Ethiopian Immigrants In Israel Research Articles

The Challenges of Tuberculosis Management beyond Professional Competence: Insights from Tuberculosis Outbreaks among Ethiopian Immigrants in Israel.

Controlling tuberculosis (TB) among immigrants from high-incidence countries presents a public health concern as well as a medical challenge. In this article, we investigate a TB outbreak in a community of people of Jewish descent who emigrated from Ethiopia to Israel (Israeli Ethiopians) that started in June 2022. The index case was a 20-year-old female who had recently immigrated to Israel with her family. Her pre-immigration tuberculin skin test was positive. After excluding active TB, treatment with daily isoniazid for latent TB (LTB) was started shortly after her arrival. A year later, she was diagnosed with smear-positive, culture-positive, pulmonary TB. Investigation of 83 contacts revealed five additional patients with active TB, and three of whom were members were of her household. In this article, we report the current TB outbreak, review previously published TB outbreaks involving Israeli Ethiopians, analyze the factors that triggered each of these outbreaks, and discuss the challenges that face the Israeli TB control program in an era of declining TB incidence and diminishing resources available for TB control.

Lower incidence of hip fractures among elderly Ethiopian immigrants to Israel: first assessment from the Israel National Trauma Registry (INTR) 2011-2020.

The incidence of osteoporotic fractures in the aging Ethiopian population that immigrated to Western countries has not been reported. This study sought to provide a first assessment of the incidence of hip fractures in Ethiopian immigrants in Israel, as a proxy for osteoporosis in this population. This is an epidemiologic study of the incidence of hip fractures (HF) in people aged ≥ 50years in Israel, between 2011 and 2020. Data were extracted from the Israel National Trauma Registry (INTR). Annual age-adjusted HF incidence rates (IR), and standardized incidence ratios (SIR) among Ethiopian-born (EB) relative to non-EB subjects (others) were computed. During the study period, among subjects age ≥ 50 in the INTR, only 20.1% of the EB suffered a HF, in contrast to 32.3% of subjects from other origins (P < 0.0001). Although EB subjects were generally younger than their non-EB counterparts, the age at which they sustained a HF was similar: 80.45 ± 11.7years for EB vs. 79.44 ± 10.32years, P = 0.19. EB men were more likely to sustain a HF, as they represented 41.8% of all HF in their respective group, in comparison with 33.6% for others (P = 0.02). Annual IR of HF were lower for EB subjects throughout the study. Despite an initial rise in the SIR, these were also lower for most of the period. In Israel, EB subjects ≥ 50years still enjoy protection from HF. Our data require confirmation from other Western countries where the Ethiopian diaspora is aging. If a secular upward trend is observed, contributing risk factors should be identified to enable preventative measures.

The Collapse of Semi-Legal Institutions Among Ethiopian Immigrants in Israel and Their Impact on Intimate Partner Femicide in the Community

The Collapse of Semi-Legal Institutions Among Ethiopian Immigrants in Israel and Their Impact on Intimate Partner Femicide in the Community

Does Immigrant Selection Policy Matter? Labor Market Integration of Ethiopian Immigrants in Israel and the United States

Immigration policy debates currently focus on restricting immigration in favor of the highly skilled with the assumption that highly skilled immigrants will be better able to join the labor market and contribute to the economy. However, few studies empirically test the impact of immigrant selection policy by comparing labor market outcomes of immigrants from a single origin in multiple destinations. Fewer still address how race (specifically blackness) may impact the utility of these selection policies. This paper fills this gap by determining Ethiopian immigrants’ labor force participation, occupational status, and self-employment in the United States and Israel—countries with and without immigrant selection policies respectively. We find that Ethiopians experience similar labor market disadvantages relative to the native-born in both countries. These results indicate that rather than selection policy being the driver of labor market success, racial discrimination likely plays the largest role in determining Ethiopian (black) African immigrants’ labor market incorporation in both places.

