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1.
Rev Esc Enferm USP ; 58: e20230282, 2024.
Artigo em Inglês, Espanhol, Português | MEDLINE | ID: mdl-38743955

RESUMO

OBJECTIVE: To characterize and analyze violence committed against Venezuelan immigrant female sex workers, from the perspective of an intersectional look at social class, gender and race-ethnicity. METHOD: Exploratory study with a qualitative approach. Data sources: interviews with 15 Venezuelan immigrant women sex workers and 37 Brazilian online media reports that addressed the topic. Data were submitted to thematic content analysis, with the support of Qualitative Data Analysis (WebQDA) software. RESULTS: Thematic analysis of data from reports and interviews allowed the emergence of three empirical categories: Structural violence and reasons that led to prostitution: a question of social class; Among the forms of violence, the most feared: physical violence; Violence based on gender and race-ethnicity. CONCLUSION: The study made it possible to recognize that Venezuelan immigrant women who are sex workers in Brazil are subject to different types of violence and exploitation. This scenario is due to a reality of life and work that is based on the exploitation of female workers who experience the consequences of the interweaving of subalternities characteristic of their social insertion of class, gender and race-ethnicity.


Assuntos
Emigrantes e Imigrantes , Profissionais do Sexo , Humanos , Feminino , Venezuela , Brasil , Adulto , Emigrantes e Imigrantes/estatística & dados numéricos , Profissionais do Sexo/estatística & dados numéricos , Profissionais do Sexo/psicologia , Adulto Jovem , Violência/estatística & dados numéricos , Trabalho Sexual/estatística & dados numéricos , Pessoa de Meia-Idade
2.
Can J Surg ; 67(3): E228-E235, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38729643

RESUMO

BACKGROUND: Immigrants and refugees face unique challenges navigating the health care system to manage severe arthritis, because of unfamiliarity, lack of awareness of surgical options, or access. The purpose of this study was to assess total knee arthroplasty (TKA) uptake, surgical outcomes, and hospital utilization among immigrants and refugees compared with Canadian-born patients. METHODS: We included all adults undergoing primary TKA from January 2011 to December 2020 in Ontario. Cohorts were defined as Canadian-born or immigrants and refugees. We assessed change in yearly TKA utilization for trend. We compared differences in 1-year revision, infection rates, 30-day venous thromboembolism (VTE), presentation to emergency department, and hospital readmission between matched Canadian-born and immigrant and refugee groups. RESULTS: We included 158 031 TKA procedures. A total of 11 973 (7.6%) patients were in the immigrant and refugee group, and 146 058 (92.4%) patients were in the Canadian-born group. The proportion of TKAs in Ontario performed among immigrants and refugees nearly doubled over the 10-year study period (p < 0.001). After matching, immigrants were at relatively lower risk of 1-year revision (0.9% v. 1.6%, p < 0.001), infection (p < 0.001), death (p = 0.004), and surgical complications (p < 0.001). No differences were observed in rates of 30-day VTE or length of hospital stay. Immigrants were more likely to be discharged to rehabilitation (p < 0.001) and less likely to present to the emergency department (p < 0.001) than Canadian-born patients. CONCLUSION: Compared with Canadian-born patients, immigrants and refugees have favourable surgical outcomes and similar rates of resource utilization after TKA. We observed an underutilization of these procedures in Ontario relative to their proportion of the population. This may reflect differences in perceptions of chronic pain or barriers accessing arthroplasty.


Assuntos
Artroplastia do Joelho , Emigrantes e Imigrantes , Humanos , Artroplastia do Joelho/estatística & dados numéricos , Ontário/epidemiologia , Feminino , Masculino , Idoso , Pessoa de Meia-Idade , Emigrantes e Imigrantes/estatística & dados numéricos , Refugiados/estatística & dados numéricos , Estudos de Coortes , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Readmissão do Paciente/estatística & dados numéricos , Resultado do Tratamento , Complicações Pós-Operatórias/epidemiologia
3.
BMC Public Health ; 24(1): 1257, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38715007

