Prevalence Of Immigrants Research Articles

Impact of migration on diabetes burden: audit in the metropolitan area of Bologna, Italy.

To investigate the impact of diabetes in immigrants on the Italian healthcare system, as well as their compliance with standard protocols of control and treatment. The prevalence of immigrants with diabetes living in the metropolitan area of Bologna (about 1 million inhabitants) in 2019 was investigated using a database containing all subjects in active follow-up for diabetes, based on antidiabetic drug use, disease-specific copayment exemption, ICD-9 codes, continuous care in diabetes units. Country of origin was derived from fiscal code. The overall prevalence of diabetes (n = 53,941; 51.8% males, median age 64) was 6.1% in both Italy-born and immigrant cohorts. Immigrant prevalence was 12.4%, moderately higher than that observed in the total population (12.2%). Diabetes risk was increased in the whole immigrant cohort (odds ratio (OR) 1.74; 95% Confidence Interval (CI) 1.69-1.79). Among cases with incident diabetes, the proportion of immigrants (median age, 49 vs. 65 in Italy-born individuals) increased progressively from 11.7% to 26.5% from 2011 to 2019 (males, 8.9-21.0%; females, 14.9-32.8%) in all age groups, particularly in young adults, but also in older subjects. Metabolic control was lower in immigrants, as was adherence to shared diagnostic and therapeutic protocols, without systematic differences in antidiabetic drug use, but much lower use of drugs for comorbid conditions. The population with diabetes in the metropolitan area of Bologna is rapidly changing. Quality improvement initiatives are needed to reduce the burden for the universalistic Italian health care system generated by the rapidly-growing high-risk immigrant population.

THE PREVALENCE OF HBV, HCV AND HIV INFECTIONS IN IMMIGRANTS AND ASSOCIATED RISKS FOR LOCAL COMMUNITY IN BANIWALID – LIBYA

Since 2011, the number of illegal immigrants has dramatically increased from African counties to Libya, where they prepare for their journey through the Mediterranean Sea to Europe. Before migration, they stay for a period of time and work in Libyan cities and may contact the local community through various means. BaniWalid is a small city with a population of 120,000, receives thousands of immigrants every month, the majority of them come from countries known with endemic diseases. The study was carried out during the period from March to June 2016, with the help of Baniwalid healthcare office and non-governmental foreigners’ registration office in BaniWalid. Blood samples of 1511 immigrants from 24 nationalities were tested for infectious diseases including HBV, HCV and HIV using Rapid test kit and positive results were confirmed by ELISA. The aim of this work was to find out the prevalence in immigrants and associated risk for local community. The study found high prevalence of HBV and the results were 6.68%, 3.51% and 0.967% positive for HBV, HCV and HIV respectively. The prevalence of infection rate for each nationality was established to find the high risk group. The finding indicates that the increased contact with immigrants will represent high risks for the local community. The paper suggests that Libyan health service providers must think differently and focus on educating local community about prevention, transmission, symptoms, treatment and control of infectious diseases as the first line of defense.

Screening of hepatitis B in high risk Chilean and immigrant pregnant women: Management of mother to child transmission

Chile is a low-endemic HBV country, but countries with the highest migratory flow to Chile have an intermediate-high endemicity. In order to avoid vertical transmission of HBV, immunoprophylaxis (IP) in the newborn (NB) is a key factor. To identify HBsAg prevalence in pregnant immigrants and Chilean pregnant women with risk behaviors (RB) and to asses IP use in the NB. Prospective HBsAg screening cohort of immigrant and Chilean pregnant women with RB, between July 1, 2017 and June 30, 2018 in CABL. IP of all NB of reactive HBsAg mothers was assessed. 1,415 HBsAg samples, 1,265 immigrants and 150 Chileans with RB. 37 reactive HBsAg. Two false positive. HBsAg prevalence in immigrant pregnant women was 2.7% and 0.66% in Chileans with RB (p < 0.05). 91.1% came from Haiti, with a prevalence of 3.5% in our region. All NB (36) received IP with a median of administration of 3:02 h. The prevalence in immigrant pregnant women was higher than that reported in the general population and in Chilean women with RB. We proposed the need for universal screening in pregnancy, especially in pregnant women from countries with intermediate-high endemicity.

