona, Spain
| | - Azucena Rodríguez
- Hospital Universitario Central de Asturias, Av. Roma, s/n, 33011, Oviedo Principado de Asturias, Spain
| | - Magdalena García
- Consorcio Hospital General Universitario de Valencia, Avenida Tres Cruces, 2, 46014, Valencia, Spain
| | - Rogelio López-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain
| | - José A Pérez-Molina
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain.
| | | |
Collapse
|
13
|
Romero-Alegría Á, Cabrera MH, Velasco-Tirado V, Pisos Álamo E, Pardo-Lledías J, Sánchez NJ, Belhassen-García M, Arellano JLP. Fake imported tropical diseases: A retrospective study. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2018; 31:528-531. [PMID: 30364924 PMCID: PMC6254473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
OBJECTIVE When we evaluate a patient with a suspected imported disease we cannot forget to include any autochthonous causes that may mimic imported pathologies to avoid misdiagnosis and therapeutic delay. METHODS A descriptive longitudinal retrospective study was designed with patients in whom an imported disease was suspected but who were finally diagnosed with autochthonous processes. The patients were selected from two internal medicine practices specializing in tropical diseases between 2008-2017 in Spain. RESULTS We report 16 patients, 11 (68.7%) were males, and the mean age was 43.4 ± 13.7 years old. Thirteen patients (81.2%) were travellers. Half of the patients were from Latin America, 7 (43.5%) were from Africa, and 1 (6.2%) was from Asia. The time from trip to evaluation ranged between 1 week and 20 years (median, 4 weeks), and the mean time from evaluation to diagnosis was 58.4 ± 100.9 days. There were 5 (31.2%) cases of autochthonous infection, 5 (31.2%) cases of cancer, 2 (12.5%) cases of inflammatory disease, and 2 (12.5%) cases of vascular disease. CONCLUSIONS Travel or migration by a patient can sometimes be a confusing factor if an imported disease is suspected and may cause delays in the diagnosis and treatment of an autochthonous disease. We highlight that 1/3 of the patients with autochthonous diseases in this study had cancer. The evaluation of imported diseases requires a comprehensive approach by the internist, especially if he specializes in infectious and/or tropical diseases and is, therefore, the best qualified to make an accurate diagnosis.
Collapse
Affiliation(s)
- Ángela Romero-Alegría
- Servicio de Medicina Interna. Complejo Asistencial Universitario de Salamanca (CAUSA). Instituto de investigación Biomédica de Salamanca (IBSAL). Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS). Universidad de Salamanca
| | - Michele Hernandez Cabrera
- Departamento de Ciencias Médicas y Quirúrgicas e Instituto de Biomedicina. Universidad de Las Palmas de Gran Canaria. Unidad de Enfermedades Infecciosas y Medicina Tropical. Complejo Hospitalario Materno Insular Las Palmas de Gran Canaria
| | | | - Elena Pisos Álamo
- Departamento de Ciencias Médicas y Quirúrgicas e Instituto de Biomedicina. Universidad de Las Palmas de Gran Canaria. Unidad de Enfermedades Infecciosas y Medicina Tropical. Complejo Hospitalario Materno Insular Las Palmas de Gran Canaria
| | - Javier Pardo-Lledías
- Servicio de Medicina Interna, Hospital General de Palencia “Río Carrión”, C/ Donantes de Sangre, Palencia, Spain
| | - Nieves Jaén Sánchez
- Departamento de Ciencias Médicas y Quirúrgicas e Instituto de Biomedicina. Universidad de Las Palmas de Gran Canaria. Unidad de Enfermedades Infecciosas y Medicina Tropical. Complejo Hospitalario Materno Insular Las Palmas de Gran Canaria
| | - Moncef Belhassen-García
- Servicio de Medicina Interna. Complejo Asistencial Universitario de Salamanca (CAUSA). Instituto de investigación Biomédica de Salamanca (IBSAL). Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS). Universidad de Salamanca
| | - José Luis Pérez Arellano
- Departamento de Ciencias Médicas y Quirúrgicas e Instituto de Biomedicina. Universidad de Las Palmas de Gran Canaria. Unidad de Enfermedades Infecciosas y Medicina Tropical. Complejo Hospitalario Materno Insular Las Palmas de Gran Canaria
| |
Collapse
|
14
|
Abstract
PURPOSE OF REVIEW With increasing international travel and mass global population migration, clinicians in nonendemic countries must be familiar with imported neglected tropical diseases including onchocerciasis, which is commonly known as 'river blindness'. RECENT FINDINGS Imported onchocerciasis manifests differently in travelers compared with migrants from endemic areas and is likely underdiagnosed in both groups. Recent clinical studies confirm that eosinophilia is not a sensitive marker for Onchocerca volvulus, with one-third of patients having a normal eosinophil count. Novel diagnostics measuring antibodies to multiple recombinant O. volvulus antigens maintain a high sensitivity while improving specificity compared with conventional pan-filarial serologic testing. A 6-week course of doxycycline has macrofilaricidal activity through Wolbachia depletion and may be useful in nonendemic areas in addition to standard serial ivermectin. SUMMARY Recent studies characterizing distinct clinical presentations in travelers and migrants may enable clinicians to better recognize imported onchocerciasis. Although novel diagnostics have improved specificity, most remain restricted to tropical disease reference laboratories and to date there is no marker of cure. Prolonged doxycycline treatment may reduce the need for serial ivermectin, though more potent short-course macrofilaricidal drugs are being developed.
Collapse
Affiliation(s)
| | - Thomas B. Nutman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| |
Collapse
|
15
|
Serre-Delcor N, Ascaso C, Soriano-Arandes A, Collazos-Sanchez F, Treviño-Maruri B, Sulleiro E, Pou-Ciruelo D, Bocanegra-Garcia C, Molina-Romero I. Health Status of Asylum Seekers, Spain. Am J Trop Med Hyg 2018; 98:300-307. [PMID: 29165223 DOI: 10.4269/ajtmh.17-0438] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
The rising rate of conflicts and the unsafe situation caused by reasons of ethnicity, religion, gender, sexual orientation, political opinion, or nationality entail an increase in the number of migratory movements. The goal of this article is to describe the health status of asylum seekers visited in an international health center. We conducted a retrospective study of the asylum seekers visited between July 2013 and June 2016. A total of 303 cases were included. The median age was 28.0 years (interquartile range [IQR]: 21-35), and 203 (67.0%) were men. Of the total, 128 cases (42.2%) were from Asia, 82 (27.1%) from Eastern Europe, 42 (13.9%) from sub-Saharan Africa, 34 (11.2%) from America, and 17 (5.6%) from Maghreb. The majority, 287 (94.7%), were asymptomatic. Seventy of the 303 (23.1%) cases were diagnosed with at least one infection, this being more prevalent in men; migrants from sub-Saharan Africa; and in those who took a land-maritime migratory route. Eight of the 303 (2.6%) cases were referred to the transcultural psychiatric department. Two important challenges of the study were the communication barriers and the legal or social situation that condition the psychological symptoms. In 48 of the 303 (15.8%) cases, there was diagnosed a noncommunicable diseases. The process of care was completed by 82.5%; although 21.9% completed the vaccination for hepatitis B. The asylum seekers in this study were in general healthy young men, although special attention was given to infectious diseases with certain geoepidemiological backgrounds. Unstable living arrangements, linguistic, and cultural barriers could account for the failure of the course of care.