RESUMO

BACKGROUND: The ongoing global migration has led to multicultural societies, with many migrants who do not speak the official language in the host country. This could contribute to communication problems with staff in healthcare and a risk to patient safety. Research on patient safety in medication use in migrants is an under-researched area. The aim was to explore diverse foreign-born people's experiences and perceptions of self-management of medication and determine if home-based practice patterns have implications on medication safety, and what factors may support safe medication use. METHODS: A qualitative explorative study, with individual semi-structured interviews and participant observations in the patients' home. Qualitative content analysis was applied. RESULTS: A purposeful sample of 15 foreign-born persons identified by healthcare staff as having language difficulties in Swedish that may pose a safety risk in connection with medication use at home, was selected. Three categories were identified. The first category showed respondents being dependent on another person, having experiences of not receiving information about their medications due to language barriers, having difficulties getting access to the healthcare centre and feeling distrusted/misunderstood. The second category showed respondents being independent and self-motivated Although they struggled, they managed to get access/contact with the healthcare centre themselves and felt understood/listened to by the staff. The last category concerned factors that facilitating medication use; such as having a medication list in the respondents' own language and offering a choice of language on the answering machine at the healthcare centre. Although they knew it was impossible to get an interpreter at the pharmacy, they felt safe knowing there was always a solution for receiving understandable information. CONCLUSION: The findings highlighted that language barriers can complicate the communication between migrants and the healthcare, which can affect the medication safety. Understanding of this group is essential to improve the cooperation between patients and staff, leading to culturally congruent care. This knowledge should be used in healthcare to understand the gap in communication to increase patient safety. Further research from other angles, e.g. pharmacy/healthcare staff and relatives is needed to identify and evaluate facilitation to improve the outcome of the intended medication treatment.


Assuntos
Barreiras de Comunicação , Emigrantes e Imigrantes , Segurança do Paciente , Pesquisa Qualitativa , Humanos , Suécia , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Emigrantes e Imigrantes/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Idoso , Entrevistas como Assunto
4.
BMC Psychol ; 12(1): 251, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38715097

RESUMO

BACKGROUND: Despite a world-leading educational system, an achievement gap in educational outcomes exists between children of refugee background and native-born peers in Finland. To offer targeted support for children at schools, we need to be able to reliably assess and understand the interplay of the aspects of children's cognitive, social, and mental health functions that may explain the underachievement of refugee children. This study tests a novel research-based, universally applicable screening battery for evaluating cognitive, social, and mental health functioning of children at schools and planning supportive actions. It aims to answer research questions about a) the cognitive, social, and mental health functioning of refugee children compared with non-refugee immigrant and native-born children, b) the interplay of these different functions among refugee and other children, c) whether implementing a screening battery can inform schools in planning supportive actions for (refugee) children, and d) whether such supportive actions result in improvements in cognitive, social, and mental health functioning. METHODS: Four hundred fifty children aged 10-12 will be recruited from primary schools, including 150 children of refugee background, 150 of non-refugee immigrant background, and 150 native-born Finnish children. A screening battery including tasks and questionnaires on different aspects of cognitive, social, and mental health functioning will be used to assess the children in their classrooms at the start and end of a school year. Supporting information will also be collected from parents and teachers. The information gathered will be collated into class-level feedback reports for teachers and, with parental permission, individualized reports for multiprofessional student welfare bodies, for informing supportive actions. Correlational and latent profile analyses, ANOVAs, and linear regression will be used to answer the research questions. DISCUSSION: This study will help clarify how the interplay of cognitive, social, and mental health factors may explain underachievement at school among refugee children. It will provide evidence about the extent to which a standardized screening battery could be helpful in informing and planning supportive actions for children at schools, and whether such supportive actions can lead to positive cognitive, social, or mental health outcomes. TRIAL REGISTRATION: The study will be preregistered on the Open Science Framework.


