Undocumented migrant women in Denmark have inadequate access to pregnancy screening and have a higher prevalence Hepatitis B virus infection compared to documented migrants in Denmark: a prevalence study.
Undocumented migrant women in Denmark have inadequate access to pregnancy screening and have a higher prevalence Hepatitis B virus infection compared to documented migrants in Denmark: a prevalence study.
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DOI：
10.1186/s12889-016-3096-8
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发表时间：
2016-05-23
影响因子：
4.5
通讯作者：
Cowan SA
中科院分区：
文献类型：
--
作者：
Wendland A;Ehmsen BK;Lenskjold V;Astrup BS;Mohr M;Williams CJ;Cowan SA
丹麦的怀孕居民通过丹麦妊娠筛查计划接受全科医生当前乙型肝炎病毒 (HBV)、艾滋病毒和梅毒感染情况的检测，以识别感染情况并采取干预措施，防止母婴传播。有证件的移民 (DM) 可以接受此筛查，但无证移民 (UM) 则不能，而是依赖非政府组织运营的诊所的临时护理。我们的目的是评估 UM 的筛查频率，并比较 UM 和 DM 的感染率。我们获得了 2011 年 8 月至 2014 年 8 月期间前往三个专门从事 UM 护理的诊所就诊的孕妇的 HBV、HIV 和梅毒检测频率和结果的个人信息。我们从 2011 年 1 月至 2014 年 1 月期间从丹麦妊娠筛查计划和出生登记中获得了有记录移民的三种感染流行率的汇总数据。计划堕胎被排除在研究之外。我们描述了孕妇 UM 的人口特征，并估计了 HIV、HBV 和梅毒的筛查频率。我们通过计算标准化患病率 (SPR) 来比较当前 UM 和 DM 感染的患病率。 UM 的三个诊所登记了 219 名符合筛查资格的怀孕者。总体而言，43%、58% 和 60% 的孕妇分别记录了 HBV、梅毒和 HIV 检测结果，而包括 DM 在内的丹麦普通人群的检测结果则超过 99%。 UM 中的 HBV 患病率高于 DM 中的患病率（SPR：2.4；95% CI：1.1–5.3）。 HIV 的 SPR 为 2（95% CI：0.5–8.0）没有统计学意义，可能是由于 UM 样本量较小。怀孕的 UM 中没有人梅毒检测呈阳性。尽管 UM 孕妇的 HBV 患病率高于 DM，但其接受 HIV、HBV 和梅毒检测的机会较小。我们建议为所有 UM 提供系统性的常规妊娠筛查，以防止母婴传播并解决观察到的医疗保健不平等问题。
Pregnant residents of Denmark are tested by their GP for current infections with Hepatitis B virus (HBV), HIV and syphilis through the Danish pregnancy screening programme to identify infections and initiate interventions to prevent mother-to-child transmission. Documented migrants (DM) have access to this screening but undocumented migrants (UM) do not, instead relying on ad-hoc care from clinics run by non-governmental organisations. We aimed to assess screening frequency in UM and to compare prevalence of infection in UM with DM. We obtained individual-level information on HBV, HIV and syphilis testing frequency and results for pregnant women attending three clinics specialising in care for UM between August 2011 and August 2014. We obtained aggregate data on the prevalence of the three infections for documented migrants from the Danish pregnancy screening programme and birth register between January 2011 and January 2014. Planned abortions were excluded from the study. We described demographic features of pregnant UM and estimated the screening frequency for HIV, HBV and syphilis. We compared prevalence of current infections in UM and DM by calculating standardised prevalence ratios (SPR). The three UM clinics registered 219 pregnancies qualifying for screening. Overall 43, 58 and 60 % of pregnant UM had a test result recorded for HBV, Syphilis and HIV respectively, compared to >99 % in the general Danish population including DM. The prevalence of HBV was higher in UM than in DM (SPR: 2.4; 95 % CI: 1.1–5.3). The SPR of 2 (95 % CI: 0.5–8.0) for HIV was not statistically significant, potentially due to small sample size of UM. None of the pregnant UM tested positive for Syphilis. Pregnant UM have a poorer chance of being tested for HIV, HBV and syphilis, despite having a higher prevalence of HBV than DM. We recommend giving systematic access to routine pregnancy screening to all UM to prevent mother-to-child transmission and to address the observed health care inequity.