Infectious diseases screening approach among refugees: results from a single-center study

Abstract

Introduction: Our aim was to evaluate a screening program, with active case-finding and treatment for active tuberculosis (TB), latent tuberculosis infection (LTBI), blood-borne viruses (BBV), and sexually transmitted diseases (STDs) among refugees living in facility centers.
 Methodology: We collected data on refugees arriving to our attention in migrant centers in Sardinia, Italy. Socio-demographical data, anamnesis, and clinical features were collected. TST Mantoux was conducted, and X-ray chest (XRC) was performed if TST was positive. Blood-borne virus screening was proposed to all patients. Screening for STDs was offered according to guidelines, anamnesis, and physical examination.
 Results: Eighty-one patients were included. Seventy (86.4%) were male, and the mean age was 24.8±5.7 years. Thirty-three (40.7%) had scabies. Overall, 40/81 (49.4%) had a positive TST Mantoux. One (2.5%) was hospitalized and died for multi-drug-resistant TB. One (2.5%) patient had intestinal-TB. 52/81 (64.2%) refused HIV screening, whereas no positivity was found among tested migrants. Sixty-two (76.5%) accepted HCV screening, and one (1.6%) had a positive test. Fifty-eight (71.6%%) accepted HBV testing, and 29 (50%) of them had positive serology. Ten (12.3%) patients had anal or genital lesions due to syphilis, Molluscum contagiosum, and HPV in 7 (70%), 2 (20%), and one (10%) case, respectively.
 Conclusions: Infectious diseases control and prevention are a key strategy among refugees. The stay in a migrant center is an extraordinary occasion for healthcare provision. This condition could allow a broad screening program in which quick BBV screening tests could be a good method to implement uptake. More information and educational programs would allow a higher understanding and acceptance of HIV screening.

A systematic review of barriers and facilitators for hepatitis B and C screening among migrants in the EU/EEA region

“…The lack of symptoms is an important barrier to screening, as shown by Hamdiui, Steenbergen ( 42 ). Filling knowledge and awareness gaps through education, can increase the perceived risk, perceived disease severity and perceived healthcare needs, which are predictors for screening ( 41 , 43 , 73 , 77 ).…”

Health Risks During Ukrainian Humanitarian Crisis

“…According to a study based on data collected in migrant centres in Sardinia, Italy, 40.7% of the 81 people investigated had scabies, 49.4% had a positive Mantoux test, 50% had a positive hepatitis B virus serology, 12.3% had anal or genital lesions due to syphilis, and one person died of MDR-TB. 24 Although, as we have shown above, the current circumstances of migration are different, these data point out that there is a great need for coordination of medical surveillance in these situations. Under the current conditions of Ukrainian national health care, the country was not prepared to quickly identify the spread of COVID-19 and to respond effectively in the early stages of the pandemic.…”

Facing HCV as a Major Public Healthcare Threat in Italy: Epidemiology and Micro-Elimination Pathways among Underserved Populations

“…Other studies suggest that a higher prevalence is found among not-recently-arrived migrants. Two studies conducted among African asylum seekers report similar prevalence (Fiore et al, 2019, 1.1% and Donisi et al, 2015, 1.9%) [37,38]. At the same time, two studies addressing undocumented migrants report a higher prevalence, ranging from 2.2% to 3.3% [39,40].…”