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2.
Public Health Rep ; 136(1): 117-123, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33207130

RESUMEN

OBJECTIVES: Immigrants are believed to be at high risk of infection with severe acute respiratory syndrome coronavirus 2, the virus that causes coronavirus disease 2019 (COVID-19). A leading suspected risk factor is their role in the essential workforce. We aimed to describe COVID-19-related risk factors among Bhutanese and Burmese refugees in the United States. METHODS: We administered an anonymous online survey in May 2020 among community leaders of Bhutanese and Burmese refugees. Using a snowball sampling strategy, we invited community leaders to complete the survey and share the link with others who met inclusion criteria (English proficient, aged ≥18, currently living in the United States). We compared respondents with and without recent COVID-19 and identified risk factors for infection. RESULTS: Of 218 refugees in 23 states who completed the survey from May 15 through June 1, 2020, fifteen (6.9%) reported infection with COVID-19. Being an essential worker during the pandemic (odds ratio [OR] = 5.25; 95% CI, 1.21-22.78), having an infected family member (OR = 26.92; 95% CI, 5.19-139.75), and being female (OR = 5.63; 95% CI, 1.14-27.82) were risk factors for infection. Among 33 infected family members, 23 (69.7%) were essential workers. CONCLUSION: Although we had a small snowball sample, we found that working in essential industries was associated with an increased risk of COVID-19 infection among Bhutanese and Burmese refugees. We call for larger studies that include Asian immigrant subgroups, as well as immediate attention to protecting immigrant essential workers during the COVID-19 pandemic.


Asunto(s)
/etnología , Refugiados/estadística & datos numéricos , Adulto , Bután/etnología , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Mianmar/etnología , Exposición Profesional/estadística & datos numéricos , Pandemias , Factores de Riesgo , Factores Sexuales , Factores Socioeconómicos , Estados Unidos/epidemiología
3.
N Z Med J ; 133(1527): 51-70, 2020 12 18.
Artículo en Inglés | MEDLINE | ID: mdl-33332328

RESUMEN

AIM: To update data previously published on the health profile of the refugees resettling in New Zealand, and to draw attention to the change in health profile over time, with a decline of infectious disease/deficiencies, and a rise of non-communicable diseases, a worldwide phenomenon. METHOD: Comparative data was extracted from (1) written annual reports prepared by medical officers at the Mangere Refugee Resettlement Centre (1978-1991), (2) a Microsoft ACCESS patient management system between 1995 and 1999 and (3) a MEDTECH patient management system between 2010 and 2014. RESULTS: Over the period 1979-2014, the rate of infectious diseases has declined markedly in resettling refugees, and the rate of non-communicable diseases has increased. For example, the incidence of tuberculosis has decreased from 4% to 0.2%, gut parasites from more than 40% to, in some intakes, 15% and iron deficiency from 22% to 10%, while the diabetes rate has gone from 0.1% to 2.7%. CONCLUSION: While management of unfamiliar infectious diseases and deficiencies (especially vitamin D) still remains an important part of the management of refugee health, their management usually involves limited time and expense, and their burden is much less than before. However, refugees now resettling in New Zealand and the rest of the world often present with familiar non-communicable diseases that require long-term management.


Asunto(s)
Estado de Salud , Estilo de Vida/etnología , Atención Primaria de Salud/estadística & datos numéricos , Refugiados/estadística & datos numéricos , Adolescente , Adulto , África del Sur del Sahara/etnología , Anciano , Anciano de 80 o más Años , Asia Sudoriental/etnología , Bután/etnología , Índice de Masa Corporal , Niño , Preescolar , Colombia/etnología , Conducta Anticonceptiva/etnología , Conducta Anticonceptiva/tendencias , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus/etnología , Prescripciones de Medicamentos/estadística & datos numéricos , Femenino , Infecciones por VIH/etnología , Infecciones por Helicobacter/etnología , Helicobacter pylori , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/etnología , Lactante , Recién Nacido , Parasitosis Intestinales/etnología , Irak/etnología , Masculino , Salud Mental/etnología , Persona de Mediana Edad , Nueva Zelanda/epidemiología , Prevalencia , Enfermedades de Transmisión Sexual/etnología , Uso de Tabaco/etnología , Tuberculosis Pulmonar/etnología , Deficiencia de Vitamina D/etnología , Adulto Joven
4.
Adv Chronic Kidney Dis ; 27(5): 427-433, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-33308509

