Immigration Patterns Research Articles

Immigrant Integration and COVID-19

Covid-19 has thrust millions of people who have recently crossed international borders into unprecedented social and economic havoc. The patterns of immigration and settlement in a new country, on the one hand, and the nature of the virus, on the other hand, have placed immigrants at high risk of infection, possibly generating or accelerating anti-immigration sentiments among the local population. In this viewpoint, I discuss five complementary aspects of the migration-pandemic nexus: immigrants’ legal status, language proficiency, ethnic segregation, religiosity, and economic wellbeing. My concluding remarks carry several implications for policy.

Residential moblity in the Inka sacred valley: Oxygen, strontium, and lead isotopic analysis at Patallaqta, Peru

The Inka Empire (1400–1532 CE) made common practice of relocating individuals, households and entire communities throughout their expansive realm for different reasons depending on subjects’ assigned social status. Reconstructing patterns of residential mobility and both intra- and extra-regional mobility at Inka sites, particularly in the imperial heartland, could therefore permit some estimation of the social status(es) of their constituents, and thereby provide bottom-up insights into Inka statecraft and political economy. However, this is a difficult endeavor using only archaeological lines of evidence. This study presents oxygen, strontium and lead isotopic results from archaeological human remains (N = 81) from the site of Patallaqta, near Machu Picchu in the Sacred Valley of the southern Peruvian highlands. Isotopic data are used to reconstruct patterns of immigration at the site, which are in turn used to estimate the social status of the population. The resulting 87Sr/86Sr show moderate variation, with most individuals clustering within a range higher than the estimated values for the locale, while 206,7,8Pb/204Pb results show greater variation spanning multiple Pb isotope provinces, and δ18O results cluster broadly around estimated local water values. Taken together, these results are consistent with the expected distribution of groups drawn from communities within the vicinity of the Sacred Valley and possibly the Peruvian or Bolivian altiplano. These results are in notable contrast to published isotopic results from the nearby site of Machu Picchu, and suggest distinct compositions among the resident populations of each site. This study provides further insights into the intersection of residential movement and status dynamics in the Inka Empire.

"New White Ethnics" or "New Latinos"?: Hispanic/Latino Pan-Ethnicity and Ancestry Reporting among South American Immigrants to the United States.

This article explores the identification patterns of South American immigrants to the United States, as measured via Hispanic/Latino ethnicity and ancestry reporting on the US Census. Using data from the 2006-2010 and 2011-2015 American Community Survey, my analysis reveals four main findings. First, I show significant heterogeneity in identity patterns and in sociodemographic, immigration, and geographic characteristics between South American and Mexican immigrants in the United States. Second, I find that Southern Cone immigrants do not report Hispanic/Latino ethnicity and "birth-country" ancestry (ancestry that is concordant with birth country, such as Colombian or Chilean) to a greater extent than Andean immigrants, in favor of reporting more distal "ancestral-origin" ancestries (i.e., Spanish, Japanese, etc.). Third, I show that those immigrants who do report Hispanic/Latino ethnicity are more likely to report "birth-country" ancestry than "ancestral-origin" ancestry, net of other factors. Finally, my analysis demonstrates that Brazilian immigrants chart a different path of identification among South American immigrants and almost unanimously do not report Hispanic/Latino ethnicity while overwhelmingly reporting "Brazilian" ancestry. Taken together, variation in Hispanic/Latino ethnicity and ancestry reporting across South American immigrant groups has implications for their incorporation into US society, as well as for the degree to which these immigrants see themselves as racialized actors in the United States. Some South American immigrant groups (Southern Cone immigrants) appear to be incorporating as "New White ethnics," and others (Andean immigrants) appear to be incorporating as "New Latinos." Researchers of international migration should carefully consider these identification differences and their implications for the measurement and study of "Hispanic/Latino" immigrants and their descendants in the United States.

