Los inmigrantes viajeros

Abstract

To characterise travelling immigrants and the international movements they undertake. To identify the risk journeys that this population makes and to assess the international preventive activities for them compared with those for autochthonous travellers. Retrospective, observational study. Unit of International Health (UIH) Santa Coloma de Gramenet (Barcelona), in the Barcelonès Nord i Maresme Health Area, Primary Care Division of the Catalan Institute of Health. Patients seen between June 1999 and June 2002 (n=1163) at the UIH. They were divided into two groups, depending on their origins: those born inside (autochthonous group; no=1019) or outside (immigrant group; n1=144) the European Union. Age, country of origin, length of residence in Spain, interval between consultation and journey, reason for journey, destination, duration of the journey, kind of journey, stay in rural or isolated area, exposure to malaria, vaccinations and anti-malaria chemoprophylaxis prescribed, and overall risk of journey. Immigrants spent more time abroad than autochthonous people (mean 43.5 days; 95% CI, 37.9-49.1; and 15.8 days, 95% CI, 14.9-16.7, respectively; P<.0001). Periods between the journey and the consultation at the UIH were generally similar in the two groups (mean of 26.8 days for immigrants and 30.41 days for autochthonous people; ns), although the immigrants consulted more often in periods of less than 15 and 7 days (P<.005). 31.9% of immigrants stayed in areas of high malaria transmission (95% CI, 24.4%-39.6%) vs 21.3% (95% CI, 18.8%-23.8%) of autochthonous people (P=.04). Overall, immigrants made more risk journeys than autochthonous people (54.8% vs 43.1%; P<.01). No significant differences between the two groups were found in terms of quality in the administration of the international vaccinations prescribed. Compliance with the guidelines for anti-malaria chemoprophylaxis was less in the immigrant group than in the autochthonous one (36% vs 84%; P<.005). The immigrant group in our environment needs to be thought of as a risk group for catching and importing tropical diseases during their international movements. They form a population for whom international preventive measures should be prioritized.