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Nepomuceno de Andrade G, Bosch-Nicolau P, Nascimento BR, Martins-Melo FR, Perel P, Geissbühler Y, Demacq C, Quijano M, Mosser JF, Cousin E, Machado ÍE, Rodrigues MLAC, Ribeiro ALP, Molina I. Prevalence of Chagas disease among Latin American immigrants in non-endemic countries: an updated systematic review and meta-analysis. THE LANCET REGIONAL HEALTH. EUROPE 2024; 46:101040. [PMID: 39290806 PMCID: PMC11407232 DOI: 10.1016/j.lanepe.2024.101040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 08/06/2024] [Accepted: 08/12/2024] [Indexed: 09/19/2024]
Abstract
Background Chagas disease (CD), endemic in 21 Latin American countries, has gradually spread beyond its traditional borders due to migratory movements and emerging as a global health concern. We conducted a systematic review and meta-analysis of available data to establish updated prevalence estimates of CD in Latin American migrants residing in non-endemic countries. Methods A systematic search was conducted in MEDLINE/PubMed, Embase, Cochrane Library, Scopus, Web of Science, and LILACS via Virtual Health Library (Biblioteca Virtual em Saúde - BVS), including references published until November 1st, 2023. Pooled prevalence estimates and 95% confidence intervals (CI) were calculated using random effect models. Heterogeneity was assessed by the chi-square test and the I2 statistic. Subgroup analyses were performed to explore potential sources of heterogeneity among studies. The study was registered in the PROSPERO database (CRD42022354237). Findings From a total of 1474 articles screened, 51 studies were included. Studies were conducted in eight non-endemic countries (most in Spain), between 2006 and 2023, and involving 82,369 screened individuals. The estimated pooled prevalence of CD in Latin American migrants living in non-endemic countries was 3.5% (95% CI: 2.5-4.7; I2: 97.7%), considering studies in which screening was indicated simply because the person was Latin American. Per subgroups, the pooled CD prevalence was 11.0% (95% CI: 7.7-15.5) in non-targeted screening (unselected population in reference centers) (27 studies); in blood donors (4 studies), the pooled prevalence was 0.8% (95% CI: 0.2-3.4); among people living with HIV Latin American immigrants (4 studies) 2.4% (95% CI: 1.4-4.3) and for Latin American pregnant and postpartum women (14 studies) 3.7% (95 CI: 2.4-5.6). The pooled proportion of congenital transmission was 4.4% (95% CI: 3.3-5.8). Regarding the participants' country of origin, 7964 were from Bolivia, of which 1715 (21,5%) were diagnosed with CD, and 21,304 were from other Latin American countries of which 154 (0,72%) were affected. Interpretation CD poses a significant burden of disease in Latin American immigrants in non-endemic countries, suggesting that CD is no longer a problem limited to the American continent and must be considered as a global health challenge. Funding This study was funded by the World Heart Federation, through a research collaboration with Novartis Pharma AG.
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Affiliation(s)
- Gisele Nepomuceno de Andrade
- Department of Maternal and Child Nursing and Public Health, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Pau Bosch-Nicolau
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Bruno R Nascimento
- Department of Internal Medicine, Faculdade de Medicina, and Telehealth Center and Cardiology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Serviço de Hemodinâmica, Hospital Madre Teresa, Belo Horizonte, MG, Brazil
| | | | - Pablo Perel
- World Heart Federation, Geneva, Switzerland
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | | | | | - Jonathan F Mosser
- Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, United States of America
| | - Ewerton Cousin
- Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, United States of America
| | - Ísis Eloah Machado
- Department of Family Medicine, Mental and Collective Health, Escola de Medicina, Universidade Federal de Ouro Preto, Ouro Preto, MG, Brazil
| | - Matheus Lucca A C Rodrigues
- Department of Internal Medicine, Faculdade de Medicina, and Telehealth Center and Cardiology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Antonio Luiz P Ribeiro
- Department of Internal Medicine, Faculdade de Medicina, and Telehealth Center and Cardiology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Israel Molina
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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Requena-Méndez A, Cattaneo P, Bogale RT, Marti-Soler H, Wångdahl A, Buonfrate D, Bisoffi Z, Färnert A. Malaria parasite prevalence among migrants: a systematic review and meta-analysis. Clin Microbiol Infect 2023; 29:1528-1537. [PMID: 37739263 DOI: 10.1016/j.cmi.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/04/2023] [Accepted: 09/14/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Asymptomatic malaria infections are highly prevalent in endemic areas. OBJECTIVES This systematic review aimed to estimate the pooled prevalence of malaria parasites in migrants screened in non-endemic areas. DATA SOURCES MEDLINE-Ovid, EMBASE, Web of Science, Global Health, Lilacs, Cochrane, and MedRxiv. STUDY ELIGIBILITY CRITERIA Cross-sectional studies and observational prospective or retrospective cohort studies conducted in Europe, USA, Canada, Australia, or New Zealand regardless of language or publication status. Studies should include prevalence data on malaria in migrants that were recruited through a systematic screening approach. We excluded studies where people were tested because of malaria symptoms. PARTICIPANTS Migrant individuals exposed to malaria infection ASSESSMENT OF RISK OF BIAS: A standardized and validated appraisal instrument was used for studies reporting prevalence data (Joanna Briggs Institute Manual for Evidence Synthesis). METHODS OF DATA SYNTHESIS Pooled estimates of the parasite prevalence by PCR, microscopy, and rapid diagnostic test (RDT) were calculated with a random-effects model. Heterogeneity was explored by stratification by age, region of origin, period of study, and quality of studies. RESULTS Of 1819 studies retrieved, 23 studies were included with in total 4203 participant PCR data, 3186 microscopy and 4698 RDT data, respectively. Migrants from sub-Saharan Africa had a malaria parasite prevalence of 8.3% (95% CI 5.1-12.2) by PCR, 4.3% (1.5-8.2) by RDT, and 3.1% (0.7-6.8) by microscopy. For migrants from Asia and Latin America, the prevalence with PCR was 0% (0.0-0.08) and 0.4% (0.0-1.8), respectively. Migrants from the Central African Region had the highest PCR prevalence (9.3% [6.0-13.0]), followed by West African migrants (2.0% [0.0-7.7]). Restricting the analysis to sub-Saharan Africa migrants arriving to the host country within the previous year, the PCR-based prevalence was 11.6% (6.9-17.4). CONCLUSION We provide estimates on the malaria parasite prevalence in migrants in non-endemic setting. Despite heterogeneity between settings, these findings can contribute to inform screening strategies and guidelines targeting malaria in migrants.
