Infectious diseases at different stages of migration: an expert review.
Infectious diseases at different stages of migration: an expert review.
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DOI：
10.1093/jtm/taz007
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发表时间：
2019-02-01
影响因子：
25.7
通讯作者：
Castelli, Francesco
中科院分区：
文献类型：
--
作者：
Greenaway, Christina;Castelli, Francesco
背景：人类移徙的规模和范围都在增加。抵达高收入国家的大多数移徙者来自传染病高发国家。传染病的风险和负担是不平等的移民群体之间的分布，并与migration stage.METHODS：广泛的文献综述进行了跨不同阶段的移民之间的传染病和相关的健康结果的驱动程序。其目的是提供从业人员在每个阶段的主要传染病风险的概述，以指导健康促进strategies.RESULTS：一个复杂的相互作用的因素导致传染病和相关的不良健康结果之间的移民。最重要的驱动因素是原籍国的传染病流行病学、移徙旅程的环境和条件以及抵达后获得医疗保健的障碍。在最近一波大规模被迫向欧洲移徙期间，抵达后的主要健康问题是心理、创伤和慢性非传染性疾病。在定居初期，接待营地拥挤和不卫生的生活条件助长了呼吸道、胃肠道、皮肤感染和疫苗可预防疾病的爆发。在重新定居后，由于结核病、病毒性肝炎、艾滋病毒、慢性蠕虫病和恰加斯病造成的潜伏感染未被发现和未经治疗，导致健康状况不佳。由于旅行前预防措施和疫苗接种不足，移徙者受到疟疾、伤寒和肝炎等可预防的旅行相关疾病的严重影响。移民中的传染病可以减少在所有移民阶段的健康促进战略，以适应他们的具体需求，并提供在语言和文化上敏感的mart.CONCLUSIONS：量身定制的健康促进和筛查方法和方便和响应的卫生系统，无论法律的地位，将需要在所有移民阶段，以限制负担和传染病在移民人口中的传播。
BACKGROUND: Human migration is increasing in magnitude and scope. The majority of migrants arriving in high-income countries originate from countries with a high prevalence of infectious diseases. The risk and burden of infectious diseases are not equally distributed among migrant groups and vary with migration stage.METHODS: A broad literature review was conducted on the drivers for infectious diseases and associated health outcomes among migrants across different stages of migration. The aim was to provide practitioners with an overview of the key infectious disease risks at each stage to guide health promotion strategies.RESULTS: A complex interaction of factors leads to infectious diseases and associated poor health outcomes among migrants. The most important drivers are the epidemiology of infectious diseases in their countries of origin, the circumstances and conditions of the migration journey and barriers accessing healthcare post-arrival. During the recent large waves of forced migration into Europe, the primary health concerns on arrival were psychological, traumatic and chronic non-communicable diseases. In the early settlement period, crowded and unhygienic living conditions in reception camps facilitated outbreaks of respiratory, gastrointestinal, skin infections and vaccine preventable diseases. After re-settlement, undetected and untreated latent infections due to tuberculosis, viral hepatitis, HIV, chronic helminthiasis and Chagas' disease led to poor health outcomes. Migrants are disproportionally affected by preventable travel-related diseases such as malaria, typhoid and hepatitis due to poor uptake of pre-travel prophylaxis and vaccination. Infectious diseases among migrants can be decreased at all migration stages with health promotion strategies adapted to their specific needs and delivered in a linguistically and culturally sensitive manner.CONCLUSIONS: Tailored health promotion and screening approaches and accessible and responsive health systems, regardless of legal status, will be needed at all migration stages to limit the burden and transmission of infectious diseases in the migrant population.