Assessing trends and healthy migrant paradox in cigarette smoking among U.S. immigrant adults

The healthy migrant paradox suggests that immigrants to developed countries are, on average, healthier than the native born of the host country, with some finding that health advantages diminish after 10–20 years. This study examined trends in immigrant cigarette smoking trends, as well as smoking by the length of residence in the U.S. Data were drawn from the 1995–2015 Tobacco Use Supplement to the Current Population Survey (n = 140,254). Cochran–Armitage tests were used to assess changes in the prevalence of smoking over time in the population, as well by demographic characteristics. Multivariable logistic regression was used to compare cigarette smoking differences between immigrants' length of residence in the U.S. and the native-born population. The prevalence of immigrants' cigarette smoking significantly decreased from 15.0% in 1995/96 to 6.9% in 2014/15. Cigarette smoking rates for males and females significantly decreased from 20.8% and 9.1%% in 2007, respectively, to 10.4% and 3.6% in 2017. Differences in cigarette smoking appeared to have narrowed over time by the length of stay in the U.S. Multivariable analysis showed that immigrants had significantly lower odds of cigarette smoking (length of stay ≤5 years, Odds Ratio = 0.40, 95% Confidence Interval = 0.32–0.51; 6–10, OR = 0.39, CI =0.31–0.49; 11–20, OR = 0.39, CI =0.34–0.45; 20+, OR = 0.47, CI =0.43–0.53) compared to the native-born population. Findings show that immigrants consistently have lower smoking rates than native born, and this healthy behavior advantage did not appear to diminish based on years living in the U.S.

Long term outcome of a community-based hepatitis B awareness campaign: eight-year follow-up on linkage to care (LTC) in HBV infected individuals

BackgroundChronic hepatitis B (CHB) is a major cause of liver-related morbidity and mortality. High HBV prevalence in immigrants and ethnic minorities and numerous barriers to healthcare access are associated with serious health disparities in the United States. Reportedly, self-awareness of HBV infection is low, suggesting a greater need for effective screening and education. Further, low levels of linkage to care (LTC) (completion of a first doctor’s visit after the diagnosis of chronic HBV infection) may be responsible for the lack of engagement over the continuum of care and for needed services.MethodsDemographics and survey data were obtained from 97 Korean American adults chronically infected with HBV, initially identified through a series of community screening events in northern New Jersey between Dec. 2009 and June 2015. Eight year follow-up on these HBV-infected individuals was obtained to determine their access to care, and thus the efficacy of a campaign to improve LTC. The participants’ self-awareness of HBV infection and other factors for LTC were also evaluated.ResultsOf a total of 97 HBV-infected participants (age range 30 to 79), 74 were aware of their infections at screening. The remaining 23 had been unaware of their infections until screening. Eight years after the campaign, some 66 of these 97 individuals accessed care (LTC rate 68%). Health insurance status, presence or absence of symptoms and level of knowledge of CHB were among the most significant factors in LTC.ConclusionA community-based hepatitis B screening and education campaign can be instrumental in prompting HBV infected individuals to access care, as demonstrated in the cumulative increase in LTC in our cohort. Despite many years of awareness of HBV infection, many are not accessing care owing to a lack of health insurance, suggesting a pressing need for advocacy and health education to improve access to affordable coverage in the Asian American population. Community efforts and strategies similar to the ones employed in the current study may serve as a model to improve the engagement of HBV-infected individuals in high risk immigrant populations.

Trends and determinants of Emergency Room admissions for asthma: A retrospective evaluation in Northeast Italy

