Effectiveness of a screening program for HBV, HCV, and HIV infections in African migrants to Sicily.

BACKGROUND: Migrants from Africa are vulnerable to viral infections during their journey. METHODS: Migrants who arrived in western Sicily were offered early screening for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infection. A questionnaire was administered to evaluate risk factors, and antiviral therapy was offered to subjects with active infection. A multiple regression analysis and adjusted odds ratio were obtained to evaluate risk factors. RESULTS: Overall, 2,639 of 2,751 (95.9%) migrants who arrived between 2015 and 2017 accepted screening and 1,911 (72.4%) completed the questionnaire. HBsAg was positive in 257 (9.7%) migrants, 24 (0.9%) were anti-HCV positive and 57 (2.2%) had HIV infection. The prevalence of HBV infection was higher in women (aOR 2.47,95%CI 1.90-3.20),p = 0.003) and in people who endured physical and/or sexual violence (aOR 2.24,95%CI 1.87-3.55,p<0.001), while HIV infection was more frequent in women (aOR 5.40,95%CI 3.09-9.43, p <0.001) who were in Libya for a long period (aOR 5.66,95%CI 2.90-10.70,p = 0.004) and endured physical and/or sexual violence (aOR 14.77,95%CI 8.34-22.11,p<0.001). Being older than 18 was associated with HCV infection (p<0.001). Overall, 77% of 57 subjects with HIV infection were retained in care, 79% of 70 chronic HBV hepatitis cases started nucleot(s)ide analogues and 61% of 18 HCV-RNA positive cases received direct-acting antiviral therapy. CONCLUSIONS: These findings evidence the effectiveness and feasibility of infectious disease screening programs for migrants.

Urinary schistosomiasis in migrant population: a case series from a single centre in southern Italy.

PURPOSE: To understand the frequency of urinary schistosomiasis, in migrants in clinical follow-up at the infectious disease outpatient clinic of ARNAS Civico Hospital in Palermo Italy, to raise awareness on this neglected tropical disease. METHODS: A retrospective analysis of migrant patients in clinical care in our centre during the triennium 2015-2017. RESULTS: 2639 migrants have been in clinical care during the triennium 2015-2017, 72% are male and 28% are female. 214 patients were tested for the presence of Schistosoma eggs in urine, these patients are all male. All the patients tested, reported macroscopic haematuria and the 54% had an increase in the peripheral blood eosinophil count. Ninety subjects had a positive microscopic examination for Schistosoma haematobium eggs. Patients were treated with a standard dose of praziquantel (40 mg/kg), and tested for Schistosoma 1 month after the end of therapy. All the subjects fully recovered. CONCLUSIONS: Considering the migration phenomenon, the observation of these tropical diseases in European hospitals is becoming more and more common and an increasing number of health care professionals will be dealing with migrants. Searching for haematuria and eosinophilia and then testing for Schistosoma in this specific population will increase the number of diagnosis and correct treatment of urinary schistosomiasis, improving the patients' quality of life and preventing severe complications of the disease.