Collapse
Affiliation(s)
- Núria Serre-Delcor
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, PROSICS, Hospital Universitari Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain
| | - Carlos Ascaso
- Department of Basic Clinical Practice, Institut de Investigacions biomédiques August Pi i Sunyer, Barcelona, Spain
| | - Antoni Soriano-Arandes
- Pediatric Infectious Diseases Unit, PROSICS, Hospital Universitari Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain
| | - Francisco Collazos-Sanchez
- Department of Psychiatric, PROSICS, Hospital Universitari Vall d'Hebron, CIBERSAM, Institut Català de la Salut, Barcelona, Spain and Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Begoña Treviño-Maruri
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, PROSICS, Hospital Universitari Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain
| | - Elena Sulleiro
- Department of Microbiology, PROSICS, Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain
| | - Diana Pou-Ciruelo
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, PROSICS, Hospital Universitari Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain
| | - Cristina Bocanegra-Garcia
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, PROSICS, Hospital Universitari Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain
| | - Israel Molina-Romero
- Department of Infectious Diseases, PROSICS, Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain
| |
Collapse
|
16
|
Adeel AA. Schistosomiasis in International Refugees and Migrant Populations. CURRENT TROPICAL MEDICINE REPORTS 2017. [DOI: 10.1007/s40475-017-0128-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
17
|
Monge-Maillo B, López-Vélez R. Challenges in the management of Chagas disease in Latin-American migrants in Europe. Clin Microbiol Infect 2017; 23:290-295. [PMID: 28428122 DOI: 10.1016/j.cmi.2017.04.013] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/09/2017] [Accepted: 04/11/2017] [Indexed: 12/27/2022]
Abstract
Chagas disease is endemic in Latin America. Due to migration the infection has crossed borders and it is estimated that 68,000-120,000 people with Chagas disease are currently living in Europe and 30% of them may develop visceral involvement. However, up to 90% of Chagas disease cases in Europe remain undiagnosed. The challenges which have to be overcome in Chagas disease in non-endemic countries are focused on related downing barriers to health care access, and related to screening, diagnostic tools and therapeutic management. The aim of this review is to highlight how healthcare management for Latin American migrants with Chagas disease in Europe may be improved. Medical literature was searched using PubMed. No limits were placed with respect to the language or date of publication although most of the articles selected were articles published in the last five years. Chosen search terms were "Chagas disease" AND ("migrants" OR "screening" OR "transmission" OR "treatment"; OR "knowledge" OR "non-endemic countries"); migrants AND ("Public health" OR "Health Service Accessibility" OR "Delivery of Health care"); and "Congenital Chagas disease". Healthcare management of migrant populations with Chagas disease in Europe has to be improved: -Surveillance programmes are needed to measure the burden of the disease; -screening programmes are needed; -administrative and cultural barriers in the access to health care for migrants should be reduced; -education programmes on Chagas disease should be performed -research on new diagnostic tools and therapeutic options are required. This review highlights the needs of profound changes in the health care of Latin American migrants with Chagas disease in Europe.
Collapse
Affiliation(s)
- B Monge-Maillo
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRICYS, Madrid, Spain
| | - R López-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRICYS, Madrid, Spain.
| |
Collapse
|
18
|
Abstract
This paper reviews how migration, both geographical and social, impacts on variation in some human biological traits. Migration and mobility are considered in relation to anthropometric traits and indices, psychometric traits, health, disease and nutrition, temperature regulation and metabolism, mental health and gene flow. It is well known that migration is important in disease transmission but, as this paper demonstrates, migration can have both positive and negative impacts on both donor and recipient populations for a wide range of human traits.
Collapse
Affiliation(s)
- C G N Mascie-Taylor
- a Department of Archaeology and Anthropology , University of Cambridge , Cambridge , UK
| | - M Krzyżanowska
- b Department of Human Biology , University of Wroclaw , Wroclaw , Poland
| |
Collapse
|
19
|
López-Vélez R, Norman FF, Pérez-Molina JA. Migration and the geography of disease. Infect Dis (Lond) 2017. [DOI: 10.1002/9781119085751.ch30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Rogelio López-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department; Ramón y Cajal University Hospital; Madrid Spain
| | - Francesca F. Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department; Ramón y Cajal University Hospital; Madrid Spain
| | - José-Antonio Pérez-Molina
- National Referral Unit for Tropical Diseases, Infectious Diseases Department; Ramón y Cajal University Hospital; Madrid Spain
| |
Collapse
|
20
|
Romero-Alegria A, Belhassen-García M, Alonso-Sardón M, Velasco-Tirado V, Lopez-Bernus A, Carpio-Pérez A, Bellido JLM, Muro A, Cordero M, Pardo-Lledias J. Imported cystic echinococcosis in western Spain: a retrospective study. Trans R Soc Trop Med Hyg 2017; 110:664-669. [DOI: 10.1093/trstmh/trw081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 12/11/2016] [Accepted: 12/25/2016] [Indexed: 11/14/2022] Open
|
21
|
Zeitlmann N, Gunsenheimer-Bartmeyer B, Santos-Hövener C, Kollan C, An der Heiden M. CD4-cell counts and presence of AIDS in HIV-positive patients entering specialized care-a comparison of migrant groups in the German ClinSurv HIV Cohort Study, 1999-2013. BMC Infect Dis 2016; 16:739. [PMID: 27927190 PMCID: PMC5142349 DOI: 10.1186/s12879-016-2070-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 11/28/2016] [Indexed: 12/04/2022] Open
Abstract
Background Although early presentation to HIV-care is essential to ensure timely initiation of antiretroviral therapy, recent studies have shown that especially migrants present to HIV-care at a later stage of HIV-infection. Currently, thirty percent of all newly diagnosed HIV cases in Germany originate from abroad. So far it is unknown, which specific migrant groups in Germany are particularly at risk for late presentation to HIV-care. Methods We used data from the Clinical Surveillance of HIV Disease (ClinSurv) cohort, a multi-centre observational cohort (01/01/1999 and 31/07/2013) and included treatment-naïve patients with valid information on country of origin and date of enrolment. Migrants were patients with country of origin outside Germany. We compared time trends for percentage of AIDS (CDC Stage C) and mean CD4-count at enrolment between migrants from Western Europe (WE), Central Europe (CE), Eastern Europe (EE), Sub-Saharan Africa (SSA), South East Asia (SEA) and non-migrants using multivariable regressions. Male non-migrants with mean age of 38-years constituted the reference group. Results In total, 10,211 patients fulfilled the inclusion criteria, of which 2784 were migrants (SSA: 42%, CE: 17%, WE: 11%, EE: 10%, SEA: 9%). The percentage of patients with AIDS at enrolment was higher in SSA (Odds Ratio (OR)SSA: 1.44, 95%-confidence interval (95%-CI):1.12–1.84) and SEA-migrants (ORSEA:2.16, 95%-CI:1.43–3.27). In addition, female SEA-migrants, were more likely to present with AIDS than their male counterparts (OR:2.22, 95%-CI:1.18–4.17). Mean CD4-count at enrolment was lower for SSA- (Mean CD4-count ratio (IRR):0.72; 95%-CI:0.64-0.82) and SEA-migrants (IRR:0.62, 95%-CI:0.49-0.78). Over time, it increased in non-migrants and CE-migrants (by 1 and 3%/year, respectively), whereas no increase was seen for SEA and SSA. Conclusions SSA and SEA-migrants in Germany present to HIV-care at a later stage of HIV infection than non-migrants. Additionally, previous research found a higher risk for late HIV-testing for migrants. Collecting information about the arrival date of migrants in Germany in the HIV notification system would help to understand to which extent these problems could be tackled in Germany. Moreover, participatory approaches for HIV-testing and care as well as research regarding knowledge, behaviour and attitudes towards these topics for SSA and SEA migrants should be expanded.