RESUMEN

Racial, ethnic, socioeconomic, age, and sex-related health disparities in kidney disease are prominent in the United States. The Coronavirus Disease 2019 (COVID-19) pandemic has disproportionately affected marginalized populations. Older adults, people experiencing unstable housing, racial and ethnic minorities, and immigrants are potentially at increased risk for infection and severe complications from COVID-19. The direct and societal effects of the pandemic may increase risk of incident kidney disease and lead to worse outcomes for those with kidney disease. The rapid transition to telemedicine potentially limits access to care for older adults, immigrants, and people experiencing unstable housing. The economic impact of the pandemic has had a disproportionate effect on women, minorities, and immigrants, which may limit their ability to manage kidney disease and lead to complications or kidney disease progression. We describe the impact of COVID-19 on marginalized populations and highlight how the pandemic may exacerbate existing disparities in kidney disease.


Asunto(s)
/epidemiología , Estatus Económico/estadística & datos numéricos , Emigrantes e Inmigrantes/estadística & datos numéricos , Grupos Étnicos/estadística & datos numéricos , Disparidades en el Estado de Salud , Disparidades en Atención de Salud/estadística & datos numéricos , Personas sin Hogar/estadística & datos numéricos , Enfermedades Renales/epidemiología , Factores de Edad , Equidad en Salud , Disparidades en Atención de Salud/etnología , Humanos , Enfermedades Renales/etnología , Refugiados/estadística & datos numéricos , Factores Sexuales , Clase Social , Inmigrantes Indocumentados/estadística & datos numéricos , Estados Unidos/epidemiología
5.
Global Health ; 16(1): 118, 2020 12 17.
Artículo en Inglés | MEDLINE | ID: mdl-33334370

RESUMEN

BACKGROUND: Since 2016 Venezuela has seen a collapse in its economy and public health infrastructure resulting in a humanitarian crisis and massive outward migration. With the emergence of the novel coronavirus SARS-CoV-2 at the end of 2019, the public health emergency within its borders and in neighboring countries has become more severe and as increasing numbers of Venezuelans migrants return home or get stuck along migratory routes, new risks are emerging in the region. RESULTS: Despite clear state obligations to respect, protect and fulfil the rights to health and related economic, social, civil and political rights of its population, in Venezuela, co-occurring malaria and COVID-19 epidemics are propelled by a lack of public investment in health, weak governance, and violations of human rights, especially for certain underserved populations like indigenous groups. COVID-19 has put increased pressure on Venezuelan and regional actors and healthcare systems, as well as international public health agencies, to deal with a domestic and regional public health emergency. CONCLUSIONS: International aid and cooperation for Venezuela to deal with the re-emergence of malaria and the COVID-19 spread, including lifting US-enforced economic sanctions that limit Venezuela's capacity to deal with this crisis, is critical to protecting rights and health in the country and region.


Asunto(s)
/prevención & control , Emigración e Inmigración/estadística & datos numéricos , Derechos Humanos/normas , Malaria/transmisión , /epidemiología , Recesión Económica/estadística & datos numéricos , Derechos Humanos/tendencias , Humanos , Malaria/epidemiología , Refugiados/estadística & datos numéricos , Venezuela/epidemiología
6.
Ann Glob Health ; 86(1): 135, 2020 10 15.
Artículo en Inglés | MEDLINE | ID: mdl-33117656

RESUMEN

The intersection of digital health platforms and refugee health in the context of the novel 2019 coronavirus disease (COVID-19) has not yet been explored. We discuss the ability of a novel mobile health (mhealth) platform to be effectively adapted to improve health access for vulnerable displaced populations. In a preliminary analysis of 200 Syrian refugee women, we found positive user feedback and uptake of an mhealth application to increase access to preventive maternal and child health services for Syrian refugees under temporary protection in Turkey. Rapid adaptation of this application was successfully implemented during a global pandemic state to perform symptomatic assessment, disseminate health education, and bolster national prevention efforts. We propose that mhealth interventions can provide an innovative, cost-effective, and user-friendly approach to access the dynamic needs of refugees and other displaced populations, particularly during an emerging infectious disease outbreak.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Necesidades y Demandas de Servicios de Salud , Disparidades en Atención de Salud/estadística & datos numéricos , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Refugiados/estadística & datos numéricos , Telemedicina/organización & administración , Adulto , Niño , Preescolar , Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/prevención & control , Infecciones por Coronavirus/prevención & control , Femenino , Accesibilidad a los Servicios de Salud/organización & administración , Humanos , Masculino , Pandemias/prevención & control , Neumonía Viral/prevención & control , Turquia , Poblaciones Vulnerables/estadística & datos numéricos
8.
Psychiatr Danub ; 32(Suppl 3): 386-395, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33030459

