Keywords
screening, refugees, infectious diseases, migrants
Abstract
In the last ten years the number of asylum seekers has increased in all of Europe. Our Migrants Health Unit in Piacenza, Emilia Romagna, Italy, is designated to provide primary health care for migrants without a regular permit of stay and, since 2015, is the reference center for asylum-seekers in our Province. Aim of this study is to describe the results of the screening for infectious diseases performed in asylum seekers from January 2015 to December 2015. For any asylum seekers referred to our Centre, we recorded demographical data and we offered screening for HIV, HBV, HCV, syphilis and active tuberculosis (TB). Descriptive statistics were used to analyze the characteristics of the cohort. In 2015, 316 asylum seekers accessed to our Centre. Of them, the majority were men (N= 275; 87,03%). Africa was the most represented geographical area (221, 69,94%), followed from Asia (95, 30.06%). The median age was 25,4 years. 301 patients underwent chest X-Ray, that resulted negative in 262 cases (87%). HBsAg testing proved to be positive in 17 (5,3%) cases. The screening test for HBV, HCV, HIV and syphilis resulted respectively positive in 5.3%, 1.9%, 0.3% and 1.6%.
References
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2. UNHCR 2015 Global trends forced displacement in 2015. Available from: https://www.unhcr.org/statistics/unhcrstats/576408cd7/unhcr-globaltrends-2015.html.
3. Anci, Caritas Italiana, Cittalia, Fondazione Migrantes, Servizio Centrale dello Sprar 2016. Rapporto sulla protezione internazionale in Italia. Available from: https://www.sprar.it/pubblicazioni/rapporto-sulla-protezione-internazionale-in-italia-2016
4. Attuazione della direttiva 2013/33/UE recante norme relative all’accoglienza dei richiedenti protezione internazionale, nonchè della direttiva 2013/32/UE, recante procedure comuni ai fini del riconoscimento e della revoca dello status di protezione internazionale, D. L. 142/2015, GU 214 (Sep 15, 2015) (Implementation of Directive 2013/33 / EU containing rules relating to the reception of applicants for international protection, as well as Directive 2013/32 / EU, containing common procedures for the recognition and withdrawal of international protection status)
5. Indicazioni operative alle Aziende Sanitarie per l’organizzazione di modalità omogenee ed adeguate di assistenza sanitaria alle persone straniere – programma nazionale “Mare Nostrum”. DPG Regione Emilia-Romagna 291902/2014. (Operational indications for Healthcare Organizations for homogeneous and adequate methods of health care for foreign people - national program “Mare Nostrum)
6. Germinario C, Serena Gallone M, Tafuri S. Migrant health: The Apulian model. Epidemiol. Prev. 2015; 39: 76–80.
7. Del Pinto R, Pietropaoli D, Russomando U, Evangelista P, Ferri C. Health status of Afro-Asian refugees in an Italian urban area: a cross-sectional monocentric study. Public Health [Internet] 2018; 158: 176–182. DOI: 10.1016/j.puhe.2018.03.011
8. Coppola N, Alessio L, Gualdieri L, Pisaturo M, Sagnelli C, Minichini C, Di Caprio G, Starace M, Onorato L, Signoriello G, Macera M, Angelillo IF, Pasquale G, Sagnelli E. Hepatitis B virus infection in undocumented immigrants and refugees in Southern Italy: demographic, virological, and clinical features. Infect. Dis. Poverty [Internet] 2017; 6: 33. DOI:10.1186/s40249-016-0228-4
9. Cuomo G, Franconi I, Riva N, Bianchi A, Digaetano M, Santoro A, Codeluppi M, Bedini A, Guaraldi G, Mussini C. Migration and health: A retrospective study about the prevalence of HBV, HIV, HCV, tuberculosis and syphilis infections amongst newly arrived migrants screened at the Infectious Diseases Unit of Modena, Italy. J. Infect. Public Health [Internet] 2019; 12: 200–204 DOI: 10.1016/j.jiph.2018.10.004