Collapse
Affiliation(s)
- Nadine Zeitlmann
- Postgraduate Training for Applied Epidemiology (PAE), Robert Koch Institute, Berlin, Germany. .,European Programme for Intervention Epidemiology Training, ECDC, Stockholm, Sweden. .,Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany. .,Department for Infectious Disease Epidemiology, Bavarian Health and Food Safety Authority, Oberschleissheim, Germany.
| | | | | | - Christian Kollan
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | | | | |
Collapse
|
22
|
Frequency of infectious diseases in immigrants in a Western European country: a population-based study. J Immigr Minor Health 2016; 17:66-75. [PMID: 23979713 DOI: 10.1007/s10903-013-9888-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of this population-based study was to assess the incidence rates of infectious diseases in native- (Italian) and foreign-born (immigrants) populations in a North Italy area, in 2006-2010. Crude, age-specific incidence rates (IRs) and age-standardised rate ratios (SRRs) between foreign- and native-born subjects and their 95% confidence intervals (95% CI) were estimated. A total of 32,554 cases of infectious diseases were found (9.9% in foreign-born subjects). The highest SRRs between foreign- and nativeborn subjects were found for tuberculosis (SRR = 27.1; 95% CI 21.3-34.3), malaria (SRR = 21.1; 14.6-30.4), scabies (SRR = 8.5; 7.6-9.4), AIDS (SRR = 2.5; 1.8-3.4) and viral hepatitis B (SRR = 3.3; 2.1-5.2). The highest IR was found for AIDS in people from the Americas (IR = 4.57; 95% CI 2.2-8.4), for malaria and tuberculosis in people from Africa (IR = 13.89; 11.6-16.5 and IR = 11.87; 9.8-14.3 respectively). Therefore immigrants are at a higher risk of acquiring some common infectious diseases compared to the native population in Western European countries.
Collapse
|
23
|
Hollo V, Kotila SM, Ködmön C, Zucs P, van der Werf MJ. The effect of migration within the European Union/European Economic Area on the distribution of tuberculosis, 2007 to 2013. ACTA ACUST UNITED AC 2016; 21:30171. [PMID: 27035746 DOI: 10.2807/1560-7917.es.2016.21.12.30171] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 01/04/2016] [Indexed: 11/20/2022]
Abstract
Immigration from tuberculosis (TB) high-incidence countries is known to contribute notably to the TB burden in low-incidence countries. However, the effect of migration enabled by the free movement of persons within the European Union (EU)/European Economic Area (EEA) on TB notification has not been analysed. We analysed TB surveillance data from 29 EU/EEA countries submitted for the years 2007-2013 to The European Surveillance System. We used place of birth and nationality as proxy indicators for native, other EU/EEA and non-EU/EEA origin of the TB cases and analysed the characteristics of the subgroups by origin. From 2007-2013, a total of 527,467 TB cases were reported, of which 129,781 (24.6%) were of foreign origin including 12,566 (2.4%) originating from EU/EEA countries other than the reporting country. The countries reporting most TB cases originating from other EU/EEA countries were Germany and Italy, and the largest proportion of TB cases in individuals came from Poland (n=1,562) and Romania (n=6,285). At EU/EEA level only a small proportion of foreign TB cases originated from other EU/EEA countries, however, the uneven distribution of this presumed importation may pose a challenge to TB programmes in some countries.
Collapse
Affiliation(s)
- Vahur Hollo
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | | | | | | |
Collapse
|
24
|
Beloukas A, Psarris A, Giannelou P, Kostaki E, Hatzakis A, Paraskevis D. Molecular epidemiology of HIV-1 infection in Europe: An overview. INFECTION GENETICS AND EVOLUTION 2016; 46:180-189. [PMID: 27321440 DOI: 10.1016/j.meegid.2016.06.033] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/14/2016] [Accepted: 06/15/2016] [Indexed: 12/19/2022]
Abstract
Human Immunodeficiency Virus type 1 (HIV-1) is characterised by vast genetic diversity. Globally circulating HIV-1 viruses are classified into distinct phylogenetic strains (subtypes, sub-subtypes) and several recombinant forms. Here we describe the characteristics and evolution of European HIV-1 epidemic over time through a review of published literature and updated queries of existing HIV-1 sequence databases. HIV-1 in Western and Central Europe was introduced in the early-1980s in the form of subtype B, which is still the predominant clade. However, in Eastern Europe (Former Soviet Union (FSU) countries and Russia) the predominant strain, introduced into Ukraine in the mid-1990s, is subtype A (AFSU) with transmission mostly occurring in People Who Inject Drugs (PWID). In recent years, the epidemic is evolving towards a complex tapestry with an increase in the prevalence of non-B subtypes and recombinants in Western and Central Europe. Non-B epidemics are mainly associated with immigrants, heterosexuals and females but more recently, non-B clades have also spread amongst groups where non-B strains were previously absent - non-immigrant European populations and amongst men having sex with men (MSM). In some countries, non-B clades have spread amongst the native population, for example subtype G in Portugal and subtype A in Greece, Albania and Cyprus. Romania provides a unique case where sub-subtype F1 has predominated throughout the epidemic. In contrast, HIV-1 epidemic in FSU countries remains more homogeneous with AFSU clade predominating in all countries. The differences between the evolution of the Western epidemic and the Eastern epidemic may be attributable to differences in transmission risk behaviours, lifestyle and the patterns of human mobility. The study of HIV-1 epidemic diversity provides a useful tool by which we can understand the history of the pandemic in addition to allowing us to monitor the spread and growth of the epidemic over time.
Collapse
Affiliation(s)
- Apostolos Beloukas
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Institute of Infection & Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Alexandros Psarris
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Polina Giannelou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Kostaki
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Angelos Hatzakis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Paraskevis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| |
Collapse
|
25
|
Viral hepatitis and immigration: A challenge for the healthcare system. Rev Clin Esp 2016. [DOI: 10.1016/j.rceng.2016.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
26
|
Loos J, Vuylsteke B, Manirankunda L, Deblonde J, Kint I, Namanya F, Fransen K, Colebunders R, Laga M, Adobea D, Nöstlinger C. TOGETHER Project to Increase Understanding of the HIV Epidemic Among Sub-Saharan African Migrants: Protocol of Community-Based Participatory Mixed-Method Studies. JMIR Res Protoc 2016; 5:e48. [PMID: 26988266 PMCID: PMC4816927 DOI: 10.2196/resprot.5162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 11/18/2015] [Accepted: 11/29/2015] [Indexed: 11/20/2022] Open
Abstract
Background Sub-Saharan African Migrants (SAM) are the second largest group affected by HIV/AIDS in Belgium and the rest of Western Europe. Increasing evidence shows that, more than previously thought, SAM are acquiring HIV in their host countries. This calls for a renewed focus on primary prevention. Yet, knowledge on the magnitude of the HIV epidemic among SAM (HIV prevalence estimates and proportions of undiagnosed HIV infections) and underlying drivers are scarce and limit the development of such interventions. Objective By applying a community-based participatory and mixed-methods approach, the TOGETHER project aims to deepen our understanding of HIV transmission dynamics, as well as inform future primary prevention interventions for this target group. Methods The TOGETHER project consists of a cross-sectional study to assess HIV prevalence and risk factors among SAM visiting community settings in Antwerp city, Belgium, and links an anonymous electronic self-reported questionnaire to oral fluid samples. Three formative studies informed this method: (1) a social mapping of community settings using an adaptation of the PLACE method; (2) a multiple case study aiming to identify factors that increase risk and vulnerability for HIV infection by triangulating data from life history interviews, lifelines, and patient files; and (3) an acceptability and feasibility study of oral fluid sampling in community settings using participant observations. Results Results have been obtained from 4 interlinked studies and will be described in future research. Conclusions Combining empirically tested and innovative epidemiological and social science methods, this project provides the first HIV prevalence estimates for a representative sample of SAM residing in a West European city. By triangulating qualitative and quantitative insights, the project will generate an in-depth understanding of the factors that increase risk and vulnerability for HIV infection among SAM. Based on this knowledge, the project will identify priority subgroups within SAM communities and places for HIV prevention. Adopting a community-based participatory approach throughout the full research process should increase community ownership, investment, and mobilization for HIV prevention.