RESUMEN

The use of violence and aggression on civilians during the war has become one of the most prominent military events of the 20th and 21st centuries, resulting in an increasing number of refugees and displaced persons in the midst of regional and tribal conflicts. We are witnessing a daily increase in the number of migrants when people are fleeing from their homes because of human rights violations, persecution, poverty, and conflict. When found in "host" countries, they often encounter bad conditions, with uncertainty and instability. Many come to Europe in search of economic and personal opportunities for progress, where they face different types of process of acculturation. 'Place loss', acute and chronic trauma, family disorders, and family reunification issues became more and more important issues. Refugees, asylum seekers and irregular migrants have a higher risk for certain mental health disorders, including posttraumatic stress, depression and psychosis. In addition to being exposed to various risk factors for mental disorders, migrants often face barriers to access to adequate health care to address these issues. Some of the biggest challenges for migrant populations within "host" countries include: lack of knowledge of health care rights and health systems; poor knowledge of the language; different belief systems and cultural expectations of health care; and the general lack of trust in experts and in government. The rates of depressive and anxiety disorders usually increase over time, and poor mental health is associated with poor socioeconomic conditions - particularly with social isolation and unemployment. Acculturative stress often implies a high discrepancy in the acculturation between parents and their children. This dislocation of families in new conditions has been caused by the different degrees of acceptance of "new culture" by children and parents, which causes serious difficulties, especially in bilingual terms.


Asunto(s)
Aculturación , Salud Mental/estadística & datos numéricos , Refugiados , Migrantes , Trastornos de Ansiedad/epidemiología , Trastorno Depresivo/epidemiología , Europa (Continente) , Humanos , Refugiados/psicología , Refugiados/estadística & datos numéricos , Migrantes/psicología , Migrantes/estadística & datos numéricos
9.
Neurology ; 95(19): e2605-e2609, 2020 11 10.
Artículo en Inglés | MEDLINE | ID: mdl-33004606

RESUMEN

OBJECTIVE: Asylum seekers experience a high burden of physical and psychological trauma, yet there is a scarcity of literature regarding the epidemiology and sequelae of head injury (HI) in asylum seekers. We examined HI prevalence and association with neuropsychiatric comorbidities in asylum seekers. METHODS: A retrospective cross-sectional study was performed through review of 139 medical affidavits from an affidavit database. Affidavits written from 2010 to 2018 were included. Demographic and case-related data were collected and classified based on the presence of HI. For neuropsychiatric sequelae, the primary study outcome was headache and the secondary outcomes were depression, posttraumatic stress disorder, and anxiety. Multivariable logistic regression was performed to examine the association between HI and neuropsychiatric sequelae, adjusted for demographic and clinical characteristics. RESULTS: A total of 139 medical affidavits of asylum seekers were included. The mean age was 27.4 ± 12.1 years, 56.8% were female, and 38.8% were <19 years. Almost half (42.5%) explicitly self-reported history of HI. Compared to clients who did not report HI, clients with HI were older and more likely to report a history of headache, physical abuse, physical trauma, concussion, and loss of consciousness. After adjustment for demographic and clinical characteristics, clients with HI had greater odds for neuropsychological sequelae such as headache (odds ratio [OR] 4.2, 95% confidence interval [CI] 2.0-8.7) and depression (OR 2.5, 95% CI 1.1-5.7). CONCLUSIONS: We observed a high prevalence of HI in asylum seekers. Comprehensive screening for HI and neuropsychiatric comorbidities is encouraged when evaluating asylum seekers.