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Affiliation(s)
- Ana Requena-Méndez
- Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; Migrant Health Research group, Barcelona Institute for Global Health (ISGlobal, University of Barcelona), Barcelona, Spain; CIBERINFEC, (CIBER de Enfermedades Infecciosas), Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Spain.
| | - Paolo Cattaneo
- Department of Infectious Tropical Diseases and Microbiology, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Rebecca T Bogale
- Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Helena Marti-Soler
- Migrant Health Research group, Barcelona Institute for Global Health (ISGlobal, University of Barcelona), Barcelona, Spain
| | - Andreas Wångdahl
- Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Västerås Hospital, Västerås, Sweden
| | - Dora Buonfrate
- Department of Infectious Tropical Diseases and Microbiology, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Zeno Bisoffi
- Department of Infectious Tropical Diseases and Microbiology, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Anna Färnert
- Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
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Evaluation of Two Different Strategies for Schistosomiasis Screening in High-Risk Groups in a Non-Endemic Setting. Trop Med Infect Dis 2023; 8:tropicalmed8010044. [PMID: 36668951 PMCID: PMC9862038 DOI: 10.3390/tropicalmed8010044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/23/2022] [Accepted: 12/30/2022] [Indexed: 01/09/2023] Open
Abstract
A consensus on the recommended screening algorithms for schistosomiasis in asymptomatic high-risk subjects in non-endemic areas is lacking. The objective of this study was to evaluate the real-life performance of direct microscopy and ELISA serology for schistosomiasis screening in a high-risk population in a non-endemic setting. A retrospective cohort study was conducted in two out-patient Tropical Medicine units in Barcelona (Spain) from 2014 to 2017. Asymptomatic adults arriving from the Sub-Saharan region were included. Schistosomiasis screening was conducted according to clinical practice following a different strategy in each setting: (A) feces and urine direct examination plus S. mansoni serology if non-explained eosinophilia was present and (B) S. mansoni serology plus uroparasitological examination as the second step in case of a positive serology. Demographic, clinical and laboratory features were collected. Schistosomiasis cases, clinical management and a 24 month follow-up were recorded for each group. Four-hundred forty individuals were included. The patients were mainly from West African countries. Fifty schistosomiasis cases were detected (11.5% group A vs. 4 % group B, p = 0.733). When both microscopic and serological techniques were performed, discordant results were recorded in 18.4% (16/88). Schistosomiasis cases were younger (p < 0.001) and presented eosinophilia and elevated IgE (p < 0.001) more frequently. Schistosomiasis is a frequent diagnosis among high-risk populations. Serology achieves a similar performance to direct diagnosis for the screening of schistosomiasis in a high-risk population.
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Health and Vaccination Status of Unaccompanied Minors After Arrival in a European Border Country: A Cross-sectional Study (2017-2020). Pediatr Infect Dis J 2022; 41:872-877. [PMID: 36102691 DOI: 10.1097/inf.0000000000003670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Unaccompanied and separated children (UASC) are a high-risk group for infectious diseases and information on their vaccination status is scarce. Different approaches are used to screen newly arrived minors in Europe. The aim of this study was to describe the health status and serological protection against different vaccine-preventable diseases among UASC to inform public health decision-making. METHODS Retrospective study of all UASC seen at an international health reference center in Barcelona (Spain) between January 2017 and February 2020. Screening results were analyzed using binary logistic regression with adjustment for symptoms, geographic origin, and time since arrival. RESULTS We studied 289 UASC (88.9% males; median age, 17 years). At least one infection was diagnosed in 136 minors (47.1%). There was a high prevalence of intestinal parasites (22.8%), latent tuberculosis infection (22.5%), and hepatitis B (5.2%), even in asymptomatic individuals, and especially among UASC from sub-Saharan Africa (odds ratio, 2.5; 95% confidence interval, 1.5-4.0, P < 0.001). We did not observe a significant association between clinical symptoms and the presence of infection or differences in the prevalence of different infections according to number of months since arrival. Protection against hepatitis B virus (36%), measles (80%), and varicella (83%) was suboptimal. CONCLUSIONS Our results highlight the importance of screening and vaccination programs for UASC arriving in Europe, especially border countries. Protocols should be adjusted according to geographic origin. Absence of symptoms does not necessarily rule out infection, highlighting the importance of screening in asymptomatic minors. These programs are a public health priority and should not be neglected during the current COVID-19 pandemic.
