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1.
MMWR Morb Mortal Wkly Rep ; 69(11): 286-289, 2020 Mar 20.
Artículo en Inglés | MEDLINE | ID: mdl-32191684

RESUMEN

Since 1989, the United States has pursued a goal of eliminating tuberculosis (TB) through a strategy of rapidly identifying and treating cases and evaluating exposed contacts to limit secondary cases resulting from recent TB transmission (1). This strategy has been highly effective in reducing U.S. TB incidence (2), but the pace of decline has significantly slowed in recent years (2.2% average annual decline during 2012-2017 compared with 6.7% during 2007-2012) (3). For this report, provisional 2019 data reported to CDC's National Tuberculosis Surveillance System were analyzed to determine TB incidence overall and for selected subpopulations and these results were compared with those from previous years. During 2019, a total of 8,920 new cases were provisionally reported in the United States, representing a 1.1% decrease from 2018.* TB incidence decreased to 2.7 cases per 100,000 persons, a 1.6% decrease from 2018. Non-U.S.-born persons had a TB rate 15.5 times greater than the rate among U.S.-born persons. The U.S. TB case count and rate are the lowest ever reported, but the pace of decline remains slow. In recent years, approximately 80% of U.S. TB cases have been attributed to reactivation of latent TB infection (LTBI) acquired years in the past, often outside the United States (2). An expanded TB elimination strategy for this new decade should leverage existing health care resources, including primary care providers, to identify and treat persons with LTBI, without diverting public health resources from the continued need to limit TB transmission within the United States. Partnerships with health care providers, including private providers, are essential for this strategy's success.


Asunto(s)
Erradicación de la Enfermedad , Vigilancia de la Población , Tuberculosis/epidemiología , Tuberculosis/prevención & control , Adulto , Emigrantes e Inmigrantes/estadística & datos numéricos , Grupos Étnicos/estadística & datos numéricos , Metas , Humanos , Incidencia , Tuberculosis/etnología , Estados Unidos/epidemiología
3.
BMC Infect Dis ; 20(1): 76, 2020 Jan 28.
Artículo en Inglés | MEDLINE | ID: mdl-31992216

RESUMEN

BACKGROUND: Following migration from Schistosoma and Strongyloides endemic to non-endemic regions, people remain at high risk for adverse sequelae from these chronic infections. HIV co-infected persons are particularly vulnerable to the serious and potentially fatal consequences of untreated helminth infection. While general screening guidelines exist for parasitic infection screening in immigrant populations, they remain silent on HIV positive populations. This study assessed the seroprevalence, epidemiology and laboratory characteristics of these two parasitic infections in a non-endemic setting in an immigrant/refugee HIV positive community. METHODS: Between February 2015 and 2018 individuals born outside of Canada receiving care at the centralized HIV clinic serving southern Alberta, Canada were screened by serology and direct stool analysis for schistosomiasis and strongyloidiasis. Canadian born persons with travel-based exposure risk factors were also screened. Epidemiologic and laboratory values were analyzed using bivariate logistic regression. We assessed the screening utility of serology, direct stool analysis, eosinophilia and hematuria. RESULTS: 253 HIV positive participants were screened. The prevalence of positive serology for Schistosoma and Strongyloides was 19.9 and 4.4%, respectively. Age between 40 and 50 years (OR 2.50, 95% CI 1.13-5.50), refugee status (3.55, 1.72-7.33), country of origin within Africa (6.15, 2.44-18.60), eosinophilia (3.56, 1.25-10.16) and CD4 count < 200 cells/mm3 (2.46, 1.02-5.92) were associated with positive Schistosoma serology. Eosinophilia (11.31, 2.03-58.94) was associated with positive Strongyloides serology. No Schistosoma or Strongyloides parasites were identified by direct stool microscopy. Eosinophilia had poor sensitivity for identification of positive serology. Hematuria was not associated with positive Schistosoma serology. CONCLUSION: Positive Schistosoma and Strongyloides serology was common in this migrant HIV positive population receiving HIV care in Southern Alberta. This supports the value of routine parasitic screening as part of standard HIV care in non-endemic areas. Given the high morbidity and mortality in this relatively immunosuppressed population, especially for Strongyloides infection, screening should include both serologic and direct parasitological tests. Eosinophilia and hematuria should not be used for Schistosoma and Strongyloides serologic screening in HIV positive migrants in non-endemic settings.