BackgroundAsthma still represents a cause of death and hospital admissions worldwide. Our study aimed at analyzing the trend of Emergency Room (ER) asthma admissions in Northeast Italy in order to investigate the relevance of specific patient-related determinants and environmental triggers (pollens, mold spores, and pollutants). MethodsRetrospective data from admissions for asthma exacerbations registered between the years 2013 and 2015 in two main ERs in Northeast Italy were collected. Data about patients' age, sex and nationality were recorded. Classification of disease severity followed the current Italian ER triage scoring system (white: no need for emergency treatment; green: need for fast treatment; yellow: severe condition; red: life-threatening condition). Data on pollen/mold spore counts and pollutants were analyzed. ResultsOverall, 1745 ​ER admissions for asthma were registered, with a persistent and significant increase year by year. A slight prevalence of females and patients over 50 years old was observed. Immigrants accounted for 32%, 36% and 26% of admissions respectively in 2013, 2014 and 2015. The prevalence of immigrants' admissions was significantly higher when comparing the relative ratio of immigrant populations/Italian nationals (p ​< ​0.05). The admissions were coded as follows: white, 6.30%; green, 35.36%; yellow, 39.37%; red, 18.97%. People aged ≥50 years were more frequently admitted with a red code, but the trend was not statistically significant (p ​= ​0,0815). By contrast, amongst immigrants there was a higher prevalence of white and green codes observed in comparison with Italian nationals. Grass pollen peak and PM10 high levels represented environmental determinants of ER admissions increase. ConclusionsThe increasing rate of asthma-related ER admissions highlights the need for implementing asthma control strategies. Investigating the traits of patients referring to ER for asthma exacerbations, as well as environmental-related determinants, may help in identifying at-risk individuals and in orienting preventive strategies accordingly. Immigrants represent the most vulnerable sub-population, and their potential difficulties in accessing treatments and health services should be specifically addressed. Overall, implementing patient education in order to improve treatment adherence, as well as providing an asthma action plan to every asthmatic patient, continue to be the most urgent needs.

Predicting the Rise of EU Right-Wing Populism in Response to Unbalanced Immigration

Among the central tenets of globalization is the free migration of labor. Although much has been written about the benefits of globalization, little is known about its limitations and how antiglobalist sentiment can be strongly affected by high levels of immigration. Analyzing poll data from a group of EU countries affected by the recent migrant crisis, we find that over the last three years the percentage of right-wing (RW) populist voters in a given country depends on the prevalence of immigrants in this country’s population and the total immigration inflow into the entire EU. The latter is likely due to the perception that the EU functions as a supranational state in which a lack of inner borders means that “someone else’s problem” can easily become “my problem.” We find that the increase in the percentage of RW voters substantially surpasses the percentage of immigration inflow, implying that if this process continues, ongoing democratic processes will cause RW populism to prevail and globalization to rapidly decrease. We locate tipping points between the fraction of immigrants and the rise of RW populism, and we model our empirical findings using a complex network framework in which the success of globalization rests on a balance between immigration and immigrant integration.

A Retrospective Evaluation of A Paediatric Consult Clinic Serving Uninsured Children in Canada

Abstract BACKGROUND: Children new to Canada may not have health insurance which limits access to health care and increases their vulnerability to poorer health outcomes. As part of a resident advocacy initiative, a monthly pediatric consult clinic was created within a community health clinic to serve uninsured children living in a suburb of a major Canadian city. At the time of its inception in 2009, 35% of patients seen in the health clinic did not have provincial health insurance and an additional 35-40% did not receive Interim Federal Health (IFH) that they were otherwise entitled to (Denburg et al., 2010). OBJECTIVES: To describe the demographics and health issues of uninsured immigrant children referred to a pediatric consult clinic. DESIGN/METHODS: This study is a retrospective chart review characterizing the patients seen from 2009 – 2013. We collected demographic information, presenting symptoms, diagnoses and clinical outcomes. After REB approval, 180 patients were identified and 159 charts were found. Data was extracted from each chart and coded into a database. Of these files, 38 were removed because of duplicate entries or if they were not seen in the clinic. A total of 121 charts were included in the final analysis. An audit was performed by a blinded reviewer to identify any discrepancies in transcription prior to descriptive analysis. RESULTS: Over half (52.1%) of patients seen in our clinic were landed immigrants or Canadians, while 19.8% had refugee status. 49.3% of patients were in a 3-month waiting period for provincial health insurance, while 12.6% had IFH, 11.6% had OHIP and 21.5% had no insurance at all. Only 34% spoke English as their primary language. The top three presenting complaints were developmental, dermatologic and respiratory. The most common final diagnoses were psychiatric and behavioural, dermato-logic and nutritional. The majority of patients required counselling (67%), with 14% prescribed a short medication course and 20% requiring ongoing medication. CONCLUSION: Almost 70% of patients seen had no insurance at the time of their visit, with most in the mandatory 3-month wait for provincial health coverage. Our study suggests that children still need access to health care during this period. The most common diagnoses related to mental health and development suggesting a high prevalence in immigrants and supporting the need to screen for these issues when caring for children new to Canada.