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Salvador F, Treviño B, Bosch-Nicolau P, Serre-Delcor N, Sánchez-Montalvá A, Oliveira I, Sulleiro E, Aznar ML, Pou D, Sao-Avilés A, Molina I. Strongyloidiasis screening in migrants living in Spain: systematic review and meta-analysis. Trop Med Int Health 2020; 25:281-290. [PMID: 31758828 DOI: 10.1111/tmi.13352] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To provide information regarding the prevalence of strongyloidiasis among migrants coming from Strongyloides stercoralis-endemic areas who reside in Spain. METHODS Systematic review of the literature and meta-analysis of studies showing prevalence of S. stercoralis infection among migrants from Latin America, Africa, Eastern Europe, Asia and Oceania who reside in Spain. We included articles published until 30 April 2019 without language restriction. The keywords used for the search included 'Strongyloides stercoralis', 'strongyloidiasis', 'Spain', 'screening' and 'migrants'. RESULTS Twenty-four studies were included in the review and meta-analysis, comprising 12 386 screened people. Eleven studies (7020 patients) evaluated the presence of S. stercoralis infection only through investigation of larvae in faeces, showing an overall prevalence of 1% (95%CI 1-1%). Thirteen studies (5366 patients) used a serological test, showing an overall prevalence of 14% (95%CI 11-17%). Strongyloidiasis seroprevalence was 20% (95%CI 15-24%) among migrants from sub-Saharan Africa, 14% (95%CI 10-18%) among those from Latin America and 8% (95%CI 5-11%) among migrants from North Africa. CONCLUSIONS Migrants coming from strongyloidiasis-endemic areas living in Spain had a high S. stercoralis infection prevalence, particularly those from sub-Saharan Africa and Latin America. This population should be screened using serology as the most sensitive test for S. stercoralis infection. This could be easily implemented at primary care level.
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Affiliation(s)
- Fernando Salvador
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Begoña Treviño
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Pau Bosch-Nicolau
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Núria Serre-Delcor
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Inés Oliveira
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Elena Sulleiro
- Department of Microbiology, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Mª Luisa Aznar
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Diana Pou
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Augusto Sao-Avilés
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Israel Molina
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
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Buonfrate D, Gobbi F, Marchese V, Postiglione C, Badona Monteiro G, Giorli G, Napoletano G, Bisoffi Z. Extended screening for infectious diseases among newly-arrived asylum seekers from Africa and Asia, Verona province, Italy, April 2014 to June 2015. ACTA ACUST UNITED AC 2019; 23. [PMID: 29692316 PMCID: PMC5915973 DOI: 10.2807/1560-7917.es.2018.23.16.17-00527] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Management of health issues presented by newly-arrived migrants is often limited to communicable diseases even though other health issues may be more prevalent. We report the results of infectious disease screening proposed to 462 recently-arrived asylum seekers over 14 years of age in Verona province between April 2014 and June 2015. Methods: Screening for latent tuberculosis (TB) was performed via tuberculin skin test (TST) and/or QuantiFERON-TB Gold in-tube assay and/or chest X-ray. An ELISA was used to screen for syphilis. Stool microscopy was used to screen for helminthic infections, and serology was also used for strongyloidiasis and schistosomiasis. Screening for the latter also included urine filtration and microscopy. Results: Most individuals came from sub-Saharan Africa (77.5%), with others coming from Asia (21.0%) and North Africa (1.5%). The prevalence of viral diseases/markers of human immunodeficiency virus (HIV) infection was 1.3%, HCV infection was 0.85% and hepatitis B virus surface antigen was 11.6%. Serological tests for syphilis were positive in 3.7% of individuals. Of 125 individuals screened for TB via the TST, 44.8% were positive and of 118 screened via the assay, 44.0% were positive. Of 458 individuals tested for strongyloidiasis, 91 (19.9%) were positive, and 76 of 358 (21.2%) individuals from sub-Saharan Africa were positive for schistosomiasis. Conclusions: The screening of viral diseases is questionable because of low prevalence and/or long-term, expensive treatments. For opposing reasons, helminthic infections are probably worth to be targeted by screening strategies in asylum seekers of selected countries of origin.
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Affiliation(s)
- Dora Buonfrate
- Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy
| | - Federico Gobbi
- Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy
| | - Valentina Marchese
- University Department of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy.,Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy
| | - Chiara Postiglione
- Prevention Department, Unità Locale Socio Sanitaria (ULSS) 9, Verona, Italy
| | | | - Giovanni Giorli
- Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy
| | | | - Zeno Bisoffi
- Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy
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Christenson JC, Chehab H. Pediatric Travelers and Immigrant Children. Pediatr Ann 2019; 48:e360-e369. [PMID: 31505010 DOI: 10.3928/19382359-20190812-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Children comprise a special group of international travelers. Immigrant and refugee children, along with children traveling to visit friends and relatives abroad or on leisure trips, require special attention by clinicians to prevent and treat travel-related conditions. [Pediatr Ann. 2019;48(9):e360-e369.].