Assuntos
Cognição , Saúde Mental , Refugiados , Instituições Acadêmicas , Humanos , Refugiados/psicologia , Refugiados/estatística & dados numéricos , Criança , Finlândia , Masculino , Feminino , Emigrantes e Imigrantes/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Estudantes/psicologia , Estudantes/estatística & dados numéricos
5.
Inquiry ; 61: 469580241252567, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38708687

RESUMO

Foreign-born people have been found to be less satisfied with health care than native populations across countries. However, studies on differences in satisfaction with treatment between different foreign-born groups are lacking. This study explores differences in satisfaction with primary health care between the foreign-born population from different regions of origins and the general population of Finland. The study uses survey data on foreign-born population (n = 2708) and general population (n = 6671) living in Finland who report using health services. Satisfaction with experienced respect for privacy during treatment, benefit of treatment and smoothness of treatment are predicted by region of origin using logistic regression. Almost all foreign-born groups were less likely to consider treatment appointments beneficial as compared to the general population. Some foreign-born groups (people from Southeast Asia and South and Central Asia) were more satisfied with smoothness of care compared to general population. People from East Asia were less likely than the general population to consider that their privacy had been respected during the examinations and treatment. While we made the positive finding of high overall satisfaction with treatment, we also found important differences between groups. In particular, appointments were found less useful among the foreign-born population. Perceived unusefulness of treatment might lead to underuse of health care, which might result in accumulation of untreated health problems. The results point toward potential development points in the health care system. Addressing these issues might help decrease health disparities between population groups.


Assuntos
Emigrantes e Imigrantes , Satisfação do Paciente , Atenção Primária à Saúde , Humanos , Finlândia , Atenção Primária à Saúde/estatística & dados numéricos , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Emigrantes e Imigrantes/estatística & dados numéricos , Emigrantes e Imigrantes/psicologia , Idoso , Inquéritos e Questionários , Adolescente , Adulto Jovem
6.
Neurology ; 102(10): e209350, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38657190

RESUMO

BACKGROUND AND OBJECTIVES: While immigrants to high-income countries have a lower risk of multiple sclerosis (MS) compared with host populations, it is unknown whether this lower risk among immigrants increases over time. Our objective was to evaluate the association between proportion of life spent in Canada and the hazard of incident MS in Canadian immigrants. METHODS: We conducted a population-based retrospective cohort study in Ontario, using linked health administrative databases. We followed immigrants, who arrived in Ontario between 1985 and 2003, from January 1, 2003, to December 31, 2016, to record incident MS using a validated algorithm based on hospital admission or outpatient visits. We derived proportion of life spent in Canada based on age at arrival and time since immigration obtained from linked immigration records. We used multivariable proportional hazard models, adjusting for demographics and comorbidities, to evaluate the association between proportion of life in Canada and the incidence of MS, where proportion of life was modelled using restricted cubic spline terms. We further evaluated the role of age at migration (15 or younger vs older than 15 years), sex, and immigration class in sensitivity analyses. RESULTS: We included 1.5 million immigrants (49.9% female, mean age 35.9 [SD 14.2] years) who had spent a median of 20% (Q1-Q3 10%-30%) of their life in Canada. During a mean follow-up of 13.9 years (SD 1.0), 934 (0.44/100,000 person-years) were diagnosed with MS. Compared with the median, a higher risk of MS was observed at higher values of proportion of life spent (e.g., hazard ratio [70% vs 20% proportion of life] 1.38; 1.07-1.78). This association did not vary by sex (p(sex × proportion of life) = 0.70) or immigration class (p(immigration class × proportion of life) = 0.13). The results did not vary by age at migration but were statistically significant only at higher values of proportion of life for immigrants aged 15 years or younger at arrival. DISCUSSION: The risk of incident MS in immigrants varied with the proportion of life spent in Canada, suggesting an acculturation effect on MS risk. Further work is required to understand environmental and sociocultural factors driving the observed association.


Assuntos
Emigrantes e Imigrantes , Esclerose Múltipla , Humanos , Esclerose Múltipla/epidemiologia , Esclerose Múltipla/etnologia , Masculino , Feminino , Emigrantes e Imigrantes/estatística & dados numéricos , Adulto , Incidência , Estudos Retrospectivos , Pessoa de Meia-Idade , Ontário/epidemiologia , Adulto Jovem , Adolescente , Canadá/epidemiologia , Estudos de Coortes , Fatores Etários
7.
Soc Sci Med ; 349: 116897, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38648707

RESUMO

Empirical studies in multiple disciplines have frequently observed an immigrant mortality advantage. Yet, questions remain regarding the possible mechanisms underlying this phenomenon. We obtained data from 61 studies of relative immigrant mortality from single origin-destination country pairings, providing information on immigrants from 77 origin countries. We systematically review the arguments made in these studies about origin-country factors that might influence immigrant mortality and then use meta-analyses to examine the veracity of these arguments. We find that most existing origin-country explanations for immigrant mortality patterns (e.g., health behaviors, genetic characteristics, environmental conditions, and socioeconomic conditions) are problematic or insufficient when accounting for differential mortality by origin country. We identify non-comparative analyses and geographic aggregation as the two major obstacles to understanding the mechanisms underlying the immigrant mortality advantage. We conclude by advocating for a risk-factor-based, cross-national approach.