Asunto(s)
Ansiedad/epidemiología , Traumatismos Craneocerebrales/epidemiología , Depresión/epidemiología , Cefalea/epidemiología , Refugiados/estadística & datos numéricos , Trastornos por Estrés Postraumático/epidemiología , Violencia/estadística & datos numéricos , Adolescente , Adulto , Ansiedad/psicología , Conmoción Encefálica/epidemiología , Conmoción Encefálica/psicología , Traumatismos Craneocerebrales/psicología , Estudios Transversales , Depresión/psicología , El Salvador/etnología , Femenino , Guatemala/etnología , Haití/etnología , Cefalea/psicología , Honduras/etnología , Humanos , Masculino , Trastornos de la Memoria/epidemiología , Trastornos de la Memoria/psicología , México/etnología , Nicaragua/etnología , Oportunidad Relativa , Cuestionario de Salud del Paciente , Prevalencia , Trauma Psicológico/epidemiología , Trauma Psicológico/psicología , Refugiados/psicología , Estudios Retrospectivos , Distribución por Sexo , Delitos Sexuales/psicología , Delitos Sexuales/estadística & datos numéricos , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Trastornos del Inicio y del Mantenimiento del Sueño/psicología , Trastornos por Estrés Postraumático/psicología , Inconsciencia/epidemiología , Inconsciencia/psicología , Estados Unidos/epidemiología , Heridas y Traumatismos/epidemiología , Heridas y Traumatismos/psicología , Adulto Joven
10.
Ann Glob Health ; 86(1): 129, 2020 10 06.
Artículo en Inglés | MEDLINE | ID: mdl-33102149

RESUMEN

In August 2017, Bangladesh saw a massive influx of Rohingya refugees following their violent persecution by the Myanmar authorities. Since then, the district of Cox's Bazar has been home to nearly 900,000 Rohingya refugees living in the densely populated and unhygienic camps. The refugees have been living in makeshift settlements which are cramped into one another, making it extremely difficult to maintain "social distance". The overcrowded conditions coupled with the low literacy level, lack of basic sanitation facilities, face masks and gloves and limited communication make these camps an ideal place for the virus to spread rapidly. As nations struggle to contain the SARS-CoV-2 virus, refugees are one such population who are extremely vulnerable to the effects of this outbreak. If issues are not addressed at an early stage, its effects can be catastrophic.


Asunto(s)
Infecciones por Coronavirus , Aglomeración , Transmisión de Enfermedad Infecciosa/prevención & control , Control de Infecciones , Pandemias , Neumonía Viral , Campos de Refugiados , Refugiados/estadística & datos numéricos , Bangladesh/epidemiología , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Accesibilidad a los Servicios de Salud/normas , Necesidades y Demandas de Servicios de Salud , Humanos , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Control de Infecciones/normas , Mianmar/epidemiología , Pandemias/prevención & control , Equipo de Protección Personal/provisión & distribución , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Campos de Refugiados/normas , Campos de Refugiados/provisión & distribución , Saneamiento/normas
11.
Global Health ; 16(1): 103, 2020 10 22.
Artículo en Inglés | MEDLINE | ID: mdl-33092609

RESUMEN

The deteriorating political and economic situation in Venezuela has ramifications far beyond the Latin American country's borders as almost five million Venezuelans fled and migrated into countries in the region due to the crisis at home. The scarcity of health services, the lack of information sharing, and the absence of reliable data in Venezuela create challenges for confronting developing health emergencies and disease outbreaks. The need for accurate data is especially dire given the current COVID-19 pandemic and evolving movement of refugees. While countries and international organizations came together to form a coordinated response to Venezuela's political and humanitarian crisis, this geopolitical progress is threatened by the rapid spread of COVID-19, and the instinct for countries to focus inwards on domestic response priorities, rather than engage in regional cooperation. It is critical that the international community set aside geopolitical differences and cooperate to seek an accurate picture of the conditions on the ground to improve the welfare of Venezuelan migrants and to provide a more robust response to the current pandemic.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Exactitud de los Datos , Cooperación Internacional , Pandemias , Neumonía Viral/epidemiología , Refugiados/estadística & datos numéricos , Humanos , Política , Sistemas de Socorro , Venezuela/etnología
12.
Artículo en Inglés | MEDLINE | ID: mdl-32962038