Immigration and population simulation models for Metcalfa pruinosa nymphs in crop fields

The objective of this study was to investigate immigration patterns from the overwintering host trees to crop fields and the population dynamics of Metcalfa pruinosa nymphs. The movement of M. pruinosa nymphs was monitored using sticky traps in several regions of Korea. Using these data, a nymphal immigration degree-day model was developed with a lower development threshold of 10.1 °C. In addition, nymphal survival rates in field cages were observed, and a stage transition degree-day model from nymphs to adults was developed based on field observation data. Finally, a population simulation model was constructed by integrating the following components: (1) beginning time of crop planting time, (2) population size of immigrant nymphs, (3) nymphal survival rates in crop fields, and (4) the stage transition model from nymphs to adults. There was good agreement between the population model output and nymphal abundance under various crop cultivation conditions. Planting of the crop after 205.5° days was determined to be important because the influx number of nymphs was relatively high in the early part of the nymphal occurrence time and was followed by a decrease. The peak time of nymphal influx was predicted to be 475.3 DD. However, even with a delayed time of crop planting, the time for the maximum nymphal occurrence and the time for the end of nymphal occurrence in crop fields did not vary substantially. After 800 DD, the population of M. pruinosa in crop fields was predicted to decrease gradually due to emigration of adults. These results can help with M. pruinosa control timing based on cultivation time in crop fields in countries where this pest has invaded.

The first estimate of interjurisdictional population dynamics for bonefish, Albula vulpes, a shared resource in the western Caribbean

Many tropical fisheries are data-poor and lack population demographic information needed for effective management and conservation. In this study we used mark-recapture of bonefish, Albula vulpes, an important species in catch-and-release recreational fisheries, to estimate capture probabilities. Moreover, for the first time we generated key demographic parameters including apparent survival, new entries and population size. We marked 9657 bonefish and recaptured 605 (6.3 % recapture rate) inside and outside protected areas in northern Belize and southern Mexico. We built 20 open population model types known as POPAN in program MARK. The model with a constant superpopulation and probability, and a time-dependent survival and capture probability was best supported by our data. A potentially stable superpopulation size of bonefish > 22 cm of approximately 197,350 individuals (SE = 16,010, lower bound = 168,382, upper bound = 231,302) inhabited a larger region beyond our sampled (40.8 km2 sample area). A combination of permanent and temporary immigration and emigration patterns resulted in seasonal variations in survival, capture probabilities, probability of entry of individuals and population size (or abundance). Approximately 188,000 adult bonefish migrate and congregate in near-shore pre-spawning aggregation sites of the Caribbean Sea near Belize and Mexico during the spawning season. Population stability is likely associated with bonefish protections enacted in 1977, protected areas, and conservation practices by fishing communities of Belize and Mexico. This highlights the importance of protected areas and interjurisdictional fisheries management and suggests the need for a paradigm shift in the Caribbean to include connectivity of habitats essential to all life stages for important fish species.

Sociodemographic characteristics of pregnant women tested positive for COVID-19 admitted to a referral center in Northern Italy during lockdown period.

IntroductionWe investigated association between sociodemographic characteristics and COVID‐19 disease among pregnant women admitted to our unit, the largest high‐risk maternity unit in the Milan metropolitan area.MethodsBetween March 1, 2020 and April 30, 2020, 896 pregnant women were admitted to our Institution and tested for COVID‐19. We collected information regarding their sociodemographic characteristics. Additional information on geographical area of residence, number of family members, number of family members tested positive for COVID‐19, and clinical data was collected for women tested positive for COVID‐19. Odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of developing COVID‐19 according to sociodemographic characteristics were estimated by unconditional logistic regression models.ResultsAmong the 896 women enrolled, 50 resulted positive for COVID‐19. Pregnant women aged ≥35 years had a significantly lower risk of developing the infection (crude OR = 0.29; 95% CI:0.16–0.55). Conversely, foreign women (crude OR = 3.32; 95% CI:1.89–5.81), unemployed women (crude OR = 3.09; 95% CI: 1.77–5.40), and women with an unemployed partner (crude OR = 3.16; 95% CI: 1.48–6.79) showed a significantly higher risk of infection. Ethnicity was positively associated with the risk of developing COVID‐19 (mutually adjusted OR = 2.15; 95% CI:1.12–4.11) in the multivariate analysis. Foreign women with COVID‐19 were more likely to have a lower education level (p < 0.01), to be unemployed (p < 0.01), and to live in larger families (p < 0.01) compared to Italian pregnant women.ConclusionsThe socioeconomic conditions described are characteristic of immigration patterns in our metropolitan area. These factors may increase the risk of viral transmission, reducing the effectiveness of lockdown and social distancing.

Food Patterns among Chinese Immigrants Living in the South of Spain.