Schistosomiasis in a migrating population in the lake region of China and its potential impact on control operation

Coverage of migrating people in schistosomiasis control program is a growing concern in China. Schistosomiasis caused by Schistosoma japonicum is still one of the major infectious diseases of public health importance in China though tremendous efforts have been made to control the transmission over the past decades. Along with the rapid social-economic development, migrant population has been remarkably increasing across the country. The infected migrants may introduce a new souse of infection to endemic areas or the areas where the transmission had been controlled or interrupted but the intermediate host Oncomelania snail is still present. Preliminary studies for surveillance on schistosomiasis prevalence in migrants were reported, but there is little basic information provided. We carried out an investigation on the prevalence in immigrants, emigrants and permanent residents in three villages of Hunan province located in the main endemic area of lake region, and analyzed the potential impact of migration on control practice. In the study villages, the migrant population accounts for 53.6% of the total. Schistosoma infection was detected by modified Kato-Katz method and miracidium hatching test. Questionnaire survey was conducted comprising knowledge of disease and its transmission, water contact, personal protective measures, and whether examined and treated after water contact. The survey indicated that the migrants and permanent residents had similar life style, and the majority of them experienced water contact in agricultural work or routine life activities. However, the infection rate in immigrants was significantly higher than that in permanent residents. It was also found that the migrants had significantly less knowledge about the disease than the permanent residents, and took no personal protective measures. This is due to that the control program could not cover the migrants when they were absent at the time the program being implemented. The present study suggested that the surveillance and intervention for migrants, immigrants in particular, should be included and strengthened in schistosomiasis control program and a feasible scheme be developed.

HIV and other sexually transmitted infections among migrant population in Spain: a scoping review

Migration flows have the ability to disperse infectious agents and alter local epidemiologies. The aim of the study is to describe the socio-epidemiological, clinical and microbiology / molecular epidemiology of HIV / AIDS infection in the immigrant population. Review of the literature following the methodology Scoping review. A literature search in Medline and MEDES, original items made in Spain, published between 1998-2012, with people from Latin America, sub-Saharan Africa, North Africa, Asia and / or Eastern Europe was conducted. 41 articles were selected. The most studied population was from Latin America (48.8%). Higher HIV prevalence than in native was observed in men who have sex with men from Latin America (18.1%), transvestite and transsexual sex workers from Latin America (23.3%), pregnant women (0.9%) and men and women from sub-Saharan Africa (9.1% and 7.5%). Risk behaviors were different depending on the country of origin and sex. The diagnostic delay of HIV infections reached 43%, with higher prevalence in immigrants from sub-Saharan Africa, which showed delayed diagnosis in 41% and resistance to anti-retroviral treatment in 13%. Immigrant women had more losses to follow up, worse immunological response to antiretroviral treatment and shorter time treatment failure. Higher prevalence of HIV is presented by subjects from sub-Saharan Africa, men who have sex with men and transgender and transvestite sex workers from Latin America. Also pregnant women. Delayed diagnosis and resistance to treatment are more common in individuals from sub-Saharan Africa. Immigrant women presented poorer response to antiretroviral treatment.

Prevalence of multiple sclerosis among immigrants in Norway

Background: Multiple sclerosis (MS) prevalence is unevenly distributed worldwide. Immigration to Norway from countries with a lower MS prevalence is increasing. The aim of this study was to investigate MS prevalence in different immigrant populations in Norway and evaluate the effect of migrating from low- to high-risk regions of MS. Method: First- and second-generation immigrants from the largest immigrant populations were identified from the 2012 Norwegian prevalence study. Prevalence of MS in different ethnic groups was compared using the standardized prevalence ratio (SPR). Results: European and North-American immigrants had the highest prevalence of MS, whereas African and Asian immigrants had the lowest. The prevalence of first-generation Iranian immigrants was not significantly different from the total Norwegian population (SPR 0.70, 95% CI: 0.46–1.03). Second-generation immigrants from Pakistan (SPR 1.62, 95% CI: 0.88–2.76) had a strong increase in prevalence compared to the first generation (SPR 0.13, 95% CI: 0.05–0.28). Conclusion: MS prevalence among immigrants in Norway in general reflects the uneven distribution worldwide. The sharp increase in prevalence in immigrants seen in one generation suggests strong environmental factors affecting the MS risk in Norway.