Ongoing tuberculosis transmission among second-generation Ethiopian immigrants.

Despite considerable efforts to control tuberculosis (TB) among Ethiopian immigrants in Israel, an outbreak of TB among second-generation Ethiopian immigrants that involved native Israelis occurred between January 2011 and December 2019. The aim of this article is to report on this outbreak and discuss the patient and health system barriers that led to its propagation. Overall, 13 culture-positive TB patients were diagnosed in this outbreak. An additional 36 cases with identical mycobacterium tuberculosis genotypes were identified through cross-checking with the National TB Laboratory Registry. Among the 32 close contacts of the index case, 18 (56.3%) reported for screening and treatment of latent TB infection (LTBI) was recommended for 11 (61.1%) of them. However, none completed treatment and eight eventually developed TB. Of the 385 close contacts identified in this outbreak, 286 (74.3%) underwent contact investigation, 154 (53.8%) were recommended LTBI treatment, but only 26 (16.9%) completed the treatment. Routine contact investigation and treatment practice measures failed to contain the cascade of infection and disease, leading to the spread of the infecting strain of TB. This report highlights the challenges to identify the high-risk group and address barriers to care among such a vulnerable population.

Identification and characterization of HIV positive Ethiopian elite controllers in both Africa and Israel

HIV elite controllers (ECs) are a unique subgroup of HIV-positive patients who are long-term virologically suppressed in the absence of antiretroviral treatment (ART). The prevalence of this subgroup is estimated to be <1%. Various cohorts of ECs have been described in developed countries, most of which have been demographically heterogeneous. The aim of this study was to identify ECs in two large African cohorts and to estimate their prevalence in a relatively genetically homogenous population. We screened two cohorts of HIV-positive Ethiopian patients. The first cohort resided in Mekelle, Ethiopia. The second was comprised of HIV-positive Ethiopian immigrants in Israel. In the Mekelle cohort, ART-naïve subjects with stable CD4 counts were prospectively screened using two measurements of viral load 6months apart. Subjects were defined as ECs when both measurements were undetectable. In the Israeli cohort, subjects with consistently undetectable viral loads (mean of 17 viral load measurements/patient) and stable CD4 count >500 cells/μL were defined as ECs. In the Mekelle cohort, 16 of 9515 patients (0.16%) fitted the definition of EC, whereas seven of 1160 (0.6%) in the Israeli cohort were identified as ECs (P=0.011). This is the first large-scale screening for HIV-positive ECs to be performed in entirely African cohorts. The overall prevalence of ECs is within the range of that previously described in developing countries. The significant difference in prevalence between the two cohorts of similar genetic background is probably a consequence of selection bias but warrants further investigation into possible environmental factors which may underlie the EC state.

Effect of Helminth Infestationin Children Infected with Human Immunodeficiency Virus (HIV)

Introduction: Infection by human immunodeficiency virus results in immune destruction, while studies among the Ethiopian immigrants in Israel showed that chronic helminthiasis induces immune dysregulation. With destruction of CD4+ cell and consequently progression to AIDS, the host may be more susceptible to invading organisms such as helminths. This study was aimed at determining the effect of immune state on the prevalence and intensity of helminth infection in HIV infected children in two hospitals in Abakaliki.Material and Methods: It was a cross sectional study that involved consecutive recruitment of 84 confirmed HIV infected children attending the ART clinic. Stool analysis for subjects was done, using the Kato-Katz technique. Blood sample for estimation of CD4 cell count was carried outusing flow cytometer from the HIV positive subjects.Results: A total of 84 subjects were recruited during the study period, majority were males (58.3%). Male to female ratio was 1.4:1. The age range of participants was 2-17 years, while mean age of subjects infected with helminthiasis was 6.10± 3.34 year. A significant number of subjects in advanced and severe immunological stages had helminthiasis (χ2 =12.49, p=0.001). There was however no significant relationship between intensity of helminthiasis and immunologic stages of subjects.Conclusion: The study suggests that immunodeficiency state may increase the susceptibility of helminth infection in HIV infected children. Hence children with HIV/AIDS may benefit from routine testing and/or de-worming of helminth infection.