Asunto(s)
Esquistosomiasis/epidemiología , Estrongiloidiasis/epidemiología , Infecciones Oportunistas Relacionadas con el SIDA/epidemiología , Adulto , Alberta/epidemiología , Recuento de Linfocito CD4 , Estudios Transversales , Emigrantes e Inmigrantes/estadística & datos numéricos , Eosinofilia/parasitología , Heces/parasitología , Femenino , Infecciones por VIH/parasitología , Humanos , Huésped Inmunocomprometido , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Prevalencia , Refugiados/estadística & datos numéricos , Estudios Seroepidemiológicos , Viaje
4.
J Forensic Sci ; 65(1): 103-111, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31404476

RESUMEN

This study analyzes postmortem records from 260 homicide cases autopsied by the Department of Forensic Medicine in Rome from 2000 to 2014. The victims were mainly males (74%) and young (61% aged from 21 to 50 years). Although the victims were mostly Italians, the number of foreign victims (33%) has increased since 1990, primarily due to immigration. The offenders frequently used firearms (39%), particularly in multiple murders. An increase in blunt (20%) and sharp force (32%) weapons was also seen. The primary crime scene was residential (42%), and the head was the most frequently injured body region. Male victims occurred frequently in the context of organized crime (7.6%). In family or intimate-sexual relationships, women were the majority of victims (8%). Forensic pathologists play an important role during investigation. They should consider all the information available to them, including autopsy information, crime scene information, and crime investigation data.


Asunto(s)
Víctimas de Crimen/estadística & datos numéricos , Homicidio/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Niño , Emigrantes e Inmigrantes/estadística & datos numéricos , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Motivación , Distribución por Sexo , Suicidio/estadística & datos numéricos , Armas/estadística & datos numéricos , Heridas y Traumatismos/mortalidad , Adulto Joven
5.
BMC Public Health ; 19(1): 1697, 2019 Dec 18.
Artículo en Inglés | MEDLINE | ID: mdl-31852465

RESUMEN

BACKGROUND: In Germany, the term 'migration background' has been established to differentiate between immigrants and natives. In the present study post-traumatic stress disorder (PTSD), anxiety, and depression were analysed in immigrant populations in Germany by considering self-attribution as well as attribution by others on one's own 'migration background'. METHODS: In a population-based survey (N = 2317), socio-demographic characteristics, migration background (official statistics definition vs. self-attribution as well as the anticipated attribution by others), PTSD (PCL-5), and symptoms of anxiety and depression (PHQ-4) were assessed. Logistic regression models were applied to predict mental health outcomes by considering socio-demographic and immigration-related factors. RESULTS: A total of 10.7% of respondents (N = 248) had a 'migration background'. Immigrants of the 2nd generation compared to 1st generation immigrants are less likely to see themselves as immigrants. Attribution as an immigrant (self and/or by others) was found as significant predictor for PTSD and depression, but not anxiety. CONCLUSIONS: It seems useful to focus on immigration-related factors considering subjective perspectives and not only comparing immigrants and natives using a federal statistics definition. Our findings suggest that research on the association between immigration-related factors such as attribution as an immigrant and mental health outcomes might be a promising approach to better identify subgroups at higher risk of mental distress.


Asunto(s)
Trastorno Depresivo/epidemiología , Emigrantes e Inmigrantes/psicología , Emigrantes e Inmigrantes/estadística & datos numéricos , Salud Mental/estadística & datos numéricos , Percepción Social , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Alemania/epidemiología , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Factores Socioeconómicos , Adulto Joven
6.
BMC Public Health ; 19(1): 1741, 2019 Dec 27.
Artículo en Inglés | MEDLINE | ID: mdl-31881953