Collapse
Affiliation(s)
- Jasna Loos
- HIV and Sexual Health Unit, Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Cuenca-Gómez JA, Salas-Coronas J, Soriano-Pérez MJ, Vázquez-Villegas J, Lozano-Serrano AB, Cabezas-Fernández MT. Viral hepatitis and immigration: A challenge for the healthcare system. Rev Clin Esp 2016; 216:248-52. [PMID: 26995326 DOI: 10.1016/j.rce.2016.02.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 02/03/2016] [Accepted: 02/21/2016] [Indexed: 01/05/2023]
Abstract
BACKGROUND Viral hepatitis is a significant health problem in African countries. The increase in the immigrant population from this continent represents a challenge for the Spanish healthcare system. MATERIAL AND METHODS A descriptive study was conducted on the prevalence of the serological markers of hepatitis B (HBV), C (HCV) and D (HDV) in African immigrants treated in a specialised doctor's office. RESULTS The study included 2518 patients (87.7% Sub-Saharan natives), with a mean age of 31.3 years. Some 78.8% of the patients had a positive infection marker for HBV, and 638 patients (25.3%) were diagnosed with active hepatitis B (HBsAg +). In 19 cases, antibodies against HDV were detected (4 cases with detection of the viral genome). Sixty-eight patients had antibodies against HCV, 26 of whom had a positive viral load. CONCLUSIONS The high prevalence of viral hepatitis in immigrants, especially HBV infection, represents a significant change in the profile of patients treated in Spain and requires measures aimed at early diagnosis and transmission prevention.
Collapse
Affiliation(s)
- J A Cuenca-Gómez
- Unidad de Medicina Tropical, Hospital de Poniente, El Ejido, Almería, España.
| | - J Salas-Coronas
- Unidad de Medicina Tropical, Hospital de Poniente, El Ejido, Almería, España; CEMyRI (Centro de Estudio de las Migraciones y Relaciones Interculturales), Universidad de Almería, Almería, España
| | - M J Soriano-Pérez
- Unidad de Medicina Tropical, Hospital de Poniente, El Ejido, Almería, España
| | | | - A B Lozano-Serrano
- Unidad de Medicina Tropical, Hospital de Poniente, El Ejido, Almería, España
| | - M T Cabezas-Fernández
- Unidad de Medicina Tropical, Hospital de Poniente, El Ejido, Almería, España; CEMyRI (Centro de Estudio de las Migraciones y Relaciones Interculturales), Universidad de Almería, Almería, España
| |
Collapse
|
28
|
Serre Delcor N, Maruri BT, Arandes AS, Guiu IC, Essadik HO, Soley ME, Romero IM, Ascaso C. Infectious Diseases in Sub-Saharan Immigrants to Spain. Am J Trop Med Hyg 2016; 94:750-6. [PMID: 26880782 DOI: 10.4269/ajtmh.15-0583] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 12/08/2015] [Indexed: 12/17/2022] Open
Abstract
Immigrants may be carriers of infectious diseases because of the prevalence of these diseases in their country of origin, exposure during migration, or conditions during resettlement, with this prevalence being particularly high in sub-Saharan Africans. We performed a retrospective review of 180 sub-Saharan immigrants screened for infectious diseases at an International Health Center from January 2009 to December 2012. At least one pathogenic infectious disease was diagnosed in 72.8% patients: 60.6% latent tuberculosis infection, 36.8% intestinal parasites (intestinal protozoa or helminths), 28.1% helminths, 14.8% hepatitis B surface antigen positive, 1.2% anti-hepatitis C virus positive, 1.2% human immunodeficiency virus-positive, and 1.2% malaria. Coinfections were present in 28.4%. There was significant association between eosinophilia (absolute count or percentage) or hyper-IgE and the presence of helminths (P< 0.001). Relative eosinophilia and hyper-IgE were better indicators of helminth infection than absolute eosinophilia, particularly for schistosomiasis and strongyloidiasis. We found a high prevalence of infectious diseases in sub-Saharan immigrants, which could lead to severe health problems (in the absence of prompt treatment), representing a high cost to the public health system and possible transmission in the host country. Accurate screening and tailored protocols for infectious diseases are recommended in sub-Saharan immigrants.
Collapse
Affiliation(s)
- Núria Serre Delcor
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| | - Begoña Treviño Maruri
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| | - Antoni Soriano Arandes
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| | - Isabel Claveria Guiu
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| | - Hakima Ouaarab Essadik
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| | - Mateu Espasa Soley
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| | - Israel Molina Romero
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| | - Carlos Ascaso
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| |
Collapse
|
29
|
Pérez-Molina JA, Álvarez-Martínez MJ, Molina I. Medical care for refugees: A question of ethics and public health. Enferm Infecc Microbiol Clin 2016; 34:79-82. [PMID: 26811213 PMCID: PMC7103281 DOI: 10.1016/j.eimc.2015.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 12/30/2015] [Indexed: 01/05/2023]
Affiliation(s)
- José Antonio Pérez-Molina
- CSUR de Medicina Tropical, Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.
| | | | - Israel Molina
- Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d'Hebron, PROSICS, Barcelona, Spain
| |
Collapse
|
30
|
Pérez-Molina J. Viajar por trabajo. ¿Un nuevo perfil de viajero de alto riesgo? Rev Clin Esp 2015; 215:446-8. [PMID: 26318417 PMCID: PMC7130407 DOI: 10.1016/j.rce.2015.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 07/26/2015] [Accepted: 07/27/2015] [Indexed: 11/20/2022]
|
31
|
Dakić Z, Nikolić A, Lavadinović L, Pelemiš M, Klun I, Dulović O, Milošević B, Stevanović G, Ofori-Belić I, Poluga J, Djurković-Djaković2 O, Pavlović M. Imported parasitic infections in Serbia. Eur J Microbiol Immunol (Bp) 2015; 1:80-5. [PMID: 24466436 DOI: 10.1556/eujmi.1.2011.1.10] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Travel to the tropics is associated with a risk of parasitic infection, which is increasing in parallel with the rise in travel to these areas. We thus examined the prevalence and trend in the occurrence of parasitic infections in Serbian travelers. METHODS A retrospective analysis of the medical records of all travelers returning from tropical and subtropical areas, who presented at the Institute for Infectious and Tropical Diseases in Belgrade between January 2001 and January 2008, was performed. RESULTS Of a total of 2440 travelers, 169 (6.9%) were diagnosed with a parasitic infection, including malaria in 79, intestinal parasites in 84 (pathogenic species in 30 and non-pathogenic in 54), filariasis in four, and visceral leishmaniasis and fascioliasis in one patient each. Importantly, of the whole series only 583 (23.9%) were symptomatic, of which 19.4% were found to be infected with a parasite. The single pathogenic parasite occurring in asymptomatic patients was Giardia intestinalis. CONCLUSIONS Parasitic infection causing symptomatic disease among travelers returning from tropical areas to Serbia is not infrequent. In view of the expected increase in travel to the tropics, diagnostic protocols for tropical parasitic diseases should take these data into account.
Collapse
|
32
|
Norman FF, Monge-Maillo B, Martínez-Pérez Á, Perez-Molina JA, López-Vélez R. Parasitic infections in travelers and immigrants: part II helminths and ectoparasites. Future Microbiol 2015; 10:87-99. [PMID: 25598339 DOI: 10.2217/fmb.14.106] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Travel and migration contribute to the emergence of certain parasites which may be imported into nonendemic areas. Noncontrolled importation of food products and animals may also contribute to the diagnosis of infections caused by helminths in nonendemic countries. Some helminth infections such as strongyloidiasis may be life-threatening, especially in immunocompromised patients, and outcome depends on correct diagnosis and treatment. Other helminth infections are neglected tropical diseases associated with chronic disease and/or disability. Major challenges concern the development of improved diagnostic techniques, safer and more effective drug therapies and identification of markers of response to treatment. The study of these imported infections in travelers and immigrants may provide opportunities for research which may not be readily available in resource-poor endemic countries. Updated reviews and guidelines are necessary as new data become available. The second part of this review focuses on infections in travelers and immigrants caused by helminths and ectoparasites.