Epidemiological and clinical features of HEV infection: a survey in the district of Foggia (Apulia, Southern Italy)

In this study we assessed the seroprevalence of hepatitis E virus (HEV) infection in both the Italian population and immigrants from developing countries in Foggia (Apulia, Southern Italy). The seroprevalence of HEV was determined in 1217 subjects [412 (34%) immigrants and 805 Italian subjects (blood donors, general population, HIV-positive, haemodialysis patients)]. Serum samples were tested for anti-HEV and confirmed by Western blot assay; in positive patients HEV RNA and genotype were also determined. There were 8·8% of patients that were positive to anti-HEV, confirmed by Western blot. The prevalence in immigrants was 19·7%, and in Italians 3·9% (blood donors 1·3%, general population 2·7%, HIV-positive patients 2·0%, haemodialysis patients 9·6%). Anti-HEV IgM was found in 38/107 (35·5%) of the anti-HEV-positive serum samples (34 immigrants, four Italians). This study indicates a higher circulation of HEV in immigrants and Italian haemodialysis patients, whereas a low prevalence of HEV antibodies was seen in the remaining Italian population.

1256 PREVALENCE OF ANTIBODIES TO HEPATITIS E VIRUS: A SEROEPIDEMIOLOGICAL AND CLINICAL SURVEY IN THE DISTRICT OF FOGGIA (APULIA-SOUTHERN ITALY)

Background: Hepatitis E virus is the etiologic agent of an enterically transmitted viral hepatitis associated with inadequate hygienic conditions. HEV is endemic in developing countries where it occurs in sporadic and endemic form, but autochthonous sporadic cases of hepatitis E have been reported in North America and in Europe, including Italy. The aim of the present study is to assess the seroprevalence of antibodies to HEV in autochthonous Italian population and in immigrants from developing countries in the province of Foggia. Methods: The seroprevalence of HEV was determined in a cohort of 1217 subjects, 412 (34%) were asymptomatic immigrants (mostly from countries in Sub-Saharan Africa) who had recently arrived in Italy and 805 were four different Italian populations (volunteer blood donors, normal healthy individuals, HIV-positive patients, hemodialysis patients). Serum samples were tested for anti-HEV by a commercial enzyme immunoassay (EIA) based on recombinant proteins; repeatedly positive obtained results were confirmed with a Western Blot assay (Recomblot HEV). Results: A total of 107 (8.8%) of the 1217 serum samples examined were reactive to anti-HEV IgG and confirmed by Western Blot. The prevalence in immigrants was 19.6%, in Italians was 4.0% (blood donors 1.3%, normal healthy individuals 3.3%, HIV-positive patients 3.0%, hemodialysis patients 11.5%) Anti-HEV IgM was found in 20/107 subjects (18.7%) of the anti-HEV IgG positive serum samples, 17 in immigrants and 3 in Italians. All anti-HEV positive subjects were asymptomatic and alanine transferase values were elevated only in 8/20 patients with anti-HEV IgM-positive. Conclusions: The results of this study indicate a high circulation of HEV in immigrant population and hemodialysis patients, whereas the prevalence of HEV antibodies was low in the other Italian population, compared to that of other European countries.