RESUMEN

BACKGROUND: While discrimination takes multiple forms, racial or ethnic discrimination is a root cause of this health-damaging social phenomenon. We drew on intersectionality theory, which offers an account of discrimination's multiple effects, to consider associations between women's experiences of discrimination and postpartum depression (PPD) using four measures: single forms of discrimination (SFD); multiple forms of discrimination (MFD); ethnic discrimination combined with MFD (E-MFD); and a composite MFD that interacted with women's identity (C-MFD). METHODS: We interviewed a stratified sample of 1128 mothers face to face in 2014-2015 during mothers' visits to maternal and child health clinics. The mothers belonged to three groups in Israel: Palestinian-Arab minority, Jewish immigrant, and non-immigrant Jewish. We conducted unadjusted and adjusted logistic regressions for PPD, measured on the Edinburgh Postnatal Depression Scale, in associations with SFD (experiencing discrimination based on any of the following: age, sex, class, ethno-national identity, religiosity level and skin color); MFD (experiencing 0,1, 2 or ≥ 3 of SFD); E-MFD (ethnic discrimination combined with other MFD); and finally, C-MFD (interaction between MFD and women's identity). RESULTS: Palestinian-Arab mothers had higher PPD and reported higher SFD (based on ethnicity, religiosity level, and socioeconomic status), as well as higher MFD and E-MFD. This was followed by Jewish immigrant mothers, and lastly by non-immigrant Jewish mothers. However, both MFD and E-MFD had a strong association with PPD among non-immigrant Jewish mothers reporting 2MFD and ≥ 3MFD, and Palestinian-Arab mothers reporting ≥3MFD, but no significant association among immigrant Jewish mothers. When we used C-MFD, we found a dose-response association in which Palestinian-Arab mothers experiencing more MFD (2MFD and ≥ 3MFD) were more likely to experience PPD. This was followed by immigrant Jewish mothers (reporting 2MFD and ≥ 3MFD), and lastly by non-immigrant Jewish mothers. CONCLUSIONS: MFD should be considered in relation to women's identity (being part of a minority, immigrant, or non-immigrant majority group) in maternal mental health research and practice. Otherwise, we risk underestimating the effects of MFD on PPD, especially in minority and immigrant mothers, who are more likely to face interlocking forms of discrimination.


Asunto(s)
Árabes/psicología , Depresión Posparto/etnología , Emigrantes e Inmigrantes/psicología , Judíos/psicología , Grupos Minoritarios/psicología , Madres/psicología , Prejuicio/etnología , Adolescente , Adulto , Árabes/estadística & datos numéricos , Estudios Transversales , Emigrantes e Inmigrantes/estadística & datos numéricos , Femenino , Humanos , Israel , Judíos/estadística & datos numéricos , Persona de Mediana Edad , Grupos Minoritarios/estadística & datos numéricos , Madres/estadística & datos numéricos , Adulto Joven
7.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 46(4): 154-158, oct.-dic. 2019. tab, graf
Artículo en Español | IBECS | ID: ibc-184303

RESUMEN

Introducción: La mujer inmigrante presenta unas características específicas desde el punto de vista sanitario, debido a su procedencia, diferencias culturales y estrato social, que pueden afectar a sus consultas de salud. El ámbito ginecológico y la salud reproductiva son áreas de frecuente consulta en este grupo poblacional. Objetivo: Describir la enfermedad ginecológica por la que consultan las mujeres inmigrantes y definir posibles factores de riesgo. Material y métodos: Estudio descriptivo y transversal sobre las consultas de salud en la esfera ginecológica de las mujeres de origen inmigrante atendidas en la consulta de atención primaria. Estudio comparativo con una muestra de mujeres de origen nacional. Resultados: La mayoría de las pacientes inmigrantes del estudio eran de origen magrebí. La consulta de salud más habitual fueron las vaginitis de origen infeccioso. Hasta un 19% presentaban multiparidad (3 o más embarazos). Estos 2 procesos fueron significativamente mayores que en el colectivo de mujeres de origen nacional con quienes se comparó la muestra. Conclusiones: Las mujeres inmigrantes presentan, en general, una paridad elevada y más infecciones de la esfera ginecológica. Estos factores pueden causar una mayor vulnerabilidad en este colectivo


Introduction: Immigrant women have specific characteristics from the health point of view, due to their origin, cultural differences and social status, which can affect their health consultations. The gynaecological field and reproductive health are areas of frequent consultation by this population group. Objectives: To describe the gynaecological disorders for which immigrant women consult, and to define possible risk factors. Material and methods: A descriptive and cross-sectional study was conducted on gynaecological health consultations by women of immigrant origin seen in the primary care clinic. A comparative study was performed with a sample of women of Spanish origin. Results: The majority of the immigrant patients in the study were of Maghrebi origin. The most common health consultation was vaginitis of infectious origin. Up to 19% were multiparous (3 or more pregnancies) and these 2 processes were significantly greater than in the group of women of national origin in whom the sample was compared. Conclusions: Immigrant women have a high parity, in general, and have more gynaecological infections. These factors can cause greater vulnerability in this group


Asunto(s)
Humanos , Femenino , Emigrantes e Inmigrantes/estadística & datos numéricos , Factores de Riesgo , Salud Reproductiva , Atención Primaria de Salud , Enfermedades Urogenitales Femeninas/epidemiología , Estudios Transversales , Vaginitis/epidemiología , Vaginosis Bacteriana/epidemiología , Infertilidad Femenina , Enfermedades Transmisibles/epidemiología
8.
Medicine (Baltimore) ; 98(52): e18481, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31876734