Collapse
Affiliation(s)
- Francesca F Norman
- Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramon y Cajal Hospital, Ctra. De Colmenar Km 9.1, 28034 Madrid, Spain
| | | | | | | | | |
Collapse
|
33
|
Monge-Maillo B, López-Vélez R, Norman FF, Ferrere-González F, Martínez-Pérez Á, Pérez-Molina JA. Screening of imported infectious diseases among asymptomatic sub-Saharan African and Latin American immigrants: a public health challenge. Am J Trop Med Hyg 2015; 92:848-56. [PMID: 25646257 DOI: 10.4269/ajtmh.14-0520] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 12/16/2014] [Indexed: 11/07/2022] Open
Abstract
Migrants from developing countries are usually young and healthy but several studies report they may harbor asymptomatic infections for prolonged periods. Prevalence of infections were determined for asymptomatic immigrants from Latin America and sub-Saharan Africa who ettended to a European Tropical Medicine Referral Center from 2000 to 2009. A systematic screening protocol for selected infections was used. Data from 317 sub-Saharan Africans and 383 Latin Americans were analyzed. Patients were mostly young (mean age 29 years); there were significantly more males among sub-Saharan Africans (83% versus 31.6%) and pre-consultation period was longer for Latin Americans (5 versus 42 months). Diagnoses of human immunodeficiency virus (HIV), chronic hepatitis B and C virus infection, and latent tuberculosis were significantly more frequent in sub-Saharan Africans (2.3% versus 0.3%; 14% versus 1.6%; 1.3 versus 0%; 71% versus 32.1%). There were no significant differences in prevalence for syphilis and intestinal parasites. Malaria and schistosomiasis prevalence in sub-Saharan Africans was 4.6% and 5.9%, respectively, and prevalence of Chagas disease in Latin Americans was 48.5%. Identifying and treating asymptomatic imported infectious diseases may have an impact both for the individual concerned and for public health. Based on these results, a systematic screening protocol for asymptomatic immigrants is proposed.
Collapse
Affiliation(s)
- Begoña Monge-Maillo
- Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Madrid, Spain
| | - Rogelio López-Vélez
- Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Madrid, Spain
| | - Francesca F Norman
- Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Madrid, Spain
| | - Federico Ferrere-González
- Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Madrid, Spain
| | - Ángela Martínez-Pérez
- Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Madrid, Spain
| | - José Antonio Pérez-Molina
- Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Madrid, Spain
| |
Collapse
|
34
|
Norman FF, Monge-Maillo B, Martínez-Pérez Á, Perez-Molina JA, López-Vélez R. Parasitic infections in travelers and immigrants: part I protozoa. Future Microbiol 2015; 10:69-86. [DOI: 10.2217/fmb.14.105] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
ABSTRACT The growth in international commerce, travel and migration contribute to the global emergence of certain parasitic infections. Importation of vectors and food products may contribute to the emergence of protozoan infections in nonendemic countries. Infections such as malaria are potentially fatal, especially in nonimmune patients, and outcome depends largely on timely diagnosis and treatment. Diagnosis/management of imported parasitic infections may be complex especially as some patients may have underlying immunosuppressive conditions such as HIV infection. Major challenges concern the development of improved diagnostic techniques, safer/more effective drug therapies and identification of biological markers of progression and response to treatment. Imported parasitic diseases which may be transmitted vertically or through blood transfusion/organ donation could become a public health priority in the near future. Climate change may affect arthropod distribution and facilitate the spread of protozoan vector-borne diseases. The first part of this review focuses on protozoan infections in travelers and immigrants.
Collapse
Affiliation(s)
- Francesca F Norman
- Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramon y Cajal Hospital, Ctra. De Colmenar, Km 9.1, 28034 Madrid, Spain
| | - Begoña Monge-Maillo
- Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramon y Cajal Hospital, Ctra. De Colmenar, Km 9.1, 28034 Madrid, Spain
| | - Ángela Martínez-Pérez
- Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramon y Cajal Hospital, Ctra. De Colmenar, Km 9.1, 28034 Madrid, Spain
| | - Jose A Perez-Molina
- Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramon y Cajal Hospital, Ctra. De Colmenar, Km 9.1, 28034 Madrid, Spain
| | - Rogelio López-Vélez
- Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramon y Cajal Hospital, Ctra. De Colmenar, Km 9.1, 28034 Madrid, Spain
| |
Collapse
|
35
|
Ramos JM, Pinargote H, Torrús D, Sánchez-Martínez R, Merino E, Portilla J. [Infectious diseases in the adult population admitted to a general hospital]. Enferm Infecc Microbiol Clin 2014; 33:539-42. [PMID: 25541012 DOI: 10.1016/j.eimc.2014.10.011] [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: 07/27/2014] [Revised: 09/24/2014] [Accepted: 10/17/2014] [Indexed: 11/29/2022]
Abstract
INTRODUCTION To determine the infectious diseases (ID) that led to hospital admission of the foreign population>14 years. MATERIAL AND METHODS A retrospective study of foreign patients admitted to hospital (2000-2012). RESULTS A total of 3,087 foreigners were admitted with infectious diseases. Of these, 73.6% were from low income countries, and 26.4% from high income countries. Most of them (86.9%) were admitted with common ID, 11.8% with transmissible ID, and 1.6% with tropical ID. Tropical ID and transmissible ID were higher in patients from low income countries (14.7%) than from high income countries (9.7%, p<0.001). The main tropical ID was malaria (74%). The main transmissible ID were tuberculosis (40.3%), hepatitis (27.8%), and HIV/AIDS (27.5%). CONCLUSION Common ID were the main reason for admission in foreign population.
Collapse
Affiliation(s)
- José M Ramos
- Servicio de Medicina Interna, Hospital General Universitario de Alicante, Alicante, España; Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, Campus de San Juan Alicante, España.
| | - Héctor Pinargote
- Servicio de Medicina Interna, Hospital General Universitario de Alicante, Alicante, España
| | - Diego Torrús
- Unidad de Enfermedades Infecciosas, Hospital General Universitario de Alicante, Alicante, España
| | | | - Esperanza Merino
- Unidad de Enfermedades Infecciosas, Hospital General Universitario de Alicante, Alicante, España
| | - Joaquín Portilla
- Servicio de Medicina Interna, Hospital General Universitario de Alicante, Alicante, España; Unidad de Enfermedades Infecciosas, Hospital General Universitario de Alicante, Alicante, España; Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, Campus de San Juan Alicante, España
| |
Collapse
|
36
|
Belhassen-García M, Pérez Del Villar L, Pardo-Lledias J, Gutiérrez Zufiaurre MN, Velasco-Tirado V, Cordero-Sánchez M, Muñoz Criado S, Muñoz Bellido JL, Muro A. Imported transmissible diseases in minors coming to Spain from low-income areas. Clin Microbiol Infect 2014; 21:370.e5-8. [PMID: 25636386 DOI: 10.1016/j.cmi.2014.11.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 11/18/2014] [Accepted: 11/21/2014] [Indexed: 10/24/2022]
Abstract
We prospectively studied the prevalence of imported transmissible diseases in 373 immigrant children and adolescents coming from Sub-Saharan Africa, North Africa and Latin America to Salamanca, Spain. The most frequent transmissible diseases in this group were latent tuberculosis (12.7%), chronic hepatitis B virus infection (4.2%), hepatitis C virus infection (2.3%), syphilis (1.5%) and human T-lymphotropic virus type 1 or 2 infections (1.4%). A total of 24.2% of patients had serologic profiles suggesting past hepatitis B virus infection. Anti-human immunodeficiency virus antibodies were not detected in any subject. Largely asymptomatic immigrant children show a high prevalence of communicable diseases. Thus, infectious disease screenings are highly advisable in immigrant children coming from low-income countries.