Assuntos
Emigrantes e Imigrantes , Mortalidade , Humanos , Emigrantes e Imigrantes/estatística & dados numéricos , Mortalidade/tendências , Fatores de Risco , Fatores Socioeconômicos
8.
Medicine (Baltimore) ; 103(17): e37729, 2024 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-38669436

RESUMO

With the global migrant population on the rise, it's imperative to focus on the health status of more vulnerable groups within these communities. The elderly immigrants face myriad physical and psychosocial challenges that significantly impact their health and quality of life. This study aims to investigate the nutrition, daily life activities, and clinical frailty status of elderly immigrants residing in Türkiye. A cross-sectional design was employed in the Sultanbeyli District, focusing on Syrian immigrants aged 65 and over. Participants were surveyed face-to-face by interpreters proficient in Arabic. The questionnaire comprised sociodemographic details, health status, and scales like Katz Daily Life Activities, Clinical Frailty, and Mini Nutritional Assessment. The data analysis was executed using SPSS 22. Continuous variables were presented as mean ±â€…standard deviation (SD) and median, while categorical ones were expressed in numbers and percentages (%). A significance level of P < .05 was considered for the analyses. The average age of the participants was determined as 71.64 ±â€…6.20 years. In the study group, 49.7% were female, 75.5% were younger than 75 years old, 47.7% had less than primary school education, 56.3% were married, 42.4% had a low income level, and 56.9% lived in the same household with 5 or more people. Among the participants in the study group, 47% had walking and balance problems, 29.1% had a history of falls in the last year, 10.6% were disabled, 69.5% complained of pain, 82.8% had a chronic illness, and 43% had polypharmacy. The median value of the KATZ Daily Living Activities scale was 6, the mean score of the Clinical Frailty Score scale was 3.25 ±â€…1.25, and the mean score of the Mini Nutritional Assessment scale was 12.40 ±â€…2.15. Among immigrant elderly individuals, 88.1% were able to sustain their lives independently, 13.9% were clinically frail, and 3.3% were at risk of malnutrition. Factors such as age, level of education, socioeconomic status, marital status, number of cohabitants in the household, BMI, neurological problems, walking-balance disorders, disability, and presence of chronic diseases are associated with daily life activities, frailty, and malnutrition status. It is believed that broader field research with greater participation would be beneficial for evaluating the nutritional status of immigrant elderly individuals.


Assuntos
Atividades Cotidianas , Emigrantes e Imigrantes , Fragilidade , Avaliação Geriátrica , Estado Nutricional , Humanos , Feminino , Estudos Transversais , Idoso , Masculino , Emigrantes e Imigrantes/estatística & dados numéricos , Emigrantes e Imigrantes/psicologia , Fragilidade/epidemiologia , Avaliação Geriátrica/métodos , Idoso Fragilizado/estatística & dados numéricos , Idoso Fragilizado/psicologia , Idoso de 80 Anos ou mais , Turquia , Avaliação Nutricional , Qualidade de Vida , Fatores Socioeconômicos
9.
Soc Sci Med ; 348: 116822, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38569290