RESUMEN

To study the clinical presentation of Chronic Schistosomiasis (CS) in immigrants from East Africa to Israel and the tests that were useful in confirming the diagnosis.A retrospective study of all medical notes pertaining to hospitalized patients who were immigrants from East Africa with a pathological or microscopic confirmation of CS. Literature review was also conducted focusing on diagnosis of schistosomiasis among immigrants from endemic countries.We identified 32 suspected and 11 confirmed cases of CS. Most of the patients (82%) presented with gastrointestinal symptoms. Sensitivity of stool smear, serology and tissue diagnosis (by histopathology or microscopy) were 14%, 100%, 89%, respectively. Patients have undergone extensive diagnostic evaluation with long hospitalization stays (median 10 days, range 4 to 33 days).CS has multiple presentations and is seen in Israel among refugees from Eritrea and Sudan. Most of the manifestations are gastrointestinal, suggestive of infection with Schistosoma mansoni (S. mansoni). Standard diagnostic techniques used in endemic countries, such as microscopy for ova and parasites were unhelpful, necessitating more advanced procedures like colonoscopic or liver biopsy. We propose a diagnostic algorithm for CS in this patient population in order to make an accurate diagnosis and avoid unnecessary invasive procedures.


Asunto(s)
Emigrantes e Inmigrantes , Esquistosomiasis/epidemiología , Adulto , África Oriental/etnología , Animales , Enfermedad Crónica , Emigrantes e Inmigrantes/estadística & datos numéricos , Femenino , Humanos , Israel/epidemiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Schistosoma , Schistosoma mansoni , Esquistosomiasis/parasitología , Esquistosomiasis/patología , Esquistosomiasis mansoni/epidemiología , Adulto Joven
9.
Rev Med Chil ; 147(8): 1042-1052, 2019 Aug.
Artículo en Español | MEDLINE | ID: mdl-31859970

RESUMEN

BACKGROUND: Recent data suggest an increase in tuberculosis (TB) incidence in Chile. AIM: To evaluate recent epidemiological trends, geographic extension and potential factors associated with TB reemergence in Chile. MATERIAL AND METHODS: Data analysis from official sources and trend analysis. RESULTS: TB incidence rate increased from 12.3 (2014) to 14.7 (2017) per 100,000 inhabitants. Morbidity rates also increased in nine out of 15 regions. The proportion of TB cases in specific groups has also increased in the last six years: HIV/AIDS (68%), immigrants (118%), drug users/alcoholics (267%) and homeless people (370%). Several indicators of the national TB program performance have deteriorated including TB case detection, HIV co-infection study and contact tracing activities. Overall results indicate a higher than expected case-fatality ratio (> 3%), high rates of loss from follow-up (> 5%), and low percentage of cohort healing rate (< 90%). This decline is associated with a Control Program with scarce human resources whose central budget decreased by 90% from 2008 to 2014. New molecular diagnostic tools and liquid media culture were only recently implemented. CONCLUSIONS: TB trends and overall program performance indicators have deteriorated in recent years in Chile and several factors appear to be involved. Multiple strategies will be required to rectify this situation.


Asunto(s)
Tuberculosis/epidemiología , Chile/epidemiología , Emigrantes e Inmigrantes/estadística & datos numéricos , Geografía , Infecciones por VIH/epidemiología , Gastos en Salud/tendencias , Personas sin Hogar/estadística & datos numéricos , Humanos , Incidencia , Factores de Riesgo , Factores Socioeconómicos , Estadísticas no Paramétricas , Trastornos Relacionados con Sustancias/epidemiología , Factores de Tiempo , Tuberculosis/economía , Tuberculosis/etiología
10.
J Rehabil Med ; 51(11): 861-868, 2019 Dec 16.
Artículo en Inglés | MEDLINE | ID: mdl-31690950

RESUMEN

OBJECTIVE: To explore the health situation and identify specific health challenges in non-Western immigrants with polio in Norway, by comparing their status with Western immigrants with polio and native Norwegians with polio. DESIGN: A questionnaire covering demographics, polio history, life satisfaction, medical, psychological and social conditions was answered by 1,408 persons with polio, among them 34 immigrants from non-Western countries and 32 immigrants from Western countries. RESULTS: The non-Western immigrant polio group had a mean age of 46 years, were highly educated, reported high frequency of mental health problems and only one-third was working. Mean age for contracting polio was 2.8 years. Only 30% was hospitalized in the acute phase and 80% reported severe leg weakness. Use of a powered wheelchair was reported by 72%. Post-polio symptoms had started at a mean age of 31 years. The non-Western immigrant group reported more fatigue, pain and loneliness, and a high proportion reported insufficient assistance from the public health system. CONCLUSION: The group of non-Western immigrants with polio in Norway reported more health and social problems than the group of Western immigrants with polio or the native Norwegian group with polio, even though they were younger and more highly educated. Their complex psychological and social situation requires active intervention from the health system, and health professionals need extra skills to deal most effectively with their situation.