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Henriquez-Camacho C, Serre N, Norman F, Sánchez-Montalvá A, Torrús D, Goikoetxea AJ, Herrero-Martínez JM, Ruiz-Giardín JM, Treviño B, Monge-Maillo B, Molina I, Rodríguez A, García M, López-Vélez R, Pérez-Molina JA. Clinicoepidemiological characteristics of viral hepatitis in migrants and travellers of the +Redivi network. Travel Med Infect Dis 2019; 29:51-57. [PMID: 30738196 DOI: 10.1016/j.tmaid.2019.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 01/28/2019] [Accepted: 02/05/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Continuous growth of mobile populations has influenced the global epidemiology of infectious diseases, including chronic and acute viral hepatitis. METHOD A prospective observational multicentre study was performed in a Spanish network of imported infections. Viral hepatitis cases from January 2009 to September 2017 were included. RESULTS Of 14,546 records, 723 (4.97%) had imported viral hepatitis, including 48 (6.64%) acute cases and 675 (93.36%) chronic cases. Of the 48 acute cases, 31 were travellers and immigrants returning from visiting friends or relatives (VFR), while 19 (61%) were acute Hepatitis A or Hepatitis B. Only 18.2% of VFR immigrants and 35% of travellers received pre-travel advice. Acute hepatitis was more frequent in VFR immigrants (AOR 2.59, CI95% 1.20-5.60) and travellers (AOR 2.83, CI95% 1.46-5.50) than immigrants. Of the 675 Chronic cases, 570 were immigrants, and 439 (77%) had chronic Hepatitis B. Chronic hepatitis was more frequent in immigrants (AOR 20.22, CI95% 11.64-35.13) and VFR immigrants (AOR 11.12, CI95% 6.20-19.94) than travellers. CONCLUSIONS Chronic viral hepatitis was typical of immigrants, acute viral hepatitis was common among travellers, and VFR immigrants had mixed risk. Improving pre-travel consultation and screening of immigrants may contribute to preventing new cases of viral hepatitis and avoiding community transmission.
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Affiliation(s)
- Cesar Henriquez-Camacho
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain
| | - Núria Serre
- Unitat Medicina Tropical I Salut Internacional Vall d´Hebron-Drassanes, PROSICS, Av de Drassanes 17-21, 08001, Barcelona, Spain
| | - Francesca Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases, Vall d´Hebron University Hospital, Universitat Autonoma de Barcelona, PROSICS Barcelona, Passeig Vall d´Hebron 119-129, 08035, Barcelona, Spain
| | - Diego Torrús
- Alicante University Hospital, Calle Pintor Baeza 11, 03010, Alicante, Spain
| | | | | | | | - Begoña Treviño
- Unitat Medicina Tropical I Salut Internacional Vall d´Hebron-Drassanes, PROSICS, Av de Drassanes 17-21, 08001, Barcelona, Spain
| | - Begoña Monge-Maillo
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain
| | - Israel Molina
- Department of Infectious Diseases, Vall d´Hebron University Hospital, Universitat Autonoma de Barcelona, PROSICS Barcelona, Passeig Vall d´Hebron 119-129, 08035, Barcelona, Spain
| | - Azucena Rodríguez
- Hospital Universitario Central de Asturias, Av. Roma, s/n, 33011, Oviedo Principado de Asturias, Spain
| | - Magdalena García
- Consorcio Hospital General Universitario de Valencia, Avenida Tres Cruces, 2, 46014, Valencia, Spain
| | - Rogelio López-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain
| | - José A Pérez-Molina
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain.
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Souliotis K, Saridi M, Banou K, Golna C, Paraskevis D, Hatzakis A, Smith A. Health and health needs of migrants in detention in Greece: shedding light to an unknown reality. Global Health 2019; 15:4. [PMID: 30621722 PMCID: PMC6325682 DOI: 10.1186/s12992-018-0448-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 12/21/2018] [Indexed: 12/28/2022] Open
Abstract
Background Population movements have been increasing over the past years in Europe due to socioeconomic factors, global turbulence and conflicts, especially in the area of Middle East. The presence of migrant populations in Europe challenges health systems due to increased requirements for health care provision. However, to date there is limited published data on the burden of disease among this population (in Greece and elsewhere). Our objective was to record burden of disease of undocumented migrants hosted in a Detention Center and therefore generate data for migrant and public health planning. Methods Epidemiological data have been collected for 4756 male migrants hosted in a Detention Center from mid 2013 to mid 2015. Of them, 1427 have used health services in the Center, which maintained a detailed record of their medical history and tests. Results The majority of the study population was aged between 18 and 40 years old. Among those who used health services, most suffered from respiratory (45.6%) and digestive (30.1%) diseases. Injury, poisoning and other external causes accounted for 19.6% of service use, diseases of the skin and subcutaneous tissue for 18.7%, and factors affecting health status and contact with health services for 16.7%. Prevalence of communicable diseases was 15.9% amongst migrants randomly tested. Conclusion Systematic screening and monitoring of diseases and use of health services by migrants in detention centers allows for an evidence based understanding of the burden of disease related to these populations and the investment required to effectively manage it, thus providing critical input to appropriate health planning. Surveillance for communicable diseases amongst migrants in detention centers would also allow for a true picture of the impact of their presence on public health indicators and help address related prejudices and stigma.