This article aims to explore the food patterns of Chinese immigrants living in Spain and to understand the factors associated with these behaviors. This qualitative ethnographic study included 133 Chinese immigrants; using interviews with scripts were based on the National Health Survey of Spain. Three categories were defined: “Differences between Chinese food and Western food”; “Products and dishes consumed by Chinese immigrants” and “Modification of eating habits”. Participants found a remarkable difference between eastern (i.e., vegetables and rice) and western (i.e., dairy, high-fat, bread) foods. They also experienced a change in their eating habits, mostly related to acculturation and lack of time. Chinese immigrants have different eating patterns as compared to the native population in Spain and this information could help in future healthcare strategies. Knowing the food culture could infer aspects, such as insertion or integration, and promoting health and well-being.

Neighbourhoods and Workplaces: Are They Related to the Fertility of Immigrants and Their Descendants? A Register-Based Study of Finland, 1999–2014

An increasing number of studies point to the existence of fertility differences between immigrants and those who are native to the receiving countries. However, despite a large body of literature covering a wide range of settings, there is a lack of research into the factors that may underlie the observed differentials. In this article, we focus on the role of population composition in residential neighbourhoods and workplaces, which are assumed to influence the convergence of the fertility patterns of immigrants with those of the host country. The study is based on individual-based register data for the residential population of Finland from 1999 to 2014. We use discrete-time event history models to analyse transitions to first, second, and third births among immigrant women and their descendants of African and Middle Eastern origin whose fertility patterns are markedly different from those of the host society. We investigate whether the proportion of co-ethnic immigrants in residential neighbourhoods and workplaces is related with the fertility adaptation among that high-fertility group. Our results suggest that among them, a higher concentration of co-ethnic immigrants in the neighbourhood is associated with an elevated propensity of having a second and third child. The association persists among child migrants and the second generation. However, a similar association is not observed between fertility and the workplace context.

Female and male song exhibit both parallel and divergent patterns of cultural evolution: A long-term study of song structure and diversity in tropical wrens

Abstract Animal culture changes over time through processes that include drift, immigration, selection, and innovation. Cultural change has been particularly well-studied for animal vocalizations, especially for the vocalizations of male animals in the temperate zone. Here we examine the cultural change in the vocalizations of tropical Rufous-and-white Wrens (Thryophilus rufalbus), quantifying temporal variation in song structure, song type diversity, and population-level distribution of song types in both males and females. We use data from 10 microsatellite loci to quantify patterns of immigration and neutral genetic differentiation over time, to investigate whether cultural diversity changes with rates of immigration. Based on 11 yr of data, we show that the spectro-temporal features of several widely-used persistent song types maintain a relatively high level of consistency for both males and females, whereas the distribution and frequency of particular song types change over time for both sexes. Males and females exhibit comparable levels of cultural diversity (i.e. the diversity of song types across the population), although females exhibit greater rates of cultural change over time. We found that female changes in cultural diversity increased when immigration is high, whereas male cultural diversity did not change with immigration. Our study is the first long-term study to explore cultural evolution for both male and female birds and suggests that cultural patterns exhibit notable differences between the sexes.

A qualitative study on the experiences of southern European immigrant parents navigating the Norwegian healthcare system

BackgroundPatients’ experiences with health providers and their diagnostic and treatment expectations are shaped by cultural health beliefs and previous experiences with healthcare services in home country. This study explores how Southern European immigrant parents navigate the Norwegian healthcare system, through its focus on how this group manage their expectations on diagnosis and treatment practices when these are unmet.MethodsThe study had a qualitative research design. Fourteen in-depth interviews and two focus group discussions with 20 Southern European immigrant parents were conducted in 2017 in three Norwegian municipalities. With the help of NVivo software, data were transcribed verbatim and coded. Following a thematic analysis approach to identify patterns in immigrants’ experiences with the Norwegian healthcare services, the codes were organized into two themes.ResultsThe first theme includes immigrants’ expectations on diagnostic tests and medical treatment. Southern European immigrants expected more diagnostic tests and pharmacological treatment than what was deemed necessary by Norwegian health providers. Experiences with unmet expectations influenced how immigrants addressed their and their children’s healthcare needs. The second theme comprises immigrants’ experiences of seeking healthcare in Norway (attending medical consultations in the private sector, seeking immigrant healthcare providers, and navigating the healthcare through their Norwegian social networks). This category includes also the alternative solutions immigrants undertook when they were dissatisfied with the diagnosis and treatment practices they were offered in Norway (self-medication and seeking healthcare in home countries).ConclusionsCultural health beliefs and previous experiences with healthcare services from home country shaped immigrants’ expectations on diagnosis and treatment practices. This had great implications for their navigation through the healthcare system and interactions with health providers in the host country. The study suggests that successful inclusion of immigrants into the Norwegian healthcare system requires an acknowledgement of the cultural factors that influence access and use of healthcare services. Exploring immigrants’ perspectives and experiences offers important information to understand the challenges of cross-cultural healthcare and to improve communication and equitable access.