Asunto(s)
Prestación de Atención de Salud/normas , Emigrantes e Inmigrantes/estadística & datos numéricos , Poliomielitis/epidemiología , Síndrome Pospoliomielitis/epidemiología , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Noruega , Poliomielitis/psicología
11.
Artículo en Inglés | MEDLINE | ID: mdl-31581450

RESUMEN

In Taiwan, immigrant workers play an important role in fisheries but they are easily ignored by society. The health problems and associated characteristics of immigrant workers in fisheries remain unclear. Descriptive and retrospective analyses were performed. Outpatient data were collected from a primary care clinic for six fishing villages in North Eastern Taiwan between 1 August 2016 and 31 July 2017. The data of immigrant workers was recorded and compared with that of natives. A total of 241 immigrant workers and 1342 natives were enrolled. Compared with the natives, the immigrant workers had a significantly younger age, male predominance, and fewer mean visits per year. The immigrant worker's visits tended to be more highly focused during the third quarter of the year. Immigrant workers paid more registration fees and self-payment, but they paid less on diagnosis fees, oral medication, laboratory exams and had reduced total costs. The top five diagnoses for immigrant workers were respiratory diseases (38.3%), trauma (15.2%), musculoskeletal diseases (11.2%), skin-related diseases (9.5%), and digestive diseases (9.1%). Immigrant workers were positively correlated with infectious/parasitic diseases, and negatively correlated with medical consults and endocrine/metabolic diseases. Immigrant workers were also positively associated with registration fees and self-payment, but negatively correlated with diagnosis fees and total costs (all p < 0.05). The distribution of skin diseases and trauma were affected by age and sex as opposed to ethnic group. Immigrant status' health issues should be given more attention.


Asunto(s)
Emigrantes e Inmigrantes/estadística & datos numéricos , Explotaciones Pesqueras/estadística & datos numéricos , Atención Primaria de Salud/estadística & datos numéricos , Adulto , Factores de Edad , Anciano , Femenino , Financiación Personal , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Atención Primaria de Salud/economía , Estudios Retrospectivos , Factores Sexuales , Taiwán
12.
Int J Occup Med Environ Health ; 32(6): 797-804, 2019 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-31584040

RESUMEN

OBJECTIVES: This article investigates sickness presence among secondary school students in 5 European countries. The research questions asked are: What characterizes students with high sickness presence in secondary schools? Does high sickness presence influence future sickness absence? MATERIAL AND METHODS: A group of 7008 students aged 16-19 years participated in the first study (2016), and 5002 of them also participated in the follow-up study (2017). The participants came from 25 schools in Belgium, Estonia, Finland, Italy and Latvia. The response rate was high. A multivariate binomial logistic regression analysis was used. RESULTS: In 2016 high sickness presence (≥ 5 incidents) was reported by 16% of the students, and in 2017 by 15% of them. In 2016 there were significant differences between countries, and students from Latvia were most likely to report high sickness presence (adjusted odds ratio [aOR] = 3.45). Students with high absence (aOR = 1.86) and high school motivation (aOR = 1.16, for 1 pt increase on a 5-point scale) were overrepresented among those reporting high sickness presence. Country, absence and motivation were also significant factors for sickness presence in 2017. Furthermore, there was a significant positive association between high sickness presence and high sickness absence the following year. CONCLUSIONS: Country, absence, and motivation were important factors for high sickness presence in secondary schools. Engaging in high sickness presence seemed to influence future sickness absence. Int J Occup Med Environ Health. 2019;32(6):797-804.


Asunto(s)
Motivación , Presentismo/estadística & datos numéricos , Estudiantes/estadística & datos numéricos , Absentismo , Adolescente , Emigrantes e Inmigrantes/estadística & datos numéricos , Europa (Continente)/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Estudiantes/psicología , Encuestas y Cuestionarios , Adulto Joven
13.
J Prev Med Public Health ; 52(5): 299-307, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31588699