RESUMO

A growing body of scholarship examines the varying impact of legal status and race on accessing healthcare. However, a notable gap persists in comprehending the supplementary mechanisms that hinder immigrants' pathway to seek care. Drawing on ethnographic observations in various clinical settings and in-depth interviews with 28 healthcare professionals and 12 documented Haitian immigrants in a city in Upstate New York, between 2019 and 2021, I demonstrate the tension between the conceptualization and implementation of inclusive care practices by healthcare providers. I argue that the mere expansion and adoption of inclusive discourse among providers do not inherently ensure equity and the removal of barriers to healthcare access. This work contributes to the social study of medicine and race and ethnic studies by introducing the innovative concept of "immigrant-blind." Through this concept, the research sheds light on how providers' conceptualization of inclusivity proclaims medical encounters to be devoid of stratifications and rationalizes their practices which mask the profound impact of immigration status and immigration on immigrant health. Furthermore, these practices reinforce existing divisions within care settings and medical encounters, where immigration laws and enforcement practices operate and further exacerbate stratifications. By examining providers' uninformed implementation of culturally competent care practices, the findings reveal that providers stigmatize and essentialize immigrants during medical encounters. This highlights the imperative for a more nuanced and informed approach to healthcare provision, where genuine inclusivity is upheld, and barriers to access are dismantled to foster equitable and dignified healthcare experiences for all.


Assuntos
Emigrantes e Imigrantes , Acessibilidade aos Serviços de Saúde , Humanos , Emigrantes e Imigrantes/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Haiti/etnologia , New York , Feminino , Masculino , Pesquisa Qualitativa , Pessoal de Saúde/psicologia , Adulto , Antropologia Cultural
11.
Arch Iran Med ; 27(3): 142-150, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38685839

RESUMO

BACKGROUND: This study investigated the quality of inpatient care provided to Afghan immigrants in Iran during the COVID-19 pandemic (February 2019 to March 2021). For this purpose, the services received by Afghan immigrants were compared with those received by Iranian citizens. METHODS: Two emergency services (traumas with 8080 victims and 8,686 patients hospitalized with severe COVID-19 infection) were taken into consideration. The records of all patients, including the Afghan immigrants, in two referral hospitals in Kerman were reviewed, and the main variables were the length of hospitalization (LoH), intensive care unit (ICU) admission rate, and death rate. Quantile regression, multiple logistic regression, and Cox regression were used to analyze the data. RESULTS: The median and interquartile range of LoH for Afghan and Iranian nationals admitted due to traumas were 3.0±4.0 and 2.0±4.0, respectively (P<0.01). Moreover, the chance of Afghan nationals being admitted to the ICU (38%, odds ratio=1.38; 95% confidence interval [CI]=1.12; 1.69) and the hazard of death (60%, hazard rate=1.60; 95% CI=1.03; 2.49) were higher compared to Iranian nationals, which is statistically significant. However, no significant differences were observed between the COVID-19 patients from the two nationalities in terms of the median LoH, the odds of being admitted to the ICU, and the hazard of death due to COVID-19. CONCLUSION: Afghan nationals admitted to the hospital due to traumas were more likely to be admitted to ICUs or die compared to Iranian citizens. It seems that Afghan patients who had traumas went to the hospitals with more serious injuries. There was no difference between Afghan and Iranian patients in terms of COVID-19 consequences. Following the findings of this study, it seems that justice in treatment has been fully established for Afghan patients in Iran.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , COVID-19/terapia , Irã (Geográfico)/epidemiologia , Afeganistão/etnologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Emigrantes e Imigrantes/estatística & dados numéricos , Serviços Médicos de Emergência/estatística & dados numéricos , Unidades de Terapia Intensiva/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Adulto Jovem , Estudos Retrospectivos , Idoso , Hospitalização/estatística & dados numéricos , Adolescente
12.
Scand J Public Health ; 52(3): 370-378, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38600446

RESUMO

BACKGROUND: Explanations for the disproportional COVID-19 burden among immigrants relative to host-country natives include differential exposure to the virus and susceptibility due to poor health conditions. Prior to the pandemic, immigrants displayed deteriorating health with duration of residence that may be associated with increased susceptibility over time. The aim of this study was to compare immigrant-native COVID-19 mortality by immigrants' duration of residence to examine the role of differential susceptibility. METHODS: A population-based cohort study was conducted with individuals between 18 and 100 years old registered in Sweden between 1 January 2015 and 15 June 2022. Cox regression models were run to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: Inequalities in COVID-19 mortality between immigrants and the Swedish-born population in the working-age group were concentrated among those of non-Western origins and from Finland with more than 15 years in Sweden, while for those of retirement age, these groups showed higher COVID-19 mortality HRs regardless of duration of residence. Both age groups of immigrants from Africa and the Middle East showed consistently higher COVID-19 mortality HRs. For the working-age population: Africa: HR<15: 2.46, 95%CI: 1.78, 3.38; HR≥15: 1.49, 95%CI: 1.01, 2.19; and from the Middle East: HR<15: 1.20, 95%CI: 0.90, 1.60; HR≥15: 1.65, 95%CI: 1.32, 2.05. For the retirement-age population: Africa: HR<15: 3.94, 95%CI: 2.85, 5.44; HR≥15: 1.66, 95%CI: 1.32, 2.09; Middle East: HR<15: 3.27, 95%CI: 2.70, 3.97; HR≥15: 2.12, 95%CI: 1.91, 2.34. CONCLUSIONS: Differential exposure, as opposed to differential susceptibility, likely accounted for the higher COVID-19 mortality observed among those origins who were disproportionately affected by the pandemic in Sweden.