10. Papadakis G, Okoba NA, Nicolaou C, Boufidou F, Ioannidis A, Bersimis S, Chatzipanagiotou S. Serologic markers for HBV, HCV and HIV in immigrants visiting the Athens’ polyclinic of ‘Doctors of the World – Greece’. Public Health [Internet] 2013; 127: 1045–1047 DOI: 10.1016/j.puhe.2013.08.001
11. Dipartimento per le libertà civili e l’immigrazione Ministero dell’Interno. I numeri dell’asilo. Riepilogo anni 2015-2016. Available from: http://www.libertaciviliimmigrazione.dlci.interno.gov.it/sites/default/files/allegati/riepilogo_dati_2015_2016_0.pdf
12. Seedat F, Hargreaves S, Nellums LB, Ouyang J, Brown M, Friedland JS. How effective are approaches to migrant screening for infectious diseases in Europe? A systematic review. Lancet Infect. Dis. 2018; 18: e259–e271 DOI: 10.1016/S1473-3099(18)30117-8
13. Kentikelenis A, Karanikolos M, Williams G, Mladovsky P, King L, Pharris A, Suk JE, Hatzakis A, McKee M, Noori T, Stuckler D. How do economic crises affect migrants’ risk of infectious disease? A systematic-narrative review Eur. J. Public Health 2015; 25: 937–944 DOI: 10.1093/eurpub/ckv151
14. Vanino E, Tadolini M, Attard L, Po C, Francia F, Giannini A, Viale P. Systematic tuberculosis screening in Asylum Seekers in Italy. Clin. Infect. Dis. 2017; 65: 1407–1409. DOI: 10.1093/cid/cix503
15. ECDC. Public health guidance on screening and vaccination for infectious diseases in newly arrived migrants within the EU/EEA. 2018. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/Public%20health%20guidance%20on%20screening%20and%20vaccination%20of%20migrants%20in%20the%20EU%20EEA.pdf
16. Hirsch-Moverman Y, Daftary A, Franks J, Colson PW. Adherence to treatment for latent tuberculosis infection: Systematic review of studies in the US and Canada. Int. J. Tuberc. Lung Dis. 2008; 12: 1235–1254.
17. Burnett A. Asylum seekers and refugees in Britain: Health needs of asylum seekers and refugees. BMJ 2001; 322: 544–547
18. Kärki T, Napoli C, Riccardo F, Fabiani M, Dente M, Carballo M, Noori T, Declich S. Screening for Infectious Diseases among Newly Arrived Migrants in EU/EEA Countries—Varying Practices but Consensus on the Utility of Screening. Int. J. Environ. Res. Public Health 2014; 11: 11004–11014 DOI: 10.3390/ijerph11101100419.
19. Treviño-Maruri B, Collazos-Sanchez F, Pou-Ciruelo D, Serre-Delcor N, Soriano-Arandes A, Sulleiro E, Molina-Romero I, Ascaso C, Bocanegra-Garcia C. Health Status of Asylum Seekers, Spain. Am. J. Trop. Med. Hyg. 2018; 98: 300–307 DOI: 10.4269%2Fajtmh.17-0438
20. 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 DOI:10.1016/j.eimc.2015.12.00722.
21. Greenaway C, Thu Ma A, Kloda LA, Klein M, Cnossen S, Schwarzer G, Shrier I. The Seroprevalence of Hepatitis C Antibodies in Immigrants and Refugees from Intermediate and High Endemic Countries: A Systematic Review and Meta-Analysis. Grebely J. PLoS One 2015; 10: e0141715 DOI:10.1371/journal.pone.0141715
22. Istituto Nazionale per la promozione della salute delle popolazioni Migranti ed il contrasto delle malattie della Povertà, Istituto Superiore di Sanità, Società Italiana di Medicina delle Migrazioni. I controlli alla frontiera - La frontiera dei controlli. 2017 Available from: https://www.inmp.it/lg/LG_Migranti-integrata.pdf
23. Ministero della Salute. Linee guida per la programmazione degli interventi di assistenza e riabilitazione nonché per il trattamento dei disturbi psichici dei titolari dello status di rifugiato e dello status di protezione sussidiaria che hanno subito torture, stupri o altre forme. 2017 Available from: http://www.salute.gov.it/imgs/C_17_pubblicazioni_2599_allegato.pdf
24. Pavli A, Maltezou H. Health problems of newly arrived migrants and refugees in Europe. J. Travel Med. 2017 DOI: 10.1093/jtm/tax016
25. Bettini M, Donisi A, Gerna L. Sportello psicologico per migranti richiedenti asilo: l’esperienza di Piacenza. Proceeding of the XIV SIMM (Italian Migration Health Society) Congress; 2016 May 11-14; Turin, IT (available at www.simmweb.it )