Intergenerational differences in dietary acculturation among Ghanaian immigrants living in New York City: a qualitative study.

Dietary acculturation may explain the increasing risk of diet-related diseases among African immigrants in the United States (US). We interviewed twenty-five Ghanaian immigrants (Youth n 13, Age (Mean ± sd) 20 y ± 5⋅4, Parents (n 6) and Grandparents (n 6) age 58⋅7 ± 9⋅7) living in New York City (NYC) to (a) understand how cultural practices and the acculturation experience influence dietary patterns of Ghanaian immigrants and (b) identify intergenerational differences in dietary acculturation among Ghanaian youth, parents and grandparents. Dietary acculturation began in Ghana, continued in NYC and was perceived as a positive process. At the interpersonal level, parents encouraged youth to embrace school lunch and foods outside the home. In contrast, parents preferred home-cooked Ghanaian meals, yet busy schedules limited time for cooking and shared meals. At the community level, greater purchasing power in NYC led to increased calories, and youth welcomed individual choice as schools and fast food exposed them to new foods. Global forces facilitated nutrition transition in Ghana as fast and packaged foods became omnipresent in urban settings. Adults sought to maintain cultural foodways while facilitating dietary acculturation for youth. Both traditional and global diets evolved as youth and adults adopted new food and healthy social norms in the US.

Critical Discourse Analysis of Diaspora Writings: A New Paradigm

This study attempted a literary discourse analysis of Unnikrishnan’s debut book Temporary People (Unnikrishnan,2017) a diasporic text that presents socio-cultural patterns of immigrants in the Gulf region, with language emerging as a strong discourse tool. The aim of this study was to attempt an inter-sectional study of Critical Discourse Analysis (CDA) and Diaspora and suggest a new paradigm shift in the research studies of both genres. The thematic content analysis approach was used to investigate the text by adopting Fairclough’s (2003) three-dimension CDA framework viz., textual analysis (description), process analysis (interpretation), and social analysis (explanation). The study investigated how the author described, interpreted and explored the lives of immigrants; how the language semiotics was used to design narrative patterns and social practices; and how the author used the language to achieve the functionality of the text, and unite two ideologies or genres. The findings of this study will provide pedagogical indicators and insight to language teachers to apply the CDA technique in the teaching of a literary text, particularly fiction. A great contribution of this study will be adding a new diasporic dimension to the CDA studies which are so far confined only to political and socio-cultural contexts. It will also expand the horizon of the research domain of CDA and motivate researchers in both literature and language domains to explore new research avenues.

The Effect of Nativity, Duration of Residence, and Age at Arrival on Obesity: Evidence from an Australian Longitudinal Study

The motivation for this paper arises from the lack of longitudinal studies which investigate changes in obesity patterns of immigrants and the effect of age at arrival on these patterns and changes. Additionally, few studies examined empirically the pathways by which changes in obesity occur overtime. We investigated differences in the levels of obesity among foreign-born people from English Speaking and non-English Speaking countries relative to native-born Australians, and how those differences changed with duration of residence and age at arrival using a large representative longitudinal dataset. We also explored whether the association between nativity, duration of residence (DoR) and obesity is mediated by English language proficiency, socioeconomic factors and health behaviour factors. We found that the odds of being obese were significantly smaller among foreign-born people, both from English speaking countries and non-English speaking countries compared with native-born people. Relative to the native-born, immigrants from non-English speaking countries lost their measurable obesity advantage with respect to the native-born after 20 years of residence in Australia, whereas immigrants from English speaking countries did not. We did not find a substantial modification in these associations by age at arrival for either immigrants from non-English speaking or English speaking countries. We found some evidence of a mediating role of English language proficiency on obesity for foreign-born people from non-English speaking countries. Given increasing proportions of foreign-born people in Australia, particularly from non-English speaking countries, our results underscore the role of English language proficiency in designing healthy weight interventions.