RESUMEN

Background: Infections are a leading cause of refugee morbidity. Recent data on the rate of airway infections and factors influencing their spread in refugee reception centers is scarce. Methods: A retrospective, cross-sectional study of de-identified medical records with a focus on respiratory infections in underage refugees was conducted at two large German refugee reception centers. Results: In total, medical data from n = 10,431 refugees over an observational period of n = 819 days was analyzed. Among pediatric patients (n = 4289), 55.3% presented at least once to the on-site medical ward with an acute respiratory infection or signs thereof. In 38.4% of pediatric consultations, acute airway infections or signs thereof were present. Airway infections spiked during colder months and were significantly more prevalent amongst preschool and resettled children. Their frequency displayed a positive correlation with the number of refugees housed at the reception centers. Conclusions: We show that respiratory infections are a leading cause for morbidity in young refugees and that their rate is influenced age, season, status, and residential density. This illustrates the need to protect refugee children from contracting airway infections which may also reduce the spread of coronavirus disease 2019 (COVID-19) during the current pandemic.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Refugiados/estadística & datos numéricos , Infecciones del Sistema Respiratorio/epidemiología , Migrantes/estadística & datos numéricos , Betacoronavirus , Niño , Preescolar , Infecciones por Coronavirus/epidemiología , Estudios Transversales , Humanos , Neumonía Viral/epidemiología , Vivienda Popular , Características de la Residencia , Estudios Retrospectivos
13.
Pediatrics ; 146(4)2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32994177

RESUMEN

BACKGROUND: New guidelines support using interferon-γ release assays (IGRAs) in children ≥2 years for diagnosis of latent tuberculosis infection (LTBI). However, lack of experience in young children and concern that IGRAs are less sensitive than tuberculin skin tests (TSTs) limit their use. Our aim was to identify active tuberculosis (TB) cases among high risk children <5 years and tested for LTBI with an IGRA. METHODS: . Retrospective review of domestic TB screening data from California's Refugee Health Electronic Information System for children <5 years old who resettled in California between October, 2013 and December, 2016. Children were crossmatched with the California TB registry to identify cases of TB disease between October 2013 and December 2018. RESULTS: A total of 3371 children <5 years were identified; the majority were born in countries with high TB incidence (>150 cases per 100 000). Half received IGRAs (n = 1878; 56%), a quarter received TSTs (n = 811; 24%); 1.4% of children were IGRA-positive (n = 26) and 13% were TST-positive (n = 106). Twenty-two IGRA results were indeterminate (1.2%). Sixteen children had both tests; 9 were discrepant (positive TST with negative IGRA). No cases of TB disease were identified during 10 797 person-years of follow-up. CONCLUSIONS: IGRA positivity was less than TST positivity in high risk children <5 years old. Despite fewer LTBI diagnoses in the IGRA-tested population, no cases of TB disease among children who tested negative were identified, suggesting IGRA is valuable tool for identifying LTBI in this population.


Asunto(s)
Ensayos de Liberación de Interferón gamma/estadística & datos numéricos , Tuberculosis Latente/diagnóstico , Refugiados/estadística & datos numéricos , Prueba de Tuberculina/estadística & datos numéricos , California/epidemiología , Preescolar , Femenino , Humanos , Tuberculosis Latente/epidemiología , Masculino , Estudios Retrospectivos
14.
PLoS One ; 15(9): e0239187, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32941533

RESUMEN

OBJECTIVES: Sexual violence can have a destructive impact on the lives of people. It is more common in unstable conditions such as during displacement or migration of people. On the Greek island of Lesvos, Médecins Sans Frontières provided medical care to survivors of sexual violence among the population of asylum seekers. This study describes the patterns of sexual violence reported by migrants and asylum seekers and the clinical care provided to them. METHODS: This is a descriptive study, using routine program data. The study population consisted of migrants and asylum seekers treated for conditions related to sexual violence at the Médecins Sans Frontières clinic on Lesvos Island (September 2017-January 2018). RESULTS: There were 215 survivors of sexual violence who presented for care, of whom 60 (28%) were male. The majority of incidents reported (94%) were cases of rape; 174 (81%) of survivors were from Africa and 185 (86%) of the incidents occurred over a month before presentation. Half the incidents (118) occurred in transit, mainly in Turkey, and 76 (35%) in the country of origin; 10 cases (5%) occurred on Lesvos. The perpetrator was known to the survivor in 23% of the cases. The need for mental health care exceeded the capacity of available mental care services. CONCLUSION: Even though the majority of cases delayed seeking medical care after the incident, it is crucial that access to mental health services is guaranteed for those in need. Such access and security measures for people in transit need to be put in place along migration routes, including in countries nominally considered safe, and secure routes need to be developed.