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Affiliation(s)
- Kyriakos Souliotis
- Faculty of Social and Political Sciences, University of Peloponnese, Corinth, Greece. .,Health Policy Institute, Athens, Greece.
| | - Maria Saridi
- Faculty of Social and Political Sciences, University of Peloponnese, Corinth, Greece
| | - Konstantina Banou
- Faculty of Social and Political Sciences, University of Peloponnese, Corinth, Greece
| | | | - Dimitrios Paraskevis
- 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
| | - Alyna Smith
- PICUM - Platform for International Cooperation on Undocumented Migrants, Brussels, Belgium
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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.
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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
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11
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Occurrence of intestinal parasites among asylum seekers in Italy: A cross-sectional study. Travel Med Infect Dis 2018; 27:46-52. [PMID: 30300756 DOI: 10.1016/j.tmaid.2018.10.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 09/17/2018] [Accepted: 10/05/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND In recent years Europe has experienced a dramatic increase in migration flows. Nevertheless, limited data is available about the occurrence of neglected parasitic diseases among migrant population. The purpose of the present study was to evaluate the prevalence of intestinal and urinary parasites in newly arrived asylum seekers. METHODS A total of 364 newly arrived migrants hosted at the Asylum Seekers Centre of Castelnuovo di Porto (Italy) were screened during 8 months period for intestinal and urinary parasites. Each enrolled subject was interviewed using a standardized questionnaire, with focus on socio-demographical data and risk factors of parasitic infections. RESULTS Stool analysis showed a prevalence of intestinal parasites of 20.6%. The travel route did not affect the prevalence of intestinal parasites (p = 0.096), while a significant negative correlation was found between the length of travel and the prevalence of parasite infection (p = 0.019). No statistically significant correlation between gastrointestinal symptoms and the presence of intestinal parasites was detected. CONCLUSION The prevalence of intestinal parasitosis reported in asylum seekers does not necessarily reflect the prevalence of the parasitosis in the motherland. An anamnestic and syndromic approach may not be sufficient to highlight the problem of intestinal parasitic infestations in a screening setting.
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Serre-Delcor N, Ascaso C, Soriano-Arandes A, Collazos-Sanchez F, Treviño-Maruri B, Sulleiro E, Pou-Ciruelo D, Bocanegra-Garcia C, Molina-Romero I. Health Status of Asylum Seekers, Spain. Am J Trop Med Hyg 2018; 98:300-307. [PMID: 29165223 DOI: 10.4269/ajtmh.17-0438] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
The rising rate of conflicts and the unsafe situation caused by reasons of ethnicity, religion, gender, sexual orientation, political opinion, or nationality entail an increase in the number of migratory movements. The goal of this article is to describe the health status of asylum seekers visited in an international health center. We conducted a retrospective study of the asylum seekers visited between July 2013 and June 2016. A total of 303 cases were included. The median age was 28.0 years (interquartile range [IQR]: 21-35), and 203 (67.0%) were men. Of the total, 128 cases (42.2%) were from Asia, 82 (27.1%) from Eastern Europe, 42 (13.9%) from sub-Saharan Africa, 34 (11.2%) from America, and 17 (5.6%) from Maghreb. The majority, 287 (94.7%), were asymptomatic. Seventy of the 303 (23.1%) cases were diagnosed with at least one infection, this being more prevalent in men; migrants from sub-Saharan Africa; and in those who took a land-maritime migratory route. Eight of the 303 (2.6%) cases were referred to the transcultural psychiatric department. Two important challenges of the study were the communication barriers and the legal or social situation that condition the psychological symptoms. In 48 of the 303 (15.8%) cases, there was diagnosed a noncommunicable diseases. The process of care was completed by 82.5%; although 21.9% completed the vaccination for hepatitis B. The asylum seekers in this study were in general healthy young men, although special attention was given to infectious diseases with certain geoepidemiological backgrounds. Unstable living arrangements, linguistic, and cultural barriers could account for the failure of the course of care.
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Affiliation(s)
- Núria Serre-Delcor
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, PROSICS, Hospital Universitari Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain
| | - Carlos Ascaso
- Department of Basic Clinical Practice, Institut de Investigacions biomédiques August Pi i Sunyer, Barcelona, Spain
| | - Antoni Soriano-Arandes
- Pediatric Infectious Diseases Unit, PROSICS, Hospital Universitari Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain
| | - Francisco Collazos-Sanchez
- Department of Psychiatric, PROSICS, Hospital Universitari Vall d'Hebron, CIBERSAM, Institut Català de la Salut, Barcelona, Spain and Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Begoña Treviño-Maruri
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, PROSICS, Hospital Universitari Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain
| | - Elena Sulleiro
- Department of Microbiology, PROSICS, Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain
| | - Diana Pou-Ciruelo
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, PROSICS, Hospital Universitari Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain
| | - Cristina Bocanegra-Garcia
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, PROSICS, Hospital Universitari Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain
| | - Israel Molina-Romero
- Department of Infectious Diseases, PROSICS, Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain
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13
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Gea-Sánchez M, Alconada-Romero Á, Briones-Vozmediano E, Pastells R, Gastaldo D, Molina F. Undocumented Immigrant Women in Spain: A Scoping Review on Access to and Utilization of Health and Social Services. J Immigr Minor Health 2017; 19:194-204. [PMID: 26880030 DOI: 10.1007/s10903-016-0356-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This scoping review summarizes and analyzes relevant studies related to the evidence published on undocumented immigrant women's access to and utilization of health and social services in Spain. Scientific literature was identified by entering search terms in seven electronic databases which combined retrieved health sciences peer-reviewed articles (Pubmed, Embase, CINAHL Plus and Scopus) and grey literature databases (Europa OpenGrey, DART-Europe and Google Scholar) published between 2004 and 2014 and written in Spanish or in English presenting data about Spain. Those that fulfill the inclusion criteria were selected after a blind peer reviewed process when pertinence and quality was debated. A total of 16 publications were included, the main topics being socio-cultural differences in the access and utilization of social and health services and barriers faced by immigrant women. None of the studies focused exclusively on undocumented women, hence further research is needed in this area.