COVID-19 and the Swedish enigma

In the second wave of the COVID-19 pandemic, the Swedish national response continues to be an outlier with cases and deaths increasing more rapidly than in its Nordic neighbours.1,2 On Dec 20, 2020, COVID-19 deaths in Sweden had reached more than 80003 or 787 deaths per 1 million population, which is 4·5 to ten times higher than its neighbours.1–3 This difference between Nordic countries cannot be explained merely by variations in national cultures, histories, population sizes and densities, immigration patterns, the routes by which the virus was first introduced, or how cases and deaths are reported.

Antidepressant adherence and its predictors in immigrants with depression: A population-based study.

Immigrants in Korea are relatively vulnerable in terms of medication self-management and have low levels of medication adherence. We aimed to evaluate antidepressant adherence and its patterns in immigrants and to identify predictors of nonadherence.In this matched cohort study using the National Health Insurance claims database, immigrants who were newly prescribed antidepressants were identified (n = 2,398). The immigrants were matched with native-born Koreans in a 1:1 ratio. Antidepressant adherence was measured by the medication possession ratio at monthly intervals. Logistic regression was performed to compare antidepressant nonadherence between immigrants and native-born Koreans, and to identify factors affecting immigrants’ nonadherence.The average medication possession ratio of immigrants was 27.1%, which was lower than that of native-born Koreans (30.9%) (P = .038). Immigrants had a lower likelihood of adherence than native-born Koreans (odds ratio [OR] 0.76, 95% confidence interval [CI] 0.3–0.92). Older age, visiting a psychiatrist for the first diagnosis of depression (OR 2.24, 95% CI 1.60–3.13), achieving appropriateness of care (OR 3.54, 95% CI 2.51–4.98), and having a usual source of care (OR 1.69, 95% CI 1.25–2.27) were associated with a higher likelihood of adherence in immigrants.This study showed that antidepressant adherence of immigrants was lower than that of native-born Koreans. However, it appears that visiting a psychiatrist, achieving appropriateness of care, and having a usual source of care might increase antidepressant adherence among immigrants. Further research that focuses on cultural and/or linguistic factors affecting immigrants’ adherence and healthcare utilization is suggested as a way to increase adherence.

Gender Patterns in Immigrants' Health Profiles in France: Tobacco, Alcohol, Obesity and Self-Reported Health.

Background: to date, little attention has been given to gender differences in the health of migrants relative to native-born. In this study, we examine the health profile of the largest immigrant groups in metropolitan France, considering several health indicators and with a special interest in the gendered patterns. Methods: The data originate from the 2017 Health Barometer survey representative of metropolitan France. A subsample of 19,857 individuals aged 18–70 years was analysed using modified Poisson regression, and risk ratio estimates (RR) were provided for the different migrant groups regarding alcohol use, current smoking, obesity and less-than-good self-reported health, adjusting for age and educational level. Results: None of the groups of male migrants differs from the native-born in terms of self-reported health, and they have healthier behaviours for alcohol (men from sub-Saharan Africa: 0.42 (0.29–0.61)) and from the Maghreb: 0.30 (0.1–0.54)) and smoking (men from sub-Saharan Africa: 0.64 (0.4–0.84)), with less frequent obesity (men from the Maghreb: 0.61 (0.3–0.95)). The latter, however, more frequently report current smoking (1.21 (1.0–1.46)). For women, less-than-good health is more frequently reported by the groups from sub-Saharan Africa (1.42 (1.1–1.75)) and from the Maghreb (1.55 (1.3–1.84)). Healthier behaviours were found for alcohol (women from overseas départements: 0.38 (0.1–0.85)) and from the Maghreb: (0.18 (0.0–0.57)) and current smoking (women from southern Europe: 0.68 (0.4–0.97), from sub-Saharan Africa: 0.23 (0.1–0.38) and from the Maghreb: 0.42 (0.2–0.61)). Conversely, some were more frequently obese (women from overseas départements: 1.79 (1.2–2.56) and from sub-Saharan Africa: 1.67 (1.2–2.23)). In the latter two groups from Africa, there is a larger relative male excess for tobacco than in the native-born (male-to-female ratios of respectively 2.87 (1.6–5.09) and 3.1 (2.0–4.65) vs 1.13 (1.0–1.20)) and there is a female excess for obesity (0.51 (0.2–0.89) and 0.41 (0.2–0.67)) in contrast with the native-born (1.07 (0.9–1.16)). The female disadvantage in terms of less-than-good self-reported health is more pronounced among migrants from the Maghreb than among the natives (0.56(0.4–0.46) vs. 0.86 (0.8–0.91)). Conclusion: Considering a set of four health indicators, we provide evidence for distinctive gender patterns among immigrants in France. Male immigrants have a healthy behavioural profile in comparison with the natives and no health disadvantage. Female immigrants have a more mixed profile, with a health disadvantage for the non-Western groups from Africa. The contribution to this discordance of socioeconomic factors and gender relations needs to be investigated.