Asunto(s)
Refugiados/estadística & datos numéricos , Delitos Sexuales/estadística & datos numéricos , Migrantes/estadística & datos numéricos , Adolescente , Adulto , Niño , Femenino , Grecia , Humanos , Masculino , Salud Mental/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Campos de Refugiados/estadística & datos numéricos , Refugiados/psicología , Sociedades Médicas/estadística & datos numéricos , Migrantes/psicología
16.
PLoS One ; 15(7): e0236646, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32735571

RESUMEN

Since 2007 the number of refugees fleeing conflict and violence has doubled to more than 25 million. We leverage high frequency data on migration, sea conditions, and riots to investigate how political and environmental risks influence migration and human smuggling across the Mediterranean Sea. We report results from two observational studies. A high frequency time-series study demonstrates that risks alter migration patterns. An event study design demonstrates the effectiveness of a policy intervention that targeted Libyan militias engaged in human smuggling. The results highlight the important role of environmental and political risks in transit countries and their implications for migration and human smuggling.


Asunto(s)
Ambiente , Migración Humana/estadística & datos numéricos , Política , Violencia , Humanos , Mar Mediterráneo , Refugiados/estadística & datos numéricos , Riesgo , Factores de Tiempo
17.
Public Health ; 186: 52-56, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32771661

RESUMEN

OBJECTIVES: Lockdown measures in response to the coronavirus disease 2019 (COVID-19) pandemic can have serious mental health effects on the population, especially in vulnerable groups, such as those living in poor socio-economic conditions, those who are homeless, migrant workers and asylum seekers/refugees. In addition, these vulnerable groups frequently have greater difficulty accessing health services and in treatment adherence. The aim of this study is to estimate the impact of the COVID-19-related lockdown on service utilisation and follow-up adherence in an Italian mental health outpatient service for migrants and individuals in socio-economic difficulties. STUDY DESIGN: The design of this study is a retrospective cross-sectional study. METHODS: All patients who visited the mental health outpatient service in the months of February and March in the years 2017-2020 were included in the study. To compare service utilisation before and after the lockdown, the number of patients who visited the mental health outpatient service for psychiatric interview were recorded. Follow-up adherence was calculated as the percentage of patients who visited in February and subsequently attended a follow-up visit in March of the same year. RESULTS: The number of patients who visited the outpatient service between February 2017 and February 2020 was continuously increasing. In March 2020, fewer patients visited the service for psychiatric interview, in line with the introduction of lockdown measures. In addition, the number of the patients who visited in February 2020 and returned for their follow-up visits in March 2020 declined from approximately 30% over the same months in 2017-2019 to 17.53% in March 2020. CONCLUSIONS: The lockdown-related reduction in numbers of patients accessing the mental health service makes it difficult to help vulnerable populations during a period of time in which their mental health needs are expected to increase. Moreover, the reduction seen in follow-up compliance increases the risk of treatment discontinuation and possible relapse. Proactive alternative strategies need to be developed to reach these vulnerable populations.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Emigrantes e Inmigrantes/psicología , Utilización de Instalaciones y Servicios/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Servicios de Salud Mental/estadística & datos numéricos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Pobreza , Cumplimiento y Adherencia al Tratamiento/estadística & datos numéricos , Adulto , Infecciones por Coronavirus/epidemiología , Estudios Transversales , Emigrantes e Inmigrantes/estadística & datos numéricos , Femenino , Personas sin Hogar/psicología , Personas sin Hogar/estadística & datos numéricos , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Neumonía Viral/epidemiología , Refugiados/psicología , Refugiados/estadística & datos numéricos , Estudios Retrospectivos , Poblaciones Vulnerables , Adulto Joven
18.
Int J Equity Health ; 19(1): 141, 2020 08 20.
Artículo en Inglés | MEDLINE | ID: mdl-32819364

RESUMEN

An estimated 2 million foreign-born migrants of working age (15-64) were living in South Africa (SA) in 2017. Structural and practical xenophobia has driven asylum-seekers, refugees, and undocumented migrants in SA to abject poverty and misery. The Coronavirus Disease 2019 (COVID-19) containment measures adopted by the SA government through the lockdown of the nation have tremendously deepened the unequal treatment of asylum-seekers and refugees in SA. This can be seen through the South African government's lack of consideration of this marginalized population in economic, poverty, and hunger alleviation schemes. Leaving this category of our society out of the national response safety nets may lead to negative coping strategies causing mental health issues and secondary health concerns. An effective response to the socioeconomic challenges imposed by the COVID-19 pandemic should consider the economic and health impact of the pandemic on asylum-seekers, refugees, and undocumented migrants.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Disparidades en el Estado de Salud , Neumonía Viral/epidemiología , Refugiados/estadística & datos numéricos , Inmigrantes Indocumentados/estadística & datos numéricos , Poblaciones Vulnerables/estadística & datos numéricos , Adolescente , Adulto , Infecciones por Coronavirus/prevención & control , Gobierno , Humanos , Persona de Mediana Edad , Pandemias/prevención & control , Neumonía Viral/prevención & control , Factores Socioeconómicos , Sudáfrica/epidemiología , Adulto Joven
19.
PLoS One ; 15(8): e0237532, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32776982

