Migration among individuals with leprosy: a population-based study in central Brazil.

This study investigates social and clinical factors associated with migration among individuals affected by leprosy. A cross-sectional study was conducted among those newly diagnosed with leprosy (2006-2008), in 79 endemic municipalities in the state of Tocantins, Brazil (N = 1,074). In total, 76.2% were born in a municipality different from their current residence. In the five years before diagnosis 16.7% migrated, and 3.6% migrated after leprosy diagnosis. Findings reflect aspects associated with historical rural-urban population movement in Brazil. Indicators of poverty were prominent among before-diagnosis migrants but not after-diagnosis migrants. Migration after diagnosis was associated with prior migration. The association of multibacillary leprosy with migration indicates healthcare access may be an obstacle to early diagnosis among before-diagnosis migrants, which may also be related to the high mobility of this group.

Migration among individuals with leprosy: a population-based study in Central Brazil / Migração entre pessoas com hanseníase: estudo de base populacional no Centro-Oeste do Brasil / La migración entre personas con lepra: un estudio basado en la población en el centro de Brasil

This study investigates social and clinical factors associated with migration among individuals affected by leprosy. A cross-sectional study was conducted among those newly diagnosed with leprosy (2006-2008), in 79 endemic municipalities in the state of Tocantins, Brazil (N = 1,074). In total, 76.2% were born in a municipality different from their current residence. In the five years before diagnosis 16.7% migrated, and 3.6% migrated after leprosy diagnosis. Findings reflect aspects associated with historical rural-urban population movement in Brazil. Indicators of poverty were prominent among before-diagnosis migrants but not after-diagnosis migrants. Migration after diagnosis was associated with prior migration. The association of multibacillary leprosy with migration indicates healthcare access may be an obstacle to early diagnosis among before-diagnosis migrants, which may also be related to the high mobility of this group.

Este estudo investiga fatores sociais e clínicos associados à migração entre pessoas afetadas pela hanseníase. Estudo transversal entre recém- diagnosticados com hanseníase (2006-2008), em 79 municípios endêmicos do Estado de Tocantins, Brasil (N = 1.074). No total, 76,2% nasceram em município diferente de sua residência atual. Nos cinco anos antes do diagnóstico, 16,7% migraram, e 3,6% migraram após o diagnóstico da hanseníase. Resultados refletem aspectos associados com o movimento histórico da população rural-urbana no Brasil. Indicadores de pobreza foram proeminentes antes do diagnóstico de migrantes. A migração após o diagnóstico foi associada com migração anterior. A associação da forma multibacilar com migração indica que o acesso à saúde pode ser um obstáculo para o diagnóstico precoce de migrantes, o que pode também estar relacionado com a elevada mobilidade desse grupo.

Este estudio investiga los factores sociales y clínicos asociados con la migración entre las personas afectadas por lepra. Un estudio transversal se llevó a cabo entre las personas recién diagnosticadas con lepra (2006-2008), en 79 municipios endémicos en el estado de Tocantins, Brasil (N = 1,074). En total, el 76,2% nacieron en otro municipio diferente a su residencia actual. En los cinco años antes del diagnóstico el 16,7% emigró, y el 3,6% migró después del diagnóstico de lepra. Los resultados reflejan aspectos relacionados con el movimiento histórico de la población rural-urbana en Brasil. Los indicadores de pobreza fueron sobresalientes entre el grupo de migrantes antes del diagnóstico. La migración tras el diagnóstico se asoció a una migración anterior. La asociación de lepra multibacilar con migración indica que el acceso a la atención médica puede ser un obstáculo para el diagnóstico temprano en el grupo de migrantes antes de la migración.

Illness in returned travelers and immigrants/refugees: the 6-year experience of two Australian infectious diseases units.

BACKGROUND: Data comparing returned travelers and immigrants/refugees managed in a hospital setting is lacking. METHODS: We prospectively collected data on 1,106 patients with an illness likely acquired overseas who presented to two hospital-based Australian infectious diseases units over a 6-year period. RESULTS: Eighty-three percent of patients were travelers and 17% immigrants/refugees. In travelers, malaria (19%), gastroenteritis/diarrhea (15%), and upper respiratory tract infection (URTI) (7%) were the most common diagnoses. When compared with immigrants/refugees, travelers were significantly more likely to be diagnosed with gastroenteritis/diarrhea [odds ratio (OR) 8], malaria (OR 7), pneumonia (OR 6), URTI (OR 3), skin infection, dengue fever, typhoid/paratyphoid fever, influenza, and rickettsial disease. They were significantly less likely to be diagnosed with leprosy (OR 0.03), chronic hepatitis (OR 0.04), tuberculosis (OR 0.05), schistosomiasis (OR 0.3), and helminthic infection (OR 0.3). In addition, travelers were more likely to present within 1 month of entry into Australia (OR 96), and have fever (OR 8), skin (OR 6), gastrointestinal (OR 5), or neurological symptoms (OR 5) but were less likely to be asymptomatic (OR 0.1) or have anaemia (OR 0.4) or eosinophilia (OR 0.3). Diseases in travelers were more likely to have been acquired via a vector (OR 13) or food and water (OR 4), and less likely to have been acquired via the respiratory (OR 0.2) or skin (OR 0.6) routes. We also found that travel destination and classification of traveler can significantly influence the likelihood of a specific diagnosis in travelers. Six percent of travelers developed a potentially vaccine-preventable disease, with failure to vaccinate occurring in 31% of these cases in the pretravel medical consultation. CONCLUSIONS: There are important differences in the spectrum of illness, clinical features, and mode of disease transmission between returned travelers and immigrants/refugees presenting to hospital-based Australian infectious diseases units with an illness acquired overseas.

Health profile of Ethiopian immigrants in Israel: an overview.

The health profile of two groups of Ethiopian immigrants in Israel was evaluated. Trichophytosis and active trachoma were observed in 5%-8.7% of prepubertal children. Among adults 13% had corneal opacities and 10.4% had cataracts. Goiter, spastic bronchitis, valvular heart disease, leprosy and onchocerciasis were prevalent. Malnutrition was common, with average body weights ranging from 72.4% to 85.2% of normal. Anemia was observed in 6.3% of young children and 70% of all immigrants. Fifty percent of children over 12 years and 98% of adults over 40 years of age had been exposed to hepatitis B virus; 9.8%-11.8% were HBsAg carriers. Tuberculin tests were positive in 9.8%-13%; and intestinal parasites were identified in 86%-98%. Hospitalization was required for 15.7% of immigrants arriving during the period 1978-90, and for 3.7% of those arriving in mid-1991 (Operation Solomon).