Shmaglena: Ethnic framework for problem mediating

ABSTRACTThe article describes traditional mediators (in Amharic, shmaglotz meaning “elders”; shmagaleh in the singular) who fill a range of roles within the community of Ethiopian immigrants in Israel, as well as a mediation process (shmaglena in Amharic). The present research is a constructivist-qualitative study. Thirteen respondents participated in the study, all of whom were exposed to the shmaglena process. The data were collected through semi-structured content interviews. The research elicited that the shmaglena function has undergone transformation and adaptation to the target nation's culture. It was also found that the shmaglotz constitute an informal authority whose roles resemble those of conflict resolvers in other cultures.

Resource loss, resource gain, PTSD, and dissociation among Ethiopian immigrants in Israel.

The aim of this study was to examine the loss and gain of resources, posttraumatic stress disorder (PTSD) and dissociation among Jewish Ethiopian immigrants in Israel following exposure to stressful events occurring pre-, peri-, and post-migration. Resources are defined as objects (e.g., housing), conditions (e.g., employment), personal (e.g., self-esteem), or energy (e.g., culture). A random sample (N=478) of three waves of immigrants participated in the research (N1=165; N2=169; N3=144). The data were collected in 2001. Age, loss and gain of resources, traumatic events peri-migration, post-migration difficulties, posttraumatic symptoms, and dissociation were assessed. The relationships between the variables were assessed with multiple hierarchical regressions predicting PTSD and dissociation with gain and loss of resources, over and above age, immigration wave, and trauma. A significant relationship was found between PTSD symptoms and loss of self-esteem resources (r=0.17 p<0.001), while dissociation was positively associated with gain of housing resources (r=0.20, p<0.001). Both PTSD and dissociation were predicted by younger age. The findings are discussed in light of the conservation of resources (COR) theory (Hobfoll, ), of resource loss and gain among Ethiopian immigrants.

The Role of Helminth Infection and Environment in the Development of Allergy: A Prospective Study of Newly-Arrived Ethiopian Immigrants in Israel.

Helminth infection may be protective against allergy and account for the low prevalence of allergy in developing countries. We studied prospectively the prevalence of allergy in Ethiopian immigrants with heavy helminth infection on arrival in Israel, and again after a year of adjustment to an urban industrialized setting, to explore the roles of helminth infection, changed environment and background immunity on the manifestations of allergy. 126 newly arrived Ethiopian immigrants were studied at baseline and 115 after a year of follow up in Israel. Allergic symptoms, Skin prick tests (SPT), Tuberculin (PPD) skin tests, stool and blood samples were obtained for determining parasites, blood IgE and eosinophil levels, respectively. Anti-helminthic therapy was offered to the entire infected individuals, but only 50/108 (46.3%) took the medication. At baseline, there was a significant negative association between helminth infection and allergy, 4/18 (22.2%) of uninfected participants were allergic compared to 7/108 (6.5%) of helminth-infected participants (p = 0.028), as well as between helminth infection and SPT reactivity, 12/18 (66.6%) of uninfected participants compared to 43/108 (39.8%) of helminth-infected participants (p = 0.033). After one year, a significant general increase in allergy and SPT was observed. While only 11/126 (8.7%) were allergic at baseline, 30/115 (26.1%) became allergic at follow-up (p<0.0001), and while 55/126 (43.7%) were SPT+ at baseline, 79/115 (68.7%) became SPT+ at follow-up (p<0.001). A twofold increase in allergen sensitization was also observed after one year in Israel, particularly for dust mites, grasses and olive tree (p<0.001). These results show that: a) Helminth infection is significantly associated with low allergy and low SPT reactivity; b) One year after immigration to Israel, allergy and SPT reactivity increased significantly in all immigrants; c) Higher increases in positive SPT and allergy were observed after a year in the group that remained infected with helminths, even though they had a lowered helminth load; d) The reasons for the increased allergy one year after immigration needs further investigation but probably reflects the combined influence of the decreased helminth load and novel environmental factors.