RESUMEN

Resettlement, as a major imperial policy in the Inca empire, appears to have been a widespread mechanism for labor mobilization and the dismantling of rebellions. While multiple ethnohistorical references exist regarding resettlement in the central Andes, the extent of this policy in the imperial provinces is still unknown, especially in cases of economic intensification that might have required more labor force. The δ18O isotope is a good proxy for human mobility when comparing the childhood isotopic signature in the teeth enamel and the local water signature at the place of death. If applied to the study of an archaeological sequence, we can observe the expansion or reduction of a population's displacement within a territory, if they received foreigners, and in general, how their social interaction and networks changed over time. In a marginal provincial setting of the Inca empire, such as Copiapó valley in Chile, the study of δ18O isotope can enable us to observe if the alleged economic intensification in metallurgical production implied the massive arrival of foreign populations. Significantly, the Late Horizon does not evidence a great change in terms of mobility, compared to previous periods in Copiapó valley. Thus, the isotopic evidence can more clearly illuminate the social and political dynamics of an imperial provincial setting, where economic activities demanded by the Inca state were mainly carried out by the local labor force.


Asunto(s)
Arqueología/métodos , Esmalte Dental/crecimiento & desarrollo , Esmalte Dental/metabolismo , Isótopos de Oxígeno/análisis , Refugiados/estadística & datos numéricos , Migrantes/estadística & datos numéricos , Adolescente , Niño , Preescolar , Humanos , Lactante , Perú , Dinámica Poblacional
20.
PLoS One ; 15(8): e0237081, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32764783

RESUMEN

BACKGROUND: Approximately 18,000 Syrian refugees have resettled to the United States. Half of these refugees are children, whose age and refugee status jeopardize their abilities to attain quality healthcare. Information on Syrian refugees' health in the U.S. is limited. This qualitative study sought to explore Syrian refugee parents' beliefs, perspectives, and practices regarding their children's health through in-depth interviews. METHODS: Eighteen Syrian refugee parents residing in Cincinnati, Ohio were interviewed in Arabic by bilingual researchers using semi-structured in-depth interviews. The interviews were recorded, transcribed, and translated. Three members of the research team independently coded each interview using an inductive thematic analysis approach. RESULTS: Analysis identified four salient themes: stressors preclude health seeking behaviors, parents perceive health barriers, parents are dissatisfied with the healthcare system, and parents use resilience behaviors to overcome barriers. Stressors included poor housing and neighborhoods, reliving traumatic experiences, depression and anxiety, and social isolation. Dissatisfaction included emergency room wait times, lack of testing and prescriptions. Health barriers included missed appointments and inadequate transportation, translation services, health literacy and care coordination. Parents reported resilience through faith, by seeking knowledge, use of natural remedies, and utilizing community resources. CONCLUSION: This qualitative study provides information on the beliefs, practices, and behaviors of Syrian refugee parents related to health care utilization of pediatric refugees in the United States. Psychosocial and environmental stressors as well as perceived systemic health barriers, hinder health seeking behaviors in Syrian refugee parents. Culturally relevant care targeting perceived barriers and incorporating resilience behaviors may improve parental satisfaction and parental health seeking behaviors. Further study is needed to implement and evaluate interventions that target identified barriers.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud/etnología , Alfabetización en Salud/estadística & datos numéricos , Padres/psicología , Aceptación de la Atención de Salud/psicología , Refugiados/psicología , Adolescente , Adulto , Niño , Preescolar , Composición Familiar/etnología , Femenino , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Lactante , Masculino , Persona de Mediana Edad , Ohio , Responsabilidad Parental/etnología , Responsabilidad Parental/psicología , Aceptación de la Atención de Salud/etnología , Aceptación de la Atención de Salud/estadística & datos numéricos , Investigación Cualitativa , Refugiados/estadística & datos numéricos , Siria , Adulto Joven
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