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Affiliation(s)
- Montserrat Gea-Sánchez
- Department of Nursing, Faculty of Nursing and Physiotherapy, GESEC, University of Lleida, Street Rovira Roure 44, 25198, Lleida, Spain. .,Research Group in Health Care (GRECS), IRB Lleida, Lleida, Spain.
| | - Álvaro Alconada-Romero
- Department of Nursing, Faculty of Nursing and Physiotherapy, GESEC, University of Lleida, Street Rovira Roure 44, 25198, Lleida, Spain.,Council of Nurses of Lleida, Lleida, Spain
| | - Erica Briones-Vozmediano
- Department of Nursing, Faculty of Nursing and Physiotherapy, GESEC, University of Lleida, Street Rovira Roure 44, 25198, Lleida, Spain.,Public Health Research Group, University of Alicante, Alicante, Spain
| | - Roland Pastells
- Department of Nursing, Faculty of Nursing and Physiotherapy, GESEC, University of Lleida, Street Rovira Roure 44, 25198, Lleida, Spain.,Research Group in Health Care (GRECS), IRB Lleida, Lleida, Spain
| | - Denise Gastaldo
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Fidel Molina
- Department of Geography and Sociology, GESEC, University of Lleida, Lleida, Spain
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14
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Salvador F, Sulleiro E, Piron M, Sánchez-Montalvá A, Sauleda S, Molina I. Seroprevalence of Strongyloides stercoralis infection among HTLV-I infected blood donors in Barcelona, Spain: A cross-sectional study. Acta Trop 2017; 176:412-414. [PMID: 28939495 DOI: 10.1016/j.actatropica.2017.09.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 09/18/2017] [Accepted: 09/18/2017] [Indexed: 11/25/2022]
Abstract
Strongyloides stercoralis infection in patients with HTLV-I infection may lead to severe clinical manifestations. The aim of the present study is to determine the seroprevalence of S. stercoralis infection among blood donors who tested positive for HTLV-I infection. A cross-sectional study was performed at the Vall d'Hebron University Hospital (Barcelona, Spain) in 2016. Serum samples from HTLV-I positive patients diagnosed from 2008 to 2015 were retrieved from the Blood Bank, and S. stercoralis serology was performed. Thirty six serum samples from HTLV-I positive patients were retrieved from the Blood Bank. The blood samples came from 36 blood donors, and most of them were born in Latin America (75%), being Peru the most frequent country (11 participants). S. stercoralis serology was positive in one patient, corresponding to a prevalence of 2.8% (3.4% if we exclude donors coming from European countries, where the risk of S. stercoralis infection is highly unlikely).
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Affiliation(s)
- Fernando Salvador
- Department of Infectious Diseases, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain.
| | - Elena Sulleiro
- Department of Microbiology, Vall d'Hebron University Hospital,PROSICS Barcelona, Barcelona, Spain
| | - Maria Piron
- Catalan Blood and Tissue Bank (Banc de Sang i Teixits de Catalunya), Transfusion Safety Laboratory, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREhd), Instituto de Salud Carlos III, Spain
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Silvia Sauleda
- Catalan Blood and Tissue Bank (Banc de Sang i Teixits de Catalunya), Transfusion Safety Laboratory, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREhd), Instituto de Salud Carlos III, Spain
| | - Israel Molina
- Department of Infectious Diseases, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
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15
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Adeel AA. Schistosomiasis in International Refugees and Migrant Populations. CURRENT TROPICAL MEDICINE REPORTS 2017. [DOI: 10.1007/s40475-017-0128-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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16
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Seroprevalence of five neglected parasitic diseases among immigrants accessing five infectious and tropical diseases units in Italy: a cross-sectional study. Clin Microbiol Infect 2017; 23:335.e1-335.e5. [PMID: 28259548 DOI: 10.1016/j.cmi.2017.02.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 02/06/2017] [Accepted: 02/15/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This multicentre cross-sectional study aims to estimate the prevalence of five neglected tropical diseases (Chagas disease, filariasis, schistosomiasis, strongyloidiasis and toxocariasis) among immigrants accessing health care facilities in five Italian cities (Bologna, Brescia, Florence, Rome, Verona). METHODS Individuals underwent a different set of serological tests, according to country of origin and presence of eosinophilia. Seropositive patients were treated and further followed up. RESULTS A total of 930 adult immigrants were enrolled: 477 men (51.3%), 445 women (47.9%), eight transgender (0.8%); median age was 37.81 years (range 18-80 years). Most of them had come from the African continent (405/930, 43.5%), the rest from East Europe, South America and Asia, and 9.6% (89/930) were diagnosed with at least one of the infections under study. Seroprevalence of each specific infection varied from 3.9% (7/180) for Chagas disease to 9.7% (11/113) for toxocariasis. Seropositive people were more likely to be 35-40 years old and male, and to come from South East Asia, sub-Saharan Africa or South America. CONCLUSIONS The results of our study confirm that neglected tropical diseases represent a substantial health problem among immigrants and highlight the need to address this emerging public health issue.