Collapse
Affiliation(s)
- M Belhassen-García
- Servicio de Medicina Interna, Sección de Enfermedades Infecciosas, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de investigación Biomédica de Salamanca (IBSAL), Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Salmanca, Spain.
| | | | - J Pardo-Lledias
- Servicio de Medicina Interna, General Hospital of Palencia, Palencia, Spain
| | - M N Gutiérrez Zufiaurre
- Servicio de Microbiologia, CAUSA, IBSAL, CIETUS, Grupo de Investigación Reconocido MICRAPE de la Universidad de Salamanca, Salmanca, Spain
| | - V Velasco-Tirado
- Servicio de Medicina Interna, CAUSA, IBSAL, CIETUS, Universidad de Salamanca, Salmanca, Spain
| | - M Cordero-Sánchez
- Servicio de Medicina Interna, Sección de Enfermedades Infecciosas, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de investigación Biomédica de Salamanca (IBSAL), Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Salmanca, Spain
| | - S Muñoz Criado
- Servicio de Microbiologia, CAUSA, IBSAL, CIETUS, Grupo de Investigación Reconocido MICRAPE de la Universidad de Salamanca, Salmanca, Spain
| | - J L Muñoz Bellido
- Servicio de Microbiologia, CAUSA, IBSAL, CIETUS, Grupo de Investigación Reconocido MICRAPE de la Universidad de Salamanca, Salmanca, Spain
| | - A Muro
- Laboratorio de Inmunología Parasitaria y Molecular, IBSAL, CIETUS, Facultad de Farmacia, Universidad de Salamanca, Salmanca, Spain
| |
Collapse
|
37
|
Aldea M, García-Basteiro AL, Muñoz J, Gascón J, Aldasoro E, Bardají A, Vilella A. Factors associated with risk behavior in travelers to tropical and subtropical regions. Int Health 2014; 7:272-9. [DOI: 10.1093/inthealth/ihu076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 09/19/2014] [Indexed: 11/14/2022] Open
|
38
|
Ashrafi K, Bargues MD, O'Neill S, Mas-Coma S. Fascioliasis: A worldwide parasitic disease of importance in travel medicine. Travel Med Infect Dis 2014; 12:636-49. [DOI: 10.1016/j.tmaid.2014.09.006] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 07/10/2014] [Accepted: 09/17/2014] [Indexed: 12/31/2022]
|
39
|
Belli A, Coppola MG, Petrullo L, Lettieri G, Palumbo C, Dell'Isola C, Smeraglia R, Triassi M, Spada E, Amoroso P. The current spectrum and prevalence of intestinal parasitosis in Campania (region of southern Italy) and their relationship with migration from endemic countries. Int J Infect Dis 2014; 29:42-7. [PMID: 25449234 DOI: 10.1016/j.ijid.2014.04.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Revised: 03/11/2014] [Accepted: 04/20/2014] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND In Italy, the current clinical-epidemiological features of intestinal parasitosis and the impact of recent massive migration flows from endemic areas on their distribution are not very well known. METHODS An analysis was carried out involving 1766 patients (720 natives and 1046 immigrants) observed during the period 2009-2010 (the 'current group') and 771 native patients observed during the period 1996-1997 (the 'historical group'), a time at which immigration in the area was minimal. Patients were analyzed for intestinal parasitosis at four healthcare centres in Campania. RESULTS A wide variety of intestinal parasites was detected in the study subjects. Immigrants had a significantly higher prevalence of parasitosis and multiple simultaneous infections than natives in both groups. In both study groups of natives, the detection of at least one parasite was significantly associated with a history of travel to endemic areas. Among immigrants, we found an inverse correlation between the frequency of parasite detection and the amount of time spent in Italy. No circulation of parasites was found among contacts of parasitized patients. CONCLUSIONS Intestinal parasites are still a cause of intestinal infection in Campania. Although immigrants have a significantly higher prevalence of parasitosis than natives, this does not increase the risk of infection for that population. This is likely due to the lack of suitable biological conditions in our area.
Collapse
Affiliation(s)
- Alberta Belli
- Department of Preventive Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Maria Grazia Coppola
- Unit of Microbiology, Cotugno Hospital, AORN "Ospedali dei Colli", Naples, Italy
| | - Luciana Petrullo
- Unit of Microbiology, Cotugno Hospital, AORN "Ospedali dei Colli", Naples, Italy
| | - Gennaro Lettieri
- VI Division of Infectious Diseases, Cotugno Hospital, AORN "Ospedali dei Colli", Naples, Italy
| | - Cristiana Palumbo
- VI Division of Infectious Diseases, Cotugno Hospital, AORN "Ospedali dei Colli", Naples, Italy
| | - Chiara Dell'Isola
- VI Division of Infectious Diseases, Cotugno Hospital, AORN "Ospedali dei Colli", Naples, Italy
| | - Riccardo Smeraglia
- Unit of Microbiology, Cotugno Hospital, AORN "Ospedali dei Colli", Naples, Italy
| | - Maria Triassi
- Department of Preventive Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Enea Spada
- Department of Infectious, Parasitic and Immuno-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Pietro Amoroso
- VI Division of Infectious Diseases, Cotugno Hospital, AORN "Ospedali dei Colli", Naples, Italy.
| |
Collapse
|
40
|
Bocanegra C, Salvador F, Sulleiro E, Sánchez-Montalvá A, Pahissa A, Molina I. Screening for imported diseases in an immigrant population: experience from a teaching hospital in Barcelona, Spain. Am J Trop Med Hyg 2014; 91:1277-81. [PMID: 25331805 DOI: 10.4269/ajtmh.14-0206] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The objective of this study was to describe the screening for imported diseases among an immigrant population. This retrospective observational study was of all adult immigrants attended at the Tropical Medicine Unit of the Vall d'Hebron Teaching Hospital from September of 2007 to March of 2010. The screening strategy was adjusted by symptoms, country of origin, and length of residence in Europe. Overall, 927 patients were included. The median age was 34.5 years, and 42.1% of patients were male. A diagnosis was made in 419 (45.2%) patients. The most frequent diagnoses were Chagas disease, anemia, latent tuberculosis infection, intestinal parasitosis, hepatitis B virus (HBV) infection, and human immunodeficiency virus (HIV) infection. After screening, more diseases were identified in immigrants from sub-Saharan Africa (new diagnoses in 56.6% of patients) than patients from other geographic areas. The geographic origin and length of residence in a developed country determine the prevalence of diseases; hence, screening protocols must be based on this information.