Perceptions of social strategies in intercultural relations: The case of Ethiopian immigrants in Israel

Social strategies are a central component of intercultural competence, and are vital in understanding, theoretically and practically, the immigration and acculturation process. This study focused on an immigrant group experiencing identity threat, namely young Ethiopians in Israel, and examined their perceptions of social strategies in intergroup relations. Thematic analysis was performed on two types of qualitative data: (1) newspaper articles in which members of the Ethiopian community addressed aspects of their social strategies (31 reports collected from seven newspapers and magazines) and (2) data from two focus groups conducted afterwards with young adult members of the Ethiopian community (five to seven participants in each group). A major pattern emerging from the immigrants’ reports is the adoption of the hosts’ perspective and attitudes regarding the effective norms of social behavior. In their daily coping, on the other hand, the immigrant youth tended to exhibit a complex and at times ambivalent variety of behavioral patterns in their social interactions with members of the host culture. This spectrum of social strategies suggests dynamic processes of trial and error and reflects the unique complexity of intercultural competence. Findings were analyzed in terms of the immigrants’ perception of the threat to their identity and of their ways of coping with those threats.

HIV and helminths: time for a new direction

HIV and helminths: time for a new direction

The Coverage of "Spousal Homicide" in the Ethiopian Community in the Israeli Daily Press

In the recent years, Ethiopian immigrants in Israel have been making headlines mainly in connection to domestic violence and murder. For the last decade, 30 Ethiopian women were murdered by their husbands. Iyengar (1991) distinguishes between two types of framing in news coverage. An episodic frame, which focuses mostly on the specific details of the events, and a thematic frame, which deals with the broader context within the events occur. In the case of the thematic frame, the source of the problem is found in the wider social circles, or the care-giving facilities, and they bear the responsibility for solving the problem as well. According Carter and Weaver (2003) the media’s presentation of violent stories constitutes means of social control, which encourages fear that leads to the search for authoritative and one-dimensional solutions. In order to examine the nature of the press coverage of Ethiopian husbands who murdered their wives, two of the most popular daily newspapers in Israel have been chosen. The sample includes all the articles regarding eight Ethiopian women murdered by their partners during the years 2007-2009. It seems as the press coverage of the murdered Ethiopian women makes use of both types of frames: episodic and thematic. Strengthening the image of the poor, criminal black immigrant plays a dual functional purpose, Illustrating, on the one hand, a clear line between the dangerous and the normal and, on the other hand, removing responsibility from the rest of the Israeli society.

Supporting minority nursing students: ‘Opportunity for Success’ for Ethiopian immigrants in Israel

To report on an Israeli academic nursing project, aimed at supporting the integration of Ethiopian immigrants into nursing studies. The representation of ethnic minorities within nursing is crucial for the provision of efficient care in diverse societies. Nevertheless, successful integration of minority students in nursing programs is not a simple task and needs developing support systems that will attract and retain students from minorities. Ethiopian Jewish immigrants and their descendants in Israel form a community of 120,000 people. Their participation in the national workforce is low, as well as their average income. The paper is based on formative evaluation, using action research, of an academic nursing program in Israel. Four main strategies identify this project: (1) a policy of institutional commitment, (2) personal relations with staff, (3) personal tutoring, and (4) cultural safety education. The project has reached success in terms of attraction, retention and students' satisfactions. The project's two main challenges, which need further concern, are: (1) giving support without labelling and (2) supporting without creating dependency. CONCLUSIONS AND INTERNATIONAL POLICY IMPLICATIONS: Appropriate strategies can enable success of minority students. Nevertheless, the amount of support needed for such programs raises two major questions: (1) To what extent should individual nursing departments be expected to bear solutions to this widely experienced problem? (2) How does focusing on one minority affect cultural safety of the overall group?

