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Mishra SR, Ghimire S, Joshi C, Gyawali B, Shrestha A, Neupane D, Sharma SR, Pokharel Y, Virani SS. Cardio-metabolic disease risk factors among South Asian labour migrants to the Middle East: a scoping review and policy analysis. Global Health 2019; 15:33. [PMID: 31046779 PMCID: PMC6498694 DOI: 10.1186/s12992-019-0468-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 03/13/2019] [Indexed: 01/11/2023] Open
Abstract
This paper aims to explore the burgeoning burden of cardiovascular and metabolic disease (CMD) risk factors among South Asian labor migrants to the Middle East. We conducted a qualitative synthesis of literature using PubMed/Medline and grey literature searches, supplemented by a policy review of policies from the South Asian countries. We found a high burden of cardio-metabolic risk factors among the migrants as well as among the populations in the home and the host countries. For example, two studies reported the prevalence of diabetes mellitus (DM) ranging between 9 and 17% among South Asian migrants. Overweight and obesity were highly prevalent amongst South Asian male migrants; prevalence ranged from 30 to 66% (overweight) and 17–80% (obesity) respectively. The home country population had a significant CMD risk factor burden. Nearly 14 to 40% have three or more risk factors: such as hypertension (17 to 37%), diabetes (3 to 7%), overweight (18 to 41%), and obesity (2 to 15%). The host country also exhibited similar burden of risk factors: hypertension (13 to 38%), diabetes (8 to 17%), overweight (33 to 77%) and obesity (35 to 41%). Only Nepal, Bangladesh and Sri Lanka have some provisions related to screening of CMDs before labor migration. Further, analysis of policy papers showed that none of the reviewed documents had requirements for screening of any specific CMDs, but chronic diseases were used generically, failing to specify specific screening target. Given the high burden of risk factors, migrants’ health should become an urgent priority. The lack of specific focus on screening during different stages of labor migration should receive attention. The International Labour Organization and the International Office for Migration, through their country coordination teams should engage local stakeholders to create policies and plans to address this concern. Similarly, there is a need for the host country to become an equal partner in these efforts, as migrant’s better cardiometabolic health is in the benefit of both host and home countries.
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Affiliation(s)
| | | | | | - Bishal Gyawali
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Archana Shrestha
- Harvard T Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Dinesh Neupane
- Nepal Development Society, Bharatpur-10, Chitwan, Nepal.,Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Sudesh Raj Sharma
- Institute of Food, Nutrition and Human Health, Massey University, Wellington, New Zealand
| | - Yashashwi Pokharel
- Saint Luke's Mild America Heart Institute, University of Missouri Kansas City, Kansas City, MO, USA.,Health Foundation Nepal, Lalitpur, Nepal.,America Nepal Medical Foundation, Westfield, MA, USA
| | - Salim S Virani
- Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.,Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
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