Screening for parasites in migrant children

Bustamante, Jorge; Sainz, Talía; Montojo, Fátima Ara; Almirón, Mariana Díaz; Subirats, Mercedes; Vega, D. Montero; Mellado, María José; López‐Hortelano, Milagros García

doi:10.1016/j.tmaid.2022.102287

Cited by 7 publications

(18 citation statements)

References 44 publications

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“…Our results also suggest that parasitosis are frequent in this population, in line with previous studies [ 10 , 11 , 14 , 16 ]. Cost-effectiveness of the screening of parasitic infections is also controversial.…”

Section: Discussionsupporting

confidence: 93%

“…Cost-effectiveness of the screening of parasitic infections is also controversial. Although the potential for overdiagnosis when using serology limits their usefulness according to some authors, others rely on the benefits of early treatment to prevent long-term sequelae [ 14 ]. From our point of view, in the unique population of UM, overtreatment may be less harmful than an underdiagnosis, considering the long-term sequelae and scarce access to health care systems.…”

Section: Discussionmentioning

confidence: 99%

“…The screening of imported diseases in UM is key to prevent transmission and long-term sequelae. However, there are many obstacles in their access to the health system (e.g., language and cultural differences, overcrowding and lack of resources in the refugee centers), which complicates their linkage to care and follow-up [ 8 , 14 , 15 , 16 , 17 , 18 ]. This is a concern, especially for the prevention of TB, which requires long treatments often not well tolerated, with frequent adherence issues.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Coronavirus Pandemic on Tuberculosis and Other Imported Diseases Screening among Migrant Minors in Spain

et al. 2022

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Background: In recent decades, the increase in population movements has turned the focus to imported diseases. The COVID-19 pandemic has negatively impacted the access to health care systems, especially in highly vulnerable populations. We address the effects of the pandemic on the health screening of migrant unaccompanied minors (UM) in Spain. Method: Retrospective cross-sectional study including UM screened for imported diseases with a unified protocol at a pediatric reference unit for tropical and infectious diseases in Madrid, Spain. We compared the pre-pandemic (2018–2019) and post-pandemic periods (2020–2021). Results: A total of 192 minors were screened during the study period, with a drop in UM’s referral to our center in the post-pandemic years (140 in 2018–2019 vs. 52 in 2020–2021). Out of 192, 161 (83.9%) were diagnosed with at least one medical condition. The mean age was 16.8 years (SD 0.8) and 96.9% were males. Most cases were referred for a health exam; only 38% of children were symptomatic. Eosinophilia was present in 20.8%. The most common diagnosis were latent tuberculosis infection (LTBI) (72.9%), schistosomiasis (15.1%), toxocariasis (4.9%) and strongyloidiasis (4.9%). The prevalence of LTBI did not vary significantly (69.3% vs. 82.7%, p = 0.087). A total of 38% of the patients diagnosed with LTBI never started treatment or were lost to follow-up, as were two out of three patients with active pulmonary tuberculosis. Conclusions: In this series, the number of UM referred for health screening has dropped dramatically after the COVID pandemic, and two years after the beginning of the pandemic, access to care is still limited. Lost to follow-up rates are extremely high despite institutionalization. Specific resources, including multidisciplinary teams and accessible units are needed to improve diagnoses and linkage to care in this vulnerable population.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of Coronavirus Pandemic on Tuberculosis and Other Imported Diseases Screening among Migrant Minors in Spain

et al. 2022

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“…Although most of the IMs who come to Spain are men [ 9 ], an increase in the number of women and children has been observed [ 11 ]. Almost 20% of the IMs who arrive in Spain are child irregular migrants (ChIMs) [ 12 ], who travel of their own volition or accompanied by family members, leaving their countries of origin to seek a better future [ 13 ]. ChIMs have specific health needs.…”

Section: Introductionmentioning

confidence: 99%

“…After the emergency care, ChIMs are guarded by the national police, and afterwards, they are taken to host centers or centers for the protection of children [ 14 , 20 , 26 ]. Some studies have focused on the process of care for ChIMs from the epidemiological [ 6 , 12 ], immunological [ 33 ], cultural [ 18 ], or legislative [ 34 ] perspective or the perspective of the hosting system [ 35 ]. Nevertheless, learning about the experiences of the professionals involved in the care process is key for identifying deficits and implementing improvements.…”