Prevalence of diabetes mellitus among Ethiopian‐born HIV patients in Israel

During the mid‐1980s and early 1990s the majority of Ethiopian Jews immigrated to Israel. Diabetes mellitus (DM) rates were exceedingly low upon their arrival, reaching 0–0.4%, but rose to 16.6% at 10–16 years post‐arrival. This may be a challenging factor in HIV patients, since metabolic abnormalities are a major concern in individuals receiving highly active antiretroviral therapy (HAART). In this study we assessed the prevalence of DM in HIV‐positive Ethiopian immigrants. Data were retrospectively obtained from 245 HIV patients treated at the Clinic of Infectious Diseases at the Meir Medical Center, Kfar Saba, Israel. DM was determined according to the following: fasting glucose &gt;127 mg/dl; hemoglobin A1C &gt;6.5%; blood glucose &gt;200 mg/dl; diagnosis of DM in patient problem list. Comparison between Ethiopian and non‐Ethiopian Israelis was done by Student's t‐test and p&lt;0.05 was considered as significant. The cohort included 176 Ethiopians and 69 other Israelis. The rate of DM in the Ethiopian group was remarkably high (22.9% vs. 4.3%, p&lt;0.0001). We therefore analyzed both conventional as well as HIV‐related factors which may contribute to the development of DM. The data indicated that the mean age of the Ethiopian subjects was 5.5 years greater (47±1.1 SD vs. 41.5±1.4 SD, p=0.0056). Surprisingly, body mass index (BMI) was not increased among the Ethiopians, as compared with other Israelis (24.2±0.5 vs. 26.1±1.1, p=0.057). In terms of HIV‐related features, both groups received similar rates of HAART and had comparable levels of viral loads. The Ethiopian group had lower CD4 levels (477.0±18.0 /mm3 vs. 550.1±34.7/mm3, p=0.046), and disclosed longer periods of time elapsed from diagnosis of HIV (8.7±0.4 years vs. 6.0±0.6, p=0.0001). In conclusion, we report a considerably high prevalence of DM among Ethiopian immigrants in Israel, who are HIV patients. Plausible risk factors are ethnic background and older age. Low CD4 levels and a longer HIV‐carrier state were also noted, which had been proposed by others to increase insulin resistance by enhanced inflammation. The possibility of an exaggerated impact of HAART protocols on glucose levels in this cohort is currently being investigated. Intriguingly, BMI was not increased in the Ethiopian group, a finding that warrants further study, and implies a lower threshold to develop DM. Our data underscores the importance of defining HIV subpopulations with increased susceptibility to DM, especially among immigrants.

Coping strategies of Ethiopian immigrants in Israel: Association with PTSD and dissociation

The aim of this study was to examine the relations between coping strategies, posttraumatic stress disorder (PTSD), and dissociation among Jewish Ethiopian refugees in Israel (following exposure to pre-, peri- and post-migration stressful events). A random sample (N = 478) of three waves of refugees took part in the research (N = 165; N = 169; N = 144). Religiosity, coping strategies, stressful and traumatic events, pre- and peri- migration, post-migration difficulties, posttraumatic symptoms, and dissociation were assessed. A significant relationship was found between PTSD symptoms and avoidance coping over and above immigration wave and traumatic events. Dissociation was positively associated with passivity and antisocial coping and negatively associated with social joining and level of religiosity, over and above immigration wave and traumatic events. The findings are discussed in the light of the coping strategies employed by Ethiopian refugees.

