Migrants'living conditions, perceived health needsand implications for the use of antibiotics and antimicrobial resistance in the United Kingdom: A qualitative study.

Abstract

Antimicrobial resistance (AMR) is among the top public health concerns around the globe. Migrants, especially forced migrants, could be at higher risk of acquiring and transmitting AMR during their journeys or in host countries. There is limited understanding regarding migrants'living conditions and the wider factors contributing to their risk of acquiring infections, and behaviors around antimicrobial use, and AMR development. In this study, we aimed to explore transit experiences, living conditions, and antibiotic use of migrants living in the United Kingdom. We conducted semistructured qualitative interviews with 27 participants and identified five themes regarding migrants'journey and their living conditions during transit and after arriving in the United Kingdom, their access to water, sanitation and hygiene (WASH), and their use of antibiotics. Migrants, particularly forced migrants, experienced unfavorable living conditions, poor access to WASH, and challenges in accessing healthcare, which further contributed to health conditions like urinary and skin problems. Isolation and difficulty in accessing healthcare played significant roles in migrants'perceived need for storing and using antibiotics as a safety net. The findings highlight the need for coordinated and multilevel interventions to address these challenges and contribute towardtackling AMR and improving the health of this population group.