Assuntos
COVID-19 , Emigrantes e Imigrantes , Humanos , COVID-19/mortalidade , COVID-19/etnologia , Suécia/epidemiologia , Emigrantes e Imigrantes/estatística & dados numéricos , Adulto , Estudos de Coortes , Pessoa de Meia-Idade , Feminino , Masculino , Adulto Jovem , Idoso , Adolescente , Fatores de Tempo , Idoso de 80 Anos ou mais , Disparidades nos Níveis de Saúde
13.
J Am Heart Assoc ; 13(9): e030228, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38686900

RESUMO

Europe and North America are the 2 largest recipients of international migrants from low-resource regions in the world. Here, large differences in cardiovascular disease (CVD) morbidity and death exist between migrants and the host populations. This review discusses the CVD burden and its most important contributors among the largest migrant groups in Europe and North America as well as the consequences of migration to high-income countries on CVD diagnosis and therapy. The available evidence indicates that migrants in Europe and North America generally have a higher CVD risk compared with the host populations. Cardiometabolic, behavioral, and psychosocial factors are important contributors to their increased CVD risk. However, despite these common denominators, there are important ethnic differences in the propensity to develop CVD that relate to pre- and postmigration factors, such as socioeconomic status, cultural factors, lifestyle, psychosocial stress, access to health care and health care usage. Some of these pre- and postmigration environmental factors may interact with genetic (epigenetics) and microbial factors, which further influence their CVD risk. The limited number of prospective cohorts and clinical trials in migrant populations remains an important culprit for better understanding pathophysiological mechanism driving health differences and for developing ethnic-specific CVD risk prediction and care. Only by improved understanding of the complex interaction among human biology, migration-related factors, and sociocultural determinants of health influencing CVD risk will we be able to mitigate these differences and truly make inclusive personalized treatment possible.


Assuntos
Doenças Cardiovasculares , Humanos , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etnologia , América do Norte/epidemiologia , Europa (Continente)/epidemiologia , Migrantes/estatística & dados numéricos , Migrantes/psicologia , Fatores de Risco , Medição de Risco , Emigração e Imigração , Emigrantes e Imigrantes/estatística & dados numéricos
14.
Clin Neurol Neurosurg ; 240: 108255, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38552363

RESUMO

BACKGROUND: Multiple sclerosis (MS) is the most common chronic demyelinating disease of the central nervous system and the major non-traumatic cause of permanent disability in young adults. Several migration studies have been performed over the years suggesting a pattern of higher disease disability in certain ethnic groups. To our knowledge, differences in disease progression in immigrants have not been studied in Sweden before. Thus, the aims of our study were to estimate the prevalence of multiple sclerosis among first-generation immigrants in the City of Malmö and to compare differences in disease severity with the native population. METHODS: All persons with multiple sclerosis living in Malmö on prevalence day 31 Dec 2010 were included. Cases were classified according to the country of birth into Scandinavians, Western and non-Western. RESULTS: The crude prevalence was 100/100,000 (95% CI, 80-124) among first-generation immigrants, 154/100,000 (95% CI, 137-173) among individuals with Scandinavian background, 123/100,000 (95% CI, 94-162) in the Western group and 76/100,000 (95% CI, 53-108) in the non-Western group. The mean Multiple Sclerosis Severity Score (MSSS) value among Scandinavians was 4.2 (SD 3.5), whereas the figures in the immigrant group were 4.6 (SD 3.3) and 5.2 (SD 3.7) among Westerns respectively non-Westerns, which differences were not statistically significant. When adjusting for gender, age at onset and initial disease course, the mean MSSS difference between the non-Western and the Scandinavian individuals was 1.7 (95% CI 0.18-3.3, p = 0.030). There were no differences on time to diagnosis or the time from diagnosis to treatment initiation between the three groups. CONCLUSIONS: We found a lower prevalence among Western and non-Western first-generation immigrants compared to the Scandinavian population and a more severe disease in non-Western immigrants than in Scandinavians.