RESUMEN

OBJECTIVES: While occupational stress has long been a central focus of psychological research, few studies have investigated how immigrant microbusiness owners (MBOs) respond to their unusually demanding occupation, or how their unresolved occupational stress manifests in psychological distress. Based on the job demands-resources model, this study compared MBOs to employees with regard to the relationships among emotional demands, job resources, and depressive symptoms. METHODS: Data were derived from a cross-sectional survey of 1288 Korean immigrant workers (MBOs, professionals, office workers, and manual workers) aged 30 to 70, living in Toronto and surrounding areas. Face-to-face interviews were conducted between March 2013 and November 2013. RESULTS: Among the four occupational groups, MBOs appeared to endure the greatest level of emotional demands, while reporting relatively lower levels of job satisfaction and job security; but MBOs reported the greatest job autonomy. The effect of emotional demands on depressive symptoms was greater for MBOs than for professionals. However, an inspection of stress-resource interactions indicated that though MBOs enjoyed the greatest autonomy, the protective effects of job satisfaction and security on the psychological risk of emotional demands appeared to be more pronounced for MBOs than for any of the employee groups. CONCLUSIONS: One in two Korean immigrants choose self-employment, most typically in family-owned microbusinesses that involve emotionally taxing dealings with clients and suppliers. However, the benefits of job satisfaction and security may protect MBOs from the adverse mental health effects of job stress.


Asunto(s)
Comercio/economía , Depresión/psicología , Emigrantes e Inmigrantes/estadística & datos numéricos , Emociones , Estrés Laboral/psicología , Ocupaciones/estadística & datos numéricos , Adulto , Anciano , Canadá , Estudios Transversales , Femenino , Humanos , Satisfacción en el Trabajo , Masculino , Persona de Mediana Edad , República de Corea/etnología , Encuestas y Cuestionarios
14.
Public Health Rep ; 134(6): 695-702, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31647883

RESUMEN

OBJECTIVES: Chronic hepatitis B virus (HBV) infection is a lifelong infection that can cause serious liver damage and liver cancer. The last surveillance-based prevalence estimate of chronic HBV infection in New York City was 1.2% in 2008; however, it did not account for persons with undiagnosed infection. The objective of this study was to calculate the prevalence of chronic HBV infection, including undiagnosed infection, for 2016 by using surveillance data and literature-based information. METHODS: We calculated the number of persons with diagnosed chronic HBV infection (2000-2016) who were alive and living in New York City in 2016 by using routine surveillance data. We estimated the percentage of persons with undiagnosed chronic HBV infection by using birth region-specific percentages from the literature, weighted by the proportion of the New York City population with diagnosed chronic HBV infection from the same birth region. We identified minimum, maximum, and most likely values for the percentage with undiagnosed chronic HBV infection to generate 95% certainty limits (CLs) of the prevalence estimate. RESULTS: The prevalence of chronic HBV infection in 2016, including undiagnosed infection, in New York City was 2.7% (95% CL, 2.2%-3.6%), representing approximately 230 000 persons. The prevalence of diagnosed chronic HBV infection was 1.5%. The estimated prevalence among non-US-born residents was 6.9% (95% CL, 5.4%-8.9%). CONCLUSIONS: The current burden of chronic HBV infection in New York City, especially for non-US-born residents, is substantial. A renewed focus and dedication of resources is required to increase the number of new diagnoses and improve provider capacity to care for the large number of persons with chronic HBV infection.


Asunto(s)
Emigrantes e Inmigrantes/estadística & datos numéricos , Hepatitis B Crónica/epidemiología , Vigilancia de la Población , Adulto , África/etnología , Asia/etnología , Femenino , Virus de la Hepatitis B/aislamiento & purificación , Hepatitis B Crónica/diagnóstico , Humanos , Masculino , Modelos Estadísticos , Ciudad de Nueva York/epidemiología , Prevalencia , Factores de Riesgo
15.
Rev Prat ; 69(6): 679-682, 2019 Jun.
Artículo en Francés | MEDLINE | ID: mdl-31626434

RESUMEN

The health of migrants is a complex issue in public health. In French Guyana, as elsewhere, globalization, through migrants in particular, has transformed the care of diseases previously geographically distant. In this context, the borders now concern the entire territory and not just the peripheries. These borders contribute to the aggravation of the migrants health determinants through the complex and sometimes risky paths that they generate. Transboundary areas are also areas of high vulnerability. However, these cross-border spaces and routes can also constitute health resources, in the original interfaces that they can produce in terms of cooperation promoting shared screening and monitoring programs.