Communicating Health Rights to Disadvantaged Populations: Challenges in Developing a Culture-Centered Approach For Ethiopian Immigrants in Israel

Knowing about one's health rights can be critical for obtaining equitable and appropriate health care. A model drawing on a culture-centered approach was used to develop and present health rights information materials for a disadvantaged cultural minority—the Ethiopian immigrant community in Israel. The model is based on the supposition that the design of health rights information materials should address both concerns and barriers identified by members of the cultural community and illustrate specific means to address them. Stories of community members' actual experiences served as the basis for several types of narratives presented in video clips, a photonovella, and an illustrated booklet. More than 100 people participated in the study in five focus groups and 50 personal interviews. Findings indicate participants felt the materials developed using this approach were informative and represented their concerns and cultural barriers to realizing these rights from their perspective and would help motivate them to realize their health rights. The analytic process, which involved members from the cultural community, resulted in the identification of dilemmas associated with the development of solution-oriented materials that draw on the culture-centered approach. These dilemmas pose additional theoretical challenges to the culture-centered approach.

Dietary acculturation and increasing rates of obesity in Ethiopian women living in Israel

Objective Immigration from Third World countries to the developed world is characterized by modification of lifestyle and acculturation to local customs. This study investigated changes in nutritional status and eating behaviors in female Ethiopian immigrants in Israel. Methods Personal interviews, two 24-h dietary recalls, and anthropometric measurements were carried out in a random sample of 53 women 32 ± 6 y of age. Results After living in Israel for an average of 14 y, body mass index was similar to the general Israeli population, with 42% of participants with a body mass index greater than 24.9 kg/m 2, including 11% categorized as obese. This is in stark contrast to the body mass index measured at arrival in Israel (∼19–20 kg/m 2). Less than optimal consumption of dietary fiber, calcium, folate, and B12 was documented. Analysis by food groups showed that intake of dairy products, fruits, and vegetables was negligible, whereas simple sugar intakes were high. The women continued to prepare traditional Ethiopian foods but also incorporated local, less healthy foods into their diets. Compared with the high energy expenditure in rural Ethiopia, participants reported minimal physical activity in Israel. Conclusions This immigrant community is at high risk for developing nutrition-related chronic diseases. Culturally sensitive nutrition education programs are urgently needed.

The Floor Falling Away: Dislocated Space and Body in the Humour of Ethiopian Immigrants in Israel

The present paper analyses humorous stories circulating among Ethiopian immigrants now living in Israel. Typically told at community gatherings, these narratives articulate the drama of dislocation and the traumatic encounter with life in Israel, by focusing on the embarrassing clash of the quintessential “traditional” Ethiopian, with a new land-scape, time-scape, and body-scape. Characterised by an easy spirit, the revelation of innocence met with forgiving and accepting laughter, these stories enable internalisation and mediation of common ambivalences and vulnerabilities, converting them into elements of pleasure.

Ethiopian Emerging Adult Immigrants in Israel

Experiences of discrimination and racism and individual coping strategies were examined among 22 emerging adult Ethiopian immigrants in Israel. In-depth interviews explored the way they perceive, understand, respond to, and cope with experiences of discrimination. Qualitative analysis identified an initial contrast between those interviewees who refuted the existence of personal and/or general experiences of racism and those who felt it acutely. Further analysis identified two strategies among those who refuted the existence of racism: a racism-free group who repudiated racism in general and a proactive strategy in which the young person felt that their own individual behavior prevented racism. Two strategies were identified among those who described frequent, painful racist experiences: (a) fighting back, involving confronting or talking back to the perpetrator, and (b) avoidance, choosing not to react openly to the situation. The article describes the different strategies together with the experience embodied in each of them in relation to integration in Israel and feelings of belonging to Israeli society. The results cast a spot light on the experience of discrimination and the ways of coping with it and suggest that active coping mechanisms are connected to a more positive internal feeling and to stronger feelings of belonging and integration, in particular when the strategy is based on an awareness of discrimination (as opposed to ignoring it).