Assuntos
Emigrantes e Imigrantes , Esclerose Múltipla , Humanos , Suécia/epidemiologia , Emigrantes e Imigrantes/estatística & dados numéricos , Adulto , Feminino , Masculino , Esclerose Múltipla/epidemiologia , Esclerose Múltipla/etnologia , Prevalência , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Idoso , Avaliação da Deficiência , Índice de Gravidade de Doença , Progressão da Doença , Pessoas com Deficiência/estatística & dados numéricos
16.
Travel Med Infect Dis ; 59: 102708, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38467231

RESUMO

INTRODUCTION: Detecting imported diseases by migrants and individuals visiting friends and relatives (VFR) is key in the prevention and management of emergent infectious diseases acquired abroad. METHODS: Retrospective descriptive study on migrants and VFR from Central and South America between 2017 and 2022 attended at a National Referral Centre for Tropical Diseases in Madrid, Spain. Demographic characteristics, syndromes and confirmed travel-related diagnoses were obtained from hospital patient medical records. RESULTS: 1654 cases were registered, median age of 42 years, 69.1% were female, and 55.2% were migrants. Most cases came from Bolivia (49.6%), followed by Ecuador (12.9%). Health screening while asymptomatic (31.6%) was the main reason for consultation, followed by Chagas disease follow-up (31%). Of those asymptomatic at screening, 47,2% were finally diagnosed of any disease, mainly Chagas disease (19,7%) and strongyloidiasis (10,2%) CONCLUSION: Our study emphasizes the importance of proactive health screening to detect asymptomatic conditions in migrants and VFR, enabling timely intervention and improved health outcomes. By understanding the unique health profiles of immigrant populations, targeted public health interventions can be devised to safeguard the well-being of these vulnerable groups.


Assuntos
Doenças Transmissíveis Importadas , Migrantes , Humanos , Estudos Retrospectivos , Feminino , Masculino , Adulto , Doenças Transmissíveis Importadas/epidemiologia , Doenças Transmissíveis Importadas/prevenção & controle , Doenças Transmissíveis Importadas/diagnóstico , Espanha/epidemiologia , Migrantes/estatística & dados numéricos , Pessoa de Meia-Idade , Viagem/estatística & dados numéricos , Adolescente , América Latina/epidemiologia , América Latina/etnologia , Adulto Jovem , Doença de Chagas/diagnóstico , Doença de Chagas/epidemiologia , Doença de Chagas/prevenção & controle , Criança , Idoso , Medicina Tropical , Encaminhamento e Consulta/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos
17.
Hawaii J Health Soc Welf ; 83(2): 48-53, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38344695

RESUMO

The objective of this study was to estimate the prevalence of chronic hepatitis B infection in foreign-born Asians and Pacific Islanders at Kalihi-Palama Health Center in Honolulu, Hawai'i, and to assess the association between both chronic and resolved hepatitis B infection and risk factors such as household exposure to hepatitis B virus and geographic location of birthplace. The study involved cross-sectional data from 997 participants who accessed medical services at Kalihi-Palama Health Center between September 2015 and July 2020. The prevalence of chronic hepatitis B was 10.7%. On multivariable logistic regression analysis, the adjusted prevalence odds ratio of chronic hepatitis B infection was 3.3 times greater (95% confidence interval: 1.1, 9.2) for those who reported household contact with a person with hepatitis B infection than those who reported no such contact. No association was found with place of birth in this study population. Age was a significant predictor of chronic hepatitis B, with participants between 35-44 years of age having the highest prevalence. Age was also a significant predictor of resolved hepatitis B infection, with participants 65 years of age or older having the highest prevalence. These findings emphasize the need for targeted screening and appropriate follow-up-including vaccination or treatment-in this at-risk population.