Asunto(s)
Emigrantes e Inmigrantes , Indicadores de Salud , Tamizaje Masivo , Migrantes , Emigrantes e Inmigrantes/estadística & datos numéricos , Guyana Francesa , Humanos , Migrantes/psicología , Migrantes/estadística & datos numéricos , Poblaciones Vulnerables
16.
Artículo en Inglés | MEDLINE | ID: mdl-31569485

RESUMEN

Background: This study aimed to explore the predictors of regular dental attendance behavior and caries experience among children of newcomers to Canada using the Theory of Planned Behavior (TPB). Methods: A total of 274 newcomer parents with a child aged 1 to 12 years old who had lived in Canada for 10 years or less participated in this cross-sectional study. Children underwent a dental examination to measure their deft/DEFT, and parents completed a self-administered questionnaire. Parental attitudes, subjective norms, perceived behavioral control (PBC), and intention were examined using Structural Equation Modeling (SEM) as predictors of dental attendance behavior and caries experience using the TPB model. Results: Out of all the components of the model, attitude and PBC significantly predicted the intention (p < 0.05) while the subjective norm had no statistical effects on the loading of the model (p > 0.05). Intention significantly predicted behavior, but behavior could not predict caries experience. Although 51.6% of the variance of intention was predicted by this model, only 0.2% of the variance for dental attendance behavior was explained. Conclusions: The theory of planned behavior was successful in predicting dental attendance intention and behavior for children among newcomers, but this behavior could not predict caries experience in children.


Asunto(s)
Actitud , Caries Dental/terapia , Emigrantes e Inmigrantes/estadística & datos numéricos , Intención , Odontología Pediátrica/estadística & datos numéricos , Alberta , Niño , Preescolar , Estudios Transversales , Caries Dental/psicología , Femenino , Humanos , Lactante , Teoría Psicológica
17.
Artículo en Inglés | MEDLINE | ID: mdl-31540218

RESUMEN

Inequity in immigrants' health during pregnancy and childbirth has been shown. We studied the Danish regional organization of public midwifery-based antenatal care (ANC) for immigrant women to assess the strengths and weaknesses of organizing ANC as either universal or immigrant-targeted. A telephone survey in 2012 to all the Danish maternity wards (n = 20) was conducted. Semi-structured interviews with midwives providing targeted care (n = 6) were undertaken and characteristics of care were qualitatively analyzed, having the immigrant density of the facilities, the Danish ANC policy, and theories of cultural competence as the frame of reference. Six maternity wards were providing immigrant-targeted ANC. Targeted care implied longer consultations and increased attention to the individual needs of immigrant women. At these facilities, navigation in the health care system, body awareness, and use of interpreter services were key topics. The selection of women for targeted care was based on criteria (including names) that risk stigmatizing immigrant women. The arguments for not providing targeted care included that immigrant-targeted care was considered stigmatizing. Current universal care may overlook the needs of immigrant women and contribute to inequities. A strategy could be to improve dynamic cultural competencies of midwives, interpreter services, and flexibility of the care provision of the universal ANC system.


Asunto(s)
Emigrantes e Inmigrantes/estadística & datos numéricos , Atención Prenatal/estadística & datos numéricos , Dinamarca , Femenino , Humanos , Partería , Servicio de Ginecología y Obstetricia en Hospital , Embarazo
18.
BMC Cancer ; 19(1): 869, 2019 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-31477050

RESUMEN

BACKGROUND: Few studies compared cancer incidence among migrants both to their host countries and to their population of origin. We aimed to compare cancer incidence of ethnic Germans who migrated from the former Soviet Union to Germany (resettlers) to those living in Russia as well as to the German and the Russian general populations. METHODS: The cancer registry of North Rhine-Westphalia identified incident cases of stomach, colorectal, lung, breast and prostate cancer in resettlers and the general population of the administrative district of Münster (Germany) between 2004 and 2013. The Tomsk cancer registry collected the same data in ethnic Germans and the general population of the Tomsk region (Russia). We used standardised incidence rate ratios (SIRs) to compare rates of resettlers and ethnic Germans with the respective general populations. RESULTS: The total number of person-years under risk was 83,289 for ethnic Germans, 8,006,775 for the population of Tomsk, 219,604 for resettlers, and 20,516,782 for the population of Münster. Incidence of the five investigated cancer types among ethnic Germans did not differ from incidence of the general population of Tomsk. Compared to the general population of Tomsk, incidence among resettlers was higher for colorectal cancer in both sexes (females: SIR 1.45 [95% CI 1.14-1.83], males: SIR 1.56 [95% CI 1.23-1.97]), breast cancer in females (SIR 1.65 [95% CI 1.40-1.95]), and prostate cancer (SIR 1.64 [95% CI 1.34-2.01]). Incidence rates of these cancer types among resettlers were more similar to rates of the general population of Münster. Incidence of stomach and lung cancer did not differ between resettlers and the general population of Tomsk. CONCLUSIONS: After an average stay of 15 years, we observed that incidence of colorectal, breast and prostate cancer among resettlers converged to levels of the general population of Münster. Resettler's incidence of stomach and lung cancer, however, was comparable to incidence in their population of origin. Causes must be investigated in subsequent analytical studies.