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17
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Sánchez-Montalvá A, Salvador F, Ruiz-Camps I, Barba P, Valcárcel D, Sulleiro E, Sanz-García E, Molina I. Imported Disease Screening Prior to Chemotherapy and Bone Marrow Transplantation for Oncohematological Malignancies. Am J Trop Med Hyg 2016; 95:1463-1468. [PMID: 27928093 DOI: 10.4269/ajtmh.16-0458] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 09/06/2016] [Indexed: 01/03/2023] Open
Abstract
Reactivation of latent imported infections has been periodically reported in migrant patients undergoing immunosuppression. We performed a prospective study at Vall d'Hebron University Hospital (Barcelona, Spain). Migrant patients over 16 years with the diagnosis of any oncohematologic disease were included. Patients were tested for soil-transmitted helminths, hepatitis virus, and human immunodeficiency virus, Treponema pallidum, human T-cell lymphotropic virus, latent tuberculosis infection, Toxoplasma spp., Plasmodium infection, Schistosoma spp., Trypanosoma cruzi infection, Leishmania spp., and dimorphic fungi. Patients were treated and followed for 1 year to assess reactivation. A total of 42 patients were included in this study. Median age was 39 (31-51) years. Twenty-five (59.5%) patients were women. More than half of the patients were of Latin American origin. Sixteen patients (38.1%) underwent hematopoietic stem cell transplantation. Of the patients, 71.4% had at least one imported infection. Patients with at least one positive result in the screening did not show any statistically significant association with the studied variables. We did not find any reactivation of the treated latent infections. After specific treatment we did not observe any reactivation. Screening of latent imported infections previous to an immunosuppressive treatment is easy to perform and it may be lifesaving.
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Affiliation(s)
- Adrián Sánchez-Montalvá
- Infectious Disease Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Fernando Salvador
- Infectious Disease Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Isabel Ruiz-Camps
- Infectious Disease Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pere Barba
- Hematological Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - David Valcárcel
- Hematological Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Sulleiro
- Microbiology Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Enrique Sanz-García
- Medical Oncology Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Israel Molina
- Infectious Disease Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
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Prevalence of chronic infections and susceptibility to measles and varicella-zoster virus in Latin American immigrants. Infect Dis Poverty 2016; 5:41. [PMID: 27164954 PMCID: PMC4863343 DOI: 10.1186/s40249-016-0136-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 04/20/2016] [Indexed: 01/15/2023] Open
Abstract
Background Large numbers of Latin American immigrants recently arrived in Western Europe. Curative and preventive programmes need to take account of their risk of suffering and transmitting imported chronic infections and of their susceptibility to cosmopolitan infections. We aimed to assess the prevalence and co-occurrence of imported chronic infections among Latin American immigrants, and their susceptibility to highly prevalent cosmopolitan infections. Methods Adult participants were recruited in the community and in a primary health centre in Geneva in 2008. Serological tests were performed on stored sera for HIV, HBV, syphilis, Strongyloides stercoralis, Trypanosoma cruzi, varicella and measles. We considered only chronic active infections in the analysis. Results and discussion The 1 012 participants, aged 37.2 (SD 11.3) years, were mostly female (82.5 %) and Bolivians (48 %). Overall, 209 (20.7 %) had at least one and 27 (2.7 %) two or more chronic infections. T. cruzi (12.8 %) and S. stercoralis (8.4 %) were the most prevalent chronic active infections compared to syphilis (0.4 %), HBV (0.4 %) and HIV (1.4 %). Concomitant infections affected 28.2 and 18.5 % of T. cruzi and S. stercoralis infected cases. Bolivian origin (aOR: 13.6; 95 % CI: 3.2–57.9) was associated with risk of multiple infections. Susceptibilities for VZV and measles were 0.7 and 1.4 %, respectively. Latin American immigrants are at risk of complications and possible reactivation of chronic parasitic infections but have overall low risks of chronic viral and syphilitic active infections. Conclusions Systematic screening for chronic active parasitic infections is therefore necessary especially among Bolivians. The high protection rate against measles and VZV doesn’t require specific preventive interventions. Electronic supplementary material The online version of this article (doi:10.1186/s40249-016-0136-7) contains supplementary material, which is available to authorized users.