TITLE: Prevalence of Immigrants and Characterization of 2008 and 2009 Patients at an Allergy Clinic of a Public Hospital in Madrid

TITLE: Prevalence of Immigrants and Characterization of 2008 and 2009 Patients at an Allergy Clinic of a Public Hospital in Madrid

Estimation of diabetes prevalence among immigrants from the Middle East in Sweden by using three different data sources

Aims To estimate diabetes prevalence in immigrants from the Middle East in Sweden compared with Swedish-born subjects. This group accounts for around 15% of Sweden's non-European immigrants. Methods Three samples were used: self-reported diabetes in a random sample (SALLS sample) of subjects aged 35–64 years in Sweden ( n = 22,032); known diabetes among patients aged 35–64 years in primary care (PC) at four primary healthcare centers in Stockholm County ( n = 30,679); and known and newly diagnosed diabetes in a random population sample of subjects aged 60 years in Stockholm County ( n = 4106). Results The odds ratio (OR) for subjects from the Middle East was: 1.69 (95% confidence interval [CI] 0.96–2.99) in the SALLS sample; 4.43 (95% CI 3.38–5.56) in the PC sample; and 3.96 (95% CI 1.98–7.92) in the age-60 sample, compared with native Swedes. Subjects from European and other Organization for Economic Cooperation and Development (OECD) countries showed an excess risk only in the SALLS sample (1.43, 95% CI 1.11–1.83). Conclusions Immigrants from the Middle East showed a four-fold higher risk of diabetes compared with Swedish-born subjects in two of the three data sources. More studies are needed to confirm these results, but the findings call for targeted preventative strategies in this population group.

Own and parental war experience as a risk factor for mental health problems among adolescents with an immigrant background: results from a cross sectional study in Oslo, Norway

BackgroundAn increasing proportion of immigrants to Western countries in the past decade are from war affected countries. The aim of this study was to estimate the prevalence of war experience among adolescents and their parents and to investigate possible differences in internalizing and externalizing mental health problems between adolescents exposed and unexposed to own and parental war experience.MethodThe study is based on a cross-sectional population-based survey of all 10th grade pupils in Oslo for two consecutive years. A total of 1,758 aadolescents were included, all with both parents born outside of Norway. Internalizing and externalizing mental health problems were measured by Hopkins Symptom Checklist-10 and subscales of the Strengths and Difficulties Questionnaire, respectively. Own and parental war experience is based on adolescent self-report.ResultsThe proportion of adolescents with own war experience was 14% with the highest prevalence in immigrants from Eastern Europe and Sub-Saharan Africa. The proportion of parental war experience was 33% with Sub-Saharan Africa being highest. Adolescents reporting own war experience had higher scores for both internalizing and externalizing mental health problems compared to immigrants without war experience, but only externalizing problems reached statistically significant differences. For parental war experience there was a statistically significant relationship between parental war experience and internalizing mental health problems. The association remained significant after adjustment for parental educational level and adolescents' own war experience.ConclusionWar exposure is highly prevalent among immigrants living in Oslo, Norway, both among adolescents themselves and their parents. Among immigrants to Norway, parental war experience appears to be stronger associated with mental health problems than adolescents own exposure to war experience.

Chronic disease prevalence in immigrants to Israel from the former USSR.

The purpose of this study was to evaluate the prevalence of chronic health conditions in the Russian population who immigrated to Israel during 1989-1992. Interviewer-supported self-administered questionnaires were distributed to a 50% random sample of 1710 immigrants residing in the city of Nazareth-Ilit in Northern Israel. The final study group included 897 adults after a 3.5% of noncompliance. The study participants were asked to report all chronic diseases from a list of 11 disease states. The data were coupled with their demographic data and are presented as age/sex-specific prevalence rates. Self-reported disease prevalence rates among the Russian immigrants to Israel were found to be very high (62.2% of the males and 68.7% of the females reported a mean 3-3.5 diseases per person). These reported rates were significantly higher for immigrants from the European republics (67.1%) than for those from Asian republics (55.6%). The highest reported age-specific disease prevalence rates were for musculoskeletal diseases (389/1000), ischemic heart disease (340/1000), gastrointestinal diseases (269/1000), and hypertension (226/1000). A higher rate among females was found for almost all disease states. The prevalence rates reported by the Russian Jews in this study are much higher than commonly observed in Western countries. This is in accordance with a similar difference in reported mortality rates between Western countries and the former USSR. The etiologic explanation of this finding is yet to be studied. In addition, and in light of the mass immigration of Eastern European residents to the West it is of major importance for local health authorities to respond appropriately to the differences in health status of these immigrating populations.