Collapse
Affiliation(s)
- Cristina Bocanegra
- Departments of Infectious Diseases and Microbiology, Vall d'Hebron Teaching Hospital, Barcelona, Spain
| | - Fernando Salvador
- Departments of Infectious Diseases and Microbiology, Vall d'Hebron Teaching Hospital, Barcelona, Spain
| | - Elena Sulleiro
- Departments of Infectious Diseases and Microbiology, Vall d'Hebron Teaching Hospital, Barcelona, Spain
| | - Adrián Sánchez-Montalvá
- Departments of Infectious Diseases and Microbiology, Vall d'Hebron Teaching Hospital, Barcelona, Spain
| | - Albert Pahissa
- Departments of Infectious Diseases and Microbiology, Vall d'Hebron Teaching Hospital, Barcelona, Spain
| | - Israel Molina
- Departments of Infectious Diseases and Microbiology, Vall d'Hebron Teaching Hospital, Barcelona, Spain
| |
Collapse
|
41
|
Kato-Miyazawa M, Miyoshi-Akiyama T, Kanno Y, Takasaki J, Kirikae T, Kobayashi N. Genetic diversity of Mycobacterium tuberculosis isolates from foreign-born and Japan-born residents in Tokyo. Clin Microbiol Infect 2014; 21:248.e1-8. [PMID: 25595707 DOI: 10.1016/j.cmi.2014.09.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 09/28/2014] [Accepted: 09/29/2014] [Indexed: 11/30/2022]
Abstract
Sequences of the full genomes of 259 clinical isolates of Mycobacterium tuberculosis, obtained from foreign-born and Japan-born patients in Tokyo, Japan, were determined, and a phylogenetic tree constructed by concatenated single-nucleotide polymorphism (SNP) sequences. The 259 isolates were clustered into four clades: Lineage 2 (East Asian or "Beijing" genotype; n = 182, 70.3%), Lineage 4 (Euro-American, n = 46, 17.8%), Lineage 1 (Indo-Oceanic, n = 23, 8.9%), and Lineage 3 (East African-Indian, n = 8, 3.1%). Of the 259, 36 (13.9%) were resistant to at least one drug. There was no multi-drug-resistant isolate. Drug resistance was greater for the strains in Lineage 2 than the non-Lineage 2. The proportion of Lineage 2 isolates was significantly smaller in foreign-born (n = 43/91, 47.3%) than in Japan-born (n = 139/168, 82.7%) patients, whereas the proportion of Lineage 1 isolates was significantly larger in foreign-born (n = 19/91, 20.9%) than in Japan-born (n = 4/168, 2.4%) patients. We also found eight SNPs specific to the typical Beijing sub-genotype in Lineage 2, including 4 non-synonymous SNPs. Of the 259 isolates, 244 had strain-specific SNP(s) and small (1-30-bp) insertions and deletions (indels). The numbers of strain-specific SNPs and indels per isolate were significantly larger from foreign-born (median 89, range 0-520) than from Japan-born (median 23, range 0-415) (p 3.66E-15) patients. These results suggested that M. tuberculosis isolates from foreign-born patients had more genetic diversity than those from Japan-born patients.
Collapse
Affiliation(s)
| | - T Miyoshi-Akiyama
- Department of Infectious Diseases, Japan; Pathogenic Microbe Laboratory, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Y Kanno
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - J Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - T Kirikae
- Department of Infectious Diseases, Japan.
| | - N Kobayashi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan; National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| |
Collapse
|
42
|
Asymptomatic malaria in refugees living in a non-endemic South African city. PLoS One 2014; 9:e107693. [PMID: 25237812 PMCID: PMC4169555 DOI: 10.1371/journal.pone.0107693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 08/22/2014] [Indexed: 11/25/2022] Open
Abstract
Background Asymptomatic malaria infection in refugees is both a threat to the lives of the individuals and the public in the host country. Although South Africa has been experiencing an unprecedented influx of refugees since 1994, data on malaria infection among refugees is lacking. Such information is critical since South Africa is among the countries that have planned to eliminate malaria. The objective of this study was to determine prevalence of asymptomatic malaria infection among a refugee population living in a city of KwaZulu-Natal province, South Africa. Methods and Findings A survey was conducted on adult refugee participants who attended a faith-based facility offering social services in a city of KwaZulu-Natal province, South Africa. The participants were screened for the presence of malaria using rapid diagnostic tests and microscopy. Demographic data for the participants were obtained using a closed ended questionnaire. Data was obtained for 303 participants consisting of 51.5% females and 47.5% males, ranging from 19 to 64 years old. More than 95% of them originated from sub-Saharan African countries. Two hundred and ninety participants provided a blood sample for screening of malaria. Of these, 3.8% tested positive for rapid diagnostic test and 5.9% for microscopy. The majority of malaria infections were due to Plasmodium falciparum. Conclusions The study confirms the presence of asymptomatic malaria infections among a refugee population residing in a city of KwaZulu-Natal province that is not endemic for malaria. The results have important implications for both public health and malaria control in South Africa, particularly since the country has decided to eliminate malaria by 2018. To achieve this goal, South Africa needs to expand research, surveillance and elimination activities to include non-endemic areas, particularly with high refugee populations. We further recommend use of powerful diagnostic tests such as PCR for these interventions.
Collapse
|
43
|
Clinical and epidemiological features of HIV/AIDS infection among migrants at first access to healthcare services as compared to Italian patients in Italy: a retrospective multicentre study, 2000-2010. Infection 2014; 42:859-67. [PMID: 24973981 DOI: 10.1007/s15010-014-0648-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 06/11/2014] [Indexed: 01/01/2023]
Abstract
PURPOSE Migrants account for approximately 8.7% of the resident population in Italy. The immigration status deeply influences access to prevention and care, thus contributing to increase the burden of HIV/AIDS among such a fragile category. The aim of this study was to investigate socio-demographic and baseline clinical and immunological features of HIV-infected migrants, as compared to Italians. METHODS We retrospectively analysed data for all the 1,611 HIV-infected migrant patients and a random sample of 4,230 HIV-infected Italian patients aged 18 or older who first accessed nine Italian clinical centres in 2000-2010 and were followed up at least 1 year. Differences in baseline characteristics between migrants and Italians were evaluated in univariate analysis, while factors associated with late presentation were evaluated in multivariate analysis using logistic regression models. RESULTS The baseline profile differs between the HIV-infected migrant and Italian patients, substantially reflecting what reported by current statistics in terms of gender, age, risk category as well as clinical features. Late presenters were more frequent among migrants as compared to Italians (53.0 vs 45.8%; adjusted odds ratio [(AOR) = 1.55, 95% confidence interval (CI) 1.34-1.78]. Other factors associated with late presentation included increasing age, as well as undocumented legal status among foreign-born subjects (AOR = 1.41, 95% CI 0.97-2.04), though of borderline significance. CONCLUSIONS Late presentation still represents a relevant problem despite the advances in the management of HIV infection. More efforts are needed to allow early diagnosis and access to care among the most vulnerable, such as undocumented foreign-born subjects in a country where migration flows are on the rise.
Collapse
|
44
|
Polo Romero FJ, Santisteban López Y, Marañés Antoñanzas I, Beato Pérez JL. [Parasitosis (I). Imported heart and lung lesions]. Medicine (Baltimore) 2014; 11:3165-3170. [PMID: 32287898 PMCID: PMC7143677 DOI: 10.1016/s0304-5412(14)70753-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
Abstract
Imported parasitoses are an uncommon condition in our setting, although recently, the increase of migratory flow has been leading to an increase in the detected cases of these diseases. This fundamentally occurs in immigrants from tropical zones where these conditions are generally endemic. However, imported parasitoses are being increasingly diagnosed in Western persons who have lived in the tropics for different reasons. When examining a subject with cardiovascular syndromes with a possible parasitic origin, it could be useful to classify the possible geographic zone of origin in order to perform disease screening. Then, if the problem is mainly respiratory, it would be well to first rule out the existence of tuberculosis in the case of long stays and to individual the diagnosis according to the geographic area, season of the year, type of exposure and symptoms presented, in the case of shorter stays.