How do clinicians define cultural sensitivity?: A mixed methods study

The aim of the study was to derive an empirically based definition of cultural sensitivity (CS) using psychologists as participants. In Study 1, nine psychologists were interviewed and asked how they conceptualized CS. Based on the results from Study 1, a survey was created for Study 2 and completed by psychologists (n= 142). Confirmatory factor analysis was used to determine if the conceptualizations of CS derived from Study 1 were a good fit. In Study 1, three emergent themes were identified regarding how psychologists conceptualized CS: awareness, cultural case conceptualization, and idiographic sensitivity. Results from Study 2 supported CS as a three-dimensional construct. Findings did not suggest that psychologists conceptualized CS as discrete group categorization. Shifts in immigration patterns, legislation, and societal trends indicate that a shift is needed whereby clients are viewed as individuals as opposed to as members of the cultural group to which they belong.

The interaction of evolving media structure and life-course dynamics: the changing landscape of media use in China (2005–2015)

ABSTRACT The advent of the Internet has brought great changes in media use, yet little is known about how media use has changed in China and what leads to the overall media-use changes. Using three waves of the China General Social Survey from 2005 to 2015, this study examines age, period, and cohort effects on transitions in Internet, television, and newspaper use. It also tracks the substitution dynamics between the Internet and existing media. The results evidence that (1) cohorts maintain their formative media-use habits in later life. (2) They also adjust media use by the interplay of evolving media structure and life-course phases. (3) The media-use adjustment is also a dynamic process balancing between the emerging and existing media use, based on their compatibility. In summary, the life courses of different cohorts are embedded in the evolving media structure, resulting in the distinguished media-use patterns of digital natives, intermediates, and immigrants. The overall media-use changes could happen through cohort succession or the profound impact of media structure transitions in a certain period.

Is it possible to halve the incidence of liver cancer in China by 2050?

A substantial proportion of liver cancers is attributable to chronic infection with hepatitis B and C (HBV/HCV). Liver cancer could become the second cancer, after cervical, to be effectively controlled globally, if proven interventions such as vaccination can be implemented on a large scale. In 2018, the global mortality rate for liver cancer was estimated to be 8.5 per 100 000 individuals. Given patterns of HBV infection and immigration across countries, liver cancer control requires combined, global action. Liver cancer trends vary between countries, in some Western countries, the incidence rates were relatively low but have increased in recent decades; conversely, in several Asian countries, the incidence rates have decreased over time. China has in the past contributed more than half of the global burden of liver cancer but more recently a national decline in liver cancer incidence has been observed. Here, we review the liver cancer burden and exposure to risk factors in China, compared to other countries. We also review the implementation status for primary and secondary prevention interventions and major outcomes achieved over the past three decades. Using Bayesian age-period-cohort analysis, we examine recent trends and based on these, predict that by 2050, the incidence of liver cancer in China could fall by half. We additionally survey the literature to identify current research needs, and review relevant national policies on liver cancer control in China. A comprehensive set of interventions is proposed to progress toward the long-term goal of liver cancer elimination based on the natural history and evidence-based interventions.

Thalassemia.

The prevalence of thalassemia in the Canadian population is not known but is likely increasing owing to immigration patterns.[1][1] Individuals from sub-Saharan Africa, Southeast Asia, Mediterranean countries, the Middle East and the Indian subcontinent are at particular risk, with prevalence