Assuntos
Asiático , Emigrantes e Imigrantes , Hepatite B Crônica , População das Ilhas do Pacífico , Adulto , Humanos , Ásia/etnologia , Asiático/estatística & dados numéricos , Estudos Transversais , Havaí/epidemiologia , Hepatite B/epidemiologia , Hepatite B Crônica/epidemiologia , Hepatite B Crônica/prevenção & controle , População das Ilhas do Pacífico/estatística & dados numéricos , Ilhas do Pacífico/etnologia , Prevalência , Fatores de Risco , Idoso , Emigrantes e Imigrantes/estatística & dados numéricos
18.
Am J Mens Health ; 18(1): 15579883241227333, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38311894

RESUMO

The digestive health of African American/Black male immigrants in the United States has not been previously studied. Much of what is known about gastrointestinal (GI) concerns in this population is based on studies conducted on the overall Black American population. The purpose of this narrative study was to understand how African American/Black male immigrants with GI concerns navigated their GI condition. Fifteen African American/Black male immigrants from various cities in the United States participated in two remote focus groups to discover what motivates them to take control of their illness. Narrative analysis was used to analyze the qualitative data. Most men, 47% (n = 7), did not have health insurance, and 67% (n = 10) reported their income was less than US$52,000. The themes identified were: (1) lack of knowledge of GI, (2) denial of initial diagnosis, (3) self-discipline, (4) positive provider interactions, (5) health as a priority, and (6) advice to other African American/Black male immigrants experiencing GI. A strengths-based approach is necessary for describing the health-seeking behaviors among African American/Black male immigrants.


Assuntos
Atitude Frente a Saúde , População Negra , Emigrantes e Imigrantes , Gastroenteropatias , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , População Negra/psicologia , População Negra/estatística & dados numéricos , Emigrantes e Imigrantes/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Grupos Focais , Comportamentos Relacionados com a Saúde/etnologia , Estados Unidos/epidemiologia , Motivação , Cidades , Atitude Frente a Saúde/etnologia , Gastroenteropatias/epidemiologia , Gastroenteropatias/etnologia , Gastroenteropatias/psicologia , Gastroenteropatias/terapia
20.
J Epidemiol Glob Health ; 14(1): 154-161, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38261173

RESUMO

OBJECTIVE: This study ascertains the effects of the pre-entry tuberculosis (TB) screening policy, which was implemented as a strategy for managing TB among immigrants, on the treatment outcomes of immigrants in South Korea. METHODS: This study linked three different datasets from 2013 to 2018, namely (1) Korean National Tuberculosis Surveillance System; (2) National Health Information Database for patients diagnosed with TB with ICD code A15-A19, B90, or U84.3; and (3) Statistics Korea database related to cause of deaths. To identify the effect of the policy, cohorts comprising Korean and immigrant TB patients notified before (January 1, 2013-December 31, 2015) and after (September 1, 2016-December 31, 2018), the implementations of the policy were established. A difference-in-differences (DID) analysis of the treatment success and mortality rates was performed. RESULTS: Data from 100,262 TB patients were included in the analysis (before policy implementation: 1240 immigrants and 65,723 Koreans; after policy implementation: 256 immigrants and 33,043 Koreans). The propensity score matching-DID analysis results showed that the difference in the treatment success rate between immigrants and Koreans decreased significantly, from 16% before to 6% after the policy implementation. The difference in the mortality rate between the two groups decreased from - 3% before to - 1% after the policy implementation; however, this difference was insignificant. CONCLUSION: The treatment outcomes of immigrant TB patients in South Korea improved after the implementation of the pre-entry active TB screening policy. Future immigrant TB policies should consider establishing active patient support strategies and a healthcare collaboration system between countries.


Assuntos
Emigrantes e Imigrantes , Programas de Rastreamento , Tuberculose , Humanos , República da Coreia/epidemiologia , Masculino , Feminino , Emigrantes e Imigrantes/estatística & dados numéricos , Adulto , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Tuberculose/diagnóstico , Resultado do Tratamento , Adulto Jovem , Adolescente , Idoso
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