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Serre-Delcor N, Treviño B, Monge B, Salvador F, Torrus D, Gutiérrez-Gutiérrez B, López-Vélez R, Soriano-Arandes A, Sulleiro E, Goikoetxea J, Pérez-Molina JA. Eosinophilia prevalence and related factors in travel and immigrants of the network +REDIVI. Enferm Infecc Microbiol Clin 2016; 35:617-623. [PMID: 27032297 DOI: 10.1016/j.eimc.2016.02.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 02/19/2016] [Accepted: 02/19/2016] [Indexed: 11/27/2022]
Abstract
The population movements during the last decades have resulted in a progressively increasing interest in certain infectious diseases. Eosinophilia is a common finding in immigrants and travellers. One of the most common causes of eosinophilia is helminth infection, and some intestinal protozoa. The aim of this paper is to describe the epidemiological characteristics of cases with eosinophilia and its association with the presence of parasites in the REDIVI data network. This is a multicentre prospective observational study that includes patients diagnosed with eosinophilia registered in the cooperative network for the study of infectious diseases in travellers and immigrants (+REDIVI) from January 2009 to December 2012. A total of 5,255 episodes were recorded in the network during the study period, and eosinophilia was observed in 8.1-31.3% of cases (depending on the immigration group). There were 60.2% men, with a median age of 31years. There were 72.4% immigrants, and 81.2% were asymptomatic. The most commonly identified parasites were S.stercoralis (34.4%), Schistosoma sp. (11.0%), and hookworm (8.6%). The relationship between eosinophilia and parasite infection was significant for all helminths (except for cutaneous larva migrans). The symptoms and duration of the journey did not significantly determine the presence of eosinophilia. In the case of eosinophilia in a person who has lived in helminth endemic areas, it is advisable to carry out targeted studies to diagnose the infection, regardless of immigration type, length of stay, or the presence of symptoms.
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Affiliation(s)
- Núria Serre-Delcor
- Unitat de Salut Internacional i Medicina Tropical Vall d'Hebron-Drassanes, PROSICS, Barcelona, España.
| | - Begoña Treviño
- Unitat de Salut Internacional i Medicina Tropical Vall d'Hebron-Drassanes, PROSICS, Barcelona, España
| | - Begoña Monge
- Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid, España
| | - Fernando Salvador
- Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d'Hebron, PROSICS, Barcelona, España
| | - Diego Torrus
- Hospital General Universitario de Alicante, Alicante, España
| | | | - Rogelio López-Vélez
- Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid, España
| | - Antoni Soriano-Arandes
- Unitat de Salut Internacional i Medicina Tropical Vall d'Hebron-Drassanes, PROSICS, Barcelona, España
| | - Elena Sulleiro
- Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d'Hebron, PROSICS, Barcelona, España
| | | | - Jose A Pérez-Molina
- Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid, España
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Serre Delcor N, Maruri BT, Arandes AS, Guiu IC, Essadik HO, Soley ME, Romero IM, Ascaso C. Infectious Diseases in Sub-Saharan Immigrants to Spain. Am J Trop Med Hyg 2016; 94:750-6. [PMID: 26880782 DOI: 10.4269/ajtmh.15-0583] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 12/08/2015] [Indexed: 12/17/2022] Open
Abstract
Immigrants may be carriers of infectious diseases because of the prevalence of these diseases in their country of origin, exposure during migration, or conditions during resettlement, with this prevalence being particularly high in sub-Saharan Africans. We performed a retrospective review of 180 sub-Saharan immigrants screened for infectious diseases at an International Health Center from January 2009 to December 2012. At least one pathogenic infectious disease was diagnosed in 72.8% patients: 60.6% latent tuberculosis infection, 36.8% intestinal parasites (intestinal protozoa or helminths), 28.1% helminths, 14.8% hepatitis B surface antigen positive, 1.2% anti-hepatitis C virus positive, 1.2% human immunodeficiency virus-positive, and 1.2% malaria. Coinfections were present in 28.4%. There was significant association between eosinophilia (absolute count or percentage) or hyper-IgE and the presence of helminths (P< 0.001). Relative eosinophilia and hyper-IgE were better indicators of helminth infection than absolute eosinophilia, particularly for schistosomiasis and strongyloidiasis. We found a high prevalence of infectious diseases in sub-Saharan immigrants, which could lead to severe health problems (in the absence of prompt treatment), representing a high cost to the public health system and possible transmission in the host country. Accurate screening and tailored protocols for infectious diseases are recommended in sub-Saharan immigrants.
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Affiliation(s)
- Núria Serre Delcor
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| | - Begoña Treviño Maruri
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| | - Antoni Soriano Arandes
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| | - Isabel Claveria Guiu
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| | - Hakima Ouaarab Essadik
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| | - Mateu Espasa Soley
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| | - Israel Molina Romero
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
| | - Carlos Ascaso
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Microbiology Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Infectious Diseases Department, (PROSICS) Hospital Vall d'Hebron, Institut Català de la Salut, Barcelona, Spain; Public Health Department, Hospital Clínic, Barcelona, Spain
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Pérez-Molina JA, Álvarez-Martínez MJ, Molina I. Medical care for refugees: A question of ethics and public health. Enferm Infecc Microbiol Clin 2016; 34:79-82. [PMID: 26811213 PMCID: PMC7103281 DOI: 10.1016/j.eimc.2015.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 12/30/2015] [Indexed: 01/05/2023]
Affiliation(s)
- José Antonio Pérez-Molina
- CSUR de Medicina Tropical, Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.
| | | | - Israel Molina
- Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d'Hebron, PROSICS, Barcelona, Spain
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