Asunto(s)
Emigrantes e Inmigrantes/estadística & datos numéricos , Neoplasias/epidemiología , Adulto , Distribución por Edad , Anciano , Femenino , Alemania/epidemiología , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Sistema de Registros , Federación de Rusia/epidemiología , Factores de Tiempo , U.R.S.S. , Adulto Joven
19.
Int J Infect Dis ; 88: 60-64, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31499208

RESUMEN

OBJECTIVES: The aim of this cross-sectional study was to describe the results of a systematic serological screening programme for strongyloidiasis. METHODS: A prospective serological screening programme for strongyloidiasis was performed between 2009 and 2014 for all immigrant patients attending the Tropical Medicine Unit. Three formalin-ether concentrated stool samples and an ELISA for anti-Strongyloides stercoralis antibodies were used as screening tools. RESULTS: Of 659 patients screened, 79 (12%) were positive for S. stercoralis regardless of the diagnostic method used. The prevalence of infection was 42.9% in East African patients, 16.3% in Central African patients, 10.9% in those from South America, and 10% in the case of West Africa. Univariate analysis showed that infection by S. stercoralis was significantly more frequent in patients from Central Africa (p=0.026; OR 1.72, 95% CI 1.03-2.85) and East Africa (p<0.001; OR 5.88, 95% CI 1.75-19.32). Taking West Africa as the reference (as the area of lowest prevalence among the positive prevalence areas), the statistical analysis showed that the risk of infection was higher in East Africa (p=0.001; OR 6.750, 95% CI 2.127-21.423) and Central Africa (p=0.065; OR 1.747, 95% CI 0.965-3.163). CONCLUSIONS: Due to the potential complications of strongyloidiasis infection, we recommend that immigrant patients from developing countries be routinely screened for S. stercoralis, especially those from East Africa. A serological test is a highly appropriate screening tool.


Asunto(s)
Emigrantes e Inmigrantes/estadística & datos numéricos , Strongyloides/inmunología , Estrongiloidiasis/diagnóstico , Adulto , África , Américas , Animales , Asia , Estudios Transversales , Heces/parasitología , Femenino , Humanos , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Estudios Prospectivos , Estudios Seroepidemiológicos , España/epidemiología , Strongyloides/aislamiento & purificación , Estrongiloidiasis/epidemiología , Estrongiloidiasis/parasitología , Adulto Joven
20.
Public Health ; 175: 120-128, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31473368

RESUMEN

OBJECTIVES: Previous research indicates that the impact of immigration on health tends to be specific as it is influenced by many factors such as life stage and host country. The aim of this study was to examine the relationship between immigration and adolescent health within the multicultural context of the Brussels-Capital Region in Belgium. STUDY DESIGN: The study was based on the 2014 Health Behaviour in School-aged Children survey. The sample consisted of 2962 adolescents from the fifth grade of primary to the last grade of secondary schools in Brussels. METHODS: Associations between health indicators and immigration status were analysed using multivariable logistic regression models adjusted for sociodemographic characteristics. RESULTS: Natives, first-generation immigrants, second-generation immigrants with both parents born abroad and second-generation immigrants with one parent born abroad represented 19%, 23%, 36% and 22% of the respondents, respectively. Sociodemographic characteristics and health behaviours varied according to immigrant status. Young immigrants were more likely to present overweight (odds ratio [OR] first-generation immigrants vs. natives = 1.76 [95% confidence interval {CI} = 1.16-2.65]; OR second-generation immigrants with both parents born abroad vs. natives = 2.06 [95% CI = 1.41-3.02]; OR second-generation immigrants with one parent born abroad vs. natives = 1.69 [95% CI = 1.12-2.56]). This effect turned out to be partially explained by sociodemographic status and health-related behaviours. No association was detected between immigration and self-rated health and multiple recurrent symptoms. CONCLUSIONS: Discrepancies in health behaviours and weight status were identified between adolescents of different immigration background, whereas this was not the case for well-being. Socio-economic status, cultural characteristics and specific behaviours partly explained these findings. Future research is needed to better understand immigration-related risk and protective factors, at individual and school levels.


Asunto(s)
Salud del Adolescente/estadística & datos numéricos , Diversidad Cultural , Emigrantes e Inmigrantes/estadística & datos numéricos , Emigración e Inmigración/estadística & datos numéricos , Adolescente , Bélgica , Niño , Femenino , Humanos , Masculino , Adulto Joven
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