Section: Introductionmentioning

confidence: 99%

Experiences of Healthcare Providers Who Provide Emergency Care to Migrant Children Who Arriving in Spain by Small Boats (Patera): A Qualitative Study

Jiménez-Lasserrotte,

Artés-Navarro,

Granero-Molina

et al. 2023

Children

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Background: The phenomenon of migration from regions with more limited resources is a reality of the globalized world. It is estimated that at the end of 2019, almost 80 million migrants were displaced around the world, with 46% of them being children. Almost 20% of the irregular immigrants who arrived in Spain were child irregular migrants, who travelled alone or accompanied by family members after leaving their countries of origin seeking, to find a better future. Child irregular migrants have specific healthcare needs. The objectives of our present study were to describe and understand the experiences of healthcare providers in relation to the healthcare needs and the process of emergency care for child irregular migrants who come to Spain in small vessels. Methods: In this descriptive qualitative study, two focus groups were convened, and in-depth interviews with 21 participants were conducted, followed by inductive data analysis using ATLAS.ti 9.3 software. Results: Three main themes emerged from the analysis: (1) more vulnerable groups for whom the priority is emergency care; (2) the health and social care of child migrants; and (3) challenges and advances in the care of child migrants. Conclusions: For healthcare providers, protecting children, placing value on the family unit, and ensuring that children feel safe at all times are very important. Learning about the experiences of healthcare providers can contribute towards improving the health and social care of children in emergency care.

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Schistosomiasis in migrant children and adolescents in a paediatric tropical referral unit in Spain: diagnosis and long-term management challenges

Rodríguez-Molino,

González Martínez,

Bustamante Amador

et al. 2024

Eur J Pediatr

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Globalisation and population movement have led to an increasing number of migrant children residing in areas non-endemic for schistosomiasis. However, diagnosing and managing schistosomiasis in children remain controversial. This study aims to investigate the prevalence of schistosomiasis in migrant children and to describe the diagnostic approach and management strategies, including long-term follow-up, to explore the potential role of serological tests in evaluating treatment response. We conducted a retrospective descriptive study spanning from January 2014–July 2021 at a referral unit for Paediatric Tropical Diseases in Madrid (Spain). The study included patients under 18 years diagnosed with schistosomiasis. Of 679 children screened for schistosomiasis, 73 (10.8%) tested positive. The median age was 16.3 years [IQR 9–17.6], 74% male. The majority originated from Sub-Saharan Africa (47%) and Asia (47%). Only 40% presented with symptoms, with gastrointestinal (18%) and cutaneous (17%) manifestations being the most common. Eosinophilia was observed in 43% (median [IQR]: 1103/mm3 [671–1536]), and ova were visualised in the urine of 2/50 (4.0%). Praziquantel treatment was administered to 92%, and 5 patients required retreatment. Follow-up data were available for 58 (80%) over a median period of 9 months [IQR 6–19.8], revealing a progressive decline in eosinophil count, IgE titres, and ELISA optical density. Conclusion: In this series, the prevalence of schistosomiasis among migrant children was significant (10%), highlighting the importance of including serological tests in migrant health screening. The disease is largely asymptomatic, eosinophilia is often absent, and visualisation of ova in urine is exceedingly rare. Eosinophil count, IgE titres, and ELISA optical density could prove valuable as an initial approach for monitoring inflammation during follow-up assessments. What is Known:• The burden of disease related to schistosomiasis is significant, particulary in children, and it is advisable to screen this vulnerable population. What is New:• Eosinophilia may not be present in parasitic infections, so serological tests are crucial for screening migrant children.• Serological monitoring facilitates long-term management of migrant children with schistosomiasis.

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Screening for parasites in migrant children

Cited by 7 publications

References 44 publications

Impact of Coronavirus Pandemic on Tuberculosis and Other Imported Diseases Screening among Migrant Minors in Spain

Impact of Coronavirus Pandemic on Tuberculosis and Other Imported Diseases Screening among Migrant Minors in Spain

Experiences of Healthcare Providers Who Provide Emergency Care to Migrant Children Who Arriving in Spain by Small Boats (Patera): A Qualitative Study

Schistosomiasis in migrant children and adolescents in a paediatric tropical referral unit in Spain: diagnosis and long-term management challenges

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