Collapse
Affiliation(s)
- F J Polo Romero
- Servicio de Medicina Interna. Hospital de Hellín. Hellín. Albacete. España
| | | | | | - J L Beato Pérez
- Servicio de Medicina Interna. Hospital de Hellín. Hellín. Albacete. España
| |
Collapse
|
45
|
Hladun O, Grau A, Esteban E, Jansà JM. Results from screening immigrants of low-income countries: data from a public primary health care. J Travel Med 2014; 21:92-8. [PMID: 24571720 DOI: 10.1111/jtm.12083] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 09/06/2013] [Accepted: 09/17/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND A total of 3,132 immigrants from low- and middle-income countries were involved in a cross-sectional observational study to screen for infectious diseases among immigrants attending public primary health care (PHC) centers. The study was conducted to clarify the degree of demographic differences and risk predictors of these diseases. METHODS Demographic and clinical variables, screening for infectious diseases [hepatitis B and C, human immunodeficiency virus infection, syphilis, and tuberculosis (TB)], and analytical data (anemia, hematuria, and liver function) were recorded from immigrants attending a public PHC unit in Barcelona. RESULTS Global hepatitis B, including chronic and previous, reached 18.1%; Morocco as the country of origin [odds ratio (OR) 2.1, 95% confidence interval (CI) 1.07-4.14] and gastrointestinal symptoms (OR 1.9, CI 1.18-3.02) were risk factors. Hepatitis C prevalence was 3.3% with elevated hepatic transaminase levels as a risk factor (OR 26.1, CI 8.68-78.37). Positive syphilis was 3.1%; latent and active TB rates were 28.1 and 5.8%, respectively. Concerning TB, we found remarkable differences both among WHO regions of origin (the Eastern Mediterranean region showed the highest rate of active TB, 8%) and the three categories of years of residence in Spain (6.5% for <1 year, 12.8% for 1-5 years, and 10% for >5 years). CONCLUSIONS The data allowed recommendation of a minimal screening of TB in immigrants from low-income countries regardless of the years of residence in Spain, hepatitis C in patients with altered transaminase levels, and hepatitis B in patients with gastrointestinal symptoms and/or from Morocco.
Collapse
Affiliation(s)
- Olga Hladun
- CAP Raval Nord-Dr Lluís Sayé, Institut Català de la Salut, Barcelona, Spain
| | | | | | | |
Collapse
|
46
|
Monge-Maillo B, López-Vélez R. Is screening for malaria necessary among asymptomatic refugees and immigrants coming from endemic countries? Expert Rev Anti Infect Ther 2014; 9:521-4. [DOI: 10.1586/eri.11.37] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
47
|
Stornaiuolo G, Cuniato V, Cuomo G, Nocera E, Brancaccio G, De Rosa M, Pontarelli A, Grasso G, Danzi G, Grossi A, Natale RF, Gaeta GB. Active recruitment strategy in disadvantaged immigrant populations improves the identification of human immunodeficiency but not of hepatitis B or C virus infections. Dig Liver Dis 2014; 46:62-6. [PMID: 24148806 DOI: 10.1016/j.dld.2013.08.126] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 07/26/2013] [Accepted: 08/03/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND Barriers to access medical screening and care may underestimate the number of diseased subjects among immigrant populations. AIMS To evaluate the prevalence of human immunodeficiency virus, hepatitis B virus and hepatitis C virus infections among immigrants recruited in a disadvantaged area. METHODS The study enrolled all subjects seen between 1999 and 2009 at an on-site health and family counselling centre for immigrants. During the first 6 years of the study a pro-active recruitment was performed using a mobile unit. RESULTS Overall 2681 subjects were enrolled (median age: 31 years; 52.8% males; 82.3% from Sub-Saharan Africa; 13.9% of the women were sex workers). A total of 206 subjects (7.6%) were hepatitis B surface antigen-positive, 84 (3.6%) were anti-hepatitis C virus-positive, 129 (5%) were anti-human immunodeficiency virus-positive, 84 (3.1%) were drug users, and 436 (16.3%) were alcohol abusers. The prevalence of hepatitis B surface antigen and anti-hepatitis C virus remained consistent throughout the study period, while the prevalence of human immunodeficiency virus significantly decreased. At multivariate analysis, hepatitis B virus infection was associated with male gender, hepatitis C virus infection with drug addiction, and human immunodeficiency virus infection was associated with female gender, drug addiction, and active recruitment. CONCLUSIONS An active recruitment strategy should be considered to reach disadvantaged populations at high risk of human immunodeficiency virus infection.
Collapse
Affiliation(s)
| | - Vincenzo Cuniato
- Social Medical Voluntary Association "Jerry Essan Masslo", Castelvolturno, Caserta, Italy
| | - Gianluca Cuomo
- Viral Hepatitis Unit, Department of Internal Medicine, Second University, Naples, Italy
| | - Espedito Nocera
- Social Medical Voluntary Association "Jerry Essan Masslo", Castelvolturno, Caserta, Italy
| | - Giuseppina Brancaccio
- Viral Hepatitis Unit, Department of Internal Medicine, Second University, Naples, Italy
| | - Maddalena De Rosa
- Social Medical Voluntary Association "Jerry Essan Masslo", Castelvolturno, Caserta, Italy
| | - Agostina Pontarelli
- Viral Hepatitis Unit, Department of Internal Medicine, Second University, Naples, Italy
| | - Giovanni Grasso
- Social Medical Voluntary Association "Jerry Essan Masslo", Castelvolturno, Caserta, Italy
| | - Gaetano Danzi
- Unit of Pathology, G. Moscati Hospital, Aversa, Italy
| | - Alessandra Grossi
- Faculty of Communication Sciences, Institute for Public Communication-ICP, Swiss Italian University, Lugano, Switzerland
| | - Renato F Natale
- Social Medical Voluntary Association "Jerry Essan Masslo", Castelvolturno, Caserta, Italy
| | - Giovanni B Gaeta
- Viral Hepatitis Unit, Department of Internal Medicine, Second University, Naples, Italy.
| |
Collapse
|
48
|
Monge-Maillo B, Norman F, Pérez-Molina J, Navarro M, Díaz-Menéndez M, López-Vélez R. Travelers visiting friends and relatives (VFR) and imported infectious disease: Travelers, immigrants or both? A comparative analysis. Travel Med Infect Dis 2014; 12:88-94. [DOI: 10.1016/j.tmaid.2013.07.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 07/05/2013] [Accepted: 07/08/2013] [Indexed: 12/16/2022]
|
49
|
Filariasis in Sub-Saharan Immigrants Attended in a Health Area of Southern Spain: Clinical and Epidemiological Findings. J Immigr Minor Health 2013; 17:306-9. [DOI: 10.1007/s10903-013-9880-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
50
|
Rivas P, Herrero MD, Poveda E, Madejón A, Treviño A, Gutiérrez M, Ladrón de Guevara C, Lago M, de Mendoza C, Soriano V, Puente S. Hepatitis B, C, and D and HIV infections among immigrants from Equatorial Guinea living in Spain. Am J Trop Med Hyg 2013; 88:789-94. [PMID: 23339201 PMCID: PMC3617871 DOI: 10.4269/ajtmh.12-0319] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 12/24/2012] [Indexed: 12/19/2022] Open
Abstract
A total of 1,220 subjects from Equatorial Guinea living in Spain (median age = 41 years; 453 male and 767 female) was examined for antibodies to human immunodeficiency virus (HIV) and Hepatitis B (HBV), C (HCV), and D (HDV) viruses. Extracted RNA and DNA from the positive samples were used to quantify viral load. The prevalence of HIV antibodies, HCV RNA, and HBV surface antigen (HBsAg) was 10.8% (N = 132), 11.6% (N = 141), and 7.9% (N = 96), respectively. The most prevalent HIV variant was CRF02_AG (38.5%; N = 40). HCV genotype 4 (60%; N = 36) and HBV genotype A3 (32%; N = 8) were the hepatitis variants most frequently found. Superinfection with HDV was seen in 20.9% (N = 24) of HBsAg carriers. A control group of 276 immigrants from other sub-Saharan countries showed similar rates of HIV and HBsAg, although no HCV cases were found. Immigrants constitute a major source of HIV and hepatitis viruses in Spain; therefore, it is important that control measures are intensified.
Collapse
Affiliation(s)
- Pablo Rivas
- Servicio de Enfermedades Infecciosas, Unidad de Medicina Tropical, Hospital Carlos III, Madrid, Spain.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|