Spectrum of illness in international migrants seen at geosentinel clinics in 1997-2009, part 2

Migrants resettled internationally and evaluated for specific health concerns

Anne E. McCarthy, Leisa H. Weld, Elizabeth D. Barnett, Heidi So, Christina M. Coyle, Christina Greenaway, William Stauffer, Karin Leder, Rogelio Lopez-Velez, Phillipe Gautret, Francesco Castelli, Nancy Jenks, Patricia F. Walker, Louis Loutan, Martin Cetron

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Background. Increasing international migration may challenge healthcare providers unfamiliar with acute and long latency infections and diseases common in this population. This study defines health conditions encountered in a large heterogenous group of migrants. Methods. Migrants seen at GeoSentinel clinics for any reason, other than those seen at clinics only providing comprehensive protocol-based health screening soon after arrival, were included. Proportionate morbidity for syndromes and diagnoses by country or region of origin were determined and compared. Results. A total of 7629 migrants from 153 countries were seen at 41 GeoSentinel clinics in 19 countries. Most (59%) were adults aged 19-39 years; 11% were children. Most (58%) were seen >1 year after arrival; 27% were seen after >5 years. The most common diagnoses were latent tuberculosis (22%), viral hepatitis (17%), active tuberculosis (10%), human immunodeficiency virus (HIV)/AIDS (7%), malaria (7%), schistosomiasis (6%), and strongyloidiasis (5%); 5% were reported healthy. Twenty percent were hospitalized (24% for active tuberculosis and 21% for febrile illness [83% due to malaria]), and 13 died. Tuberculosis diagnoses and HIV/AIDS were reported from all regions, strongyloidiasis from most regions, and chronic hepatitis B virus (HBV) particularly in Asian immigrants. Regional diagnoses included schistosomiasis (Africa) and Chagas disease (Americas). Conclusions. Eliciting a migration history is important at every encounter; migrant patients may have acute illness or chronic conditions related to exposure in their country of origin. Early detection and treatment, particularly for diagnoses related to tuberculosis, HBV, Strongyloides, and schistosomiasis, may improve outcomes. Policy makers should consider expansion of refugee screening programs to include all migrants.

Original languageEnglish (US)
Pages (from-to)925-933
Number of pages9
JournalClinical Infectious Diseases
Volume56
Issue number7
DOIs
StatePublished - Apr 1 2013

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Schistosomiasis
Tuberculosis
Strongyloidiasis
Health
Hepatitis B virus
Malaria
Acquired Immunodeficiency Syndrome
HIV
Strongyloides
Latent Tuberculosis
Refugees
Chagas Disease
Emigration and Immigration
Chronic Hepatitis B
Administrative Personnel
Health Personnel
Hepatitis
Chronic Disease
Fever
History

Keywords

  • Hepatitis
  • Migrant
  • Schistosomiasis
  • Strongyloides
  • Tuberculosis

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

Cite this

Spectrum of illness in international migrants seen at geosentinel clinics in 1997-2009, part 2 : Migrants resettled internationally and evaluated for specific health concerns. / McCarthy, Anne E.; Weld, Leisa H.; Barnett, Elizabeth D.; So, Heidi; Coyle, Christina M.; Greenaway, Christina; Stauffer, William; Leder, Karin; Lopez-Velez, Rogelio; Gautret, Phillipe; Castelli, Francesco; Jenks, Nancy; Walker, Patricia F.; Loutan, Louis; Cetron, Martin.

In: Clinical Infectious Diseases, Vol. 56, No. 7, 01.04.2013, p. 925-933.

Research output: Contribution to journalArticle

McCarthy, AE, Weld, LH, Barnett, ED, So, H, Coyle, CM, Greenaway, C, Stauffer, W, Leder, K, Lopez-Velez, R, Gautret, P, Castelli, F, Jenks, N, Walker, PF, Loutan, L & Cetron, M 2013, 'Spectrum of illness in international migrants seen at geosentinel clinics in 1997-2009, part 2: Migrants resettled internationally and evaluated for specific health concerns', Clinical Infectious Diseases, vol. 56, no. 7, pp. 925-933. https://doi.org/10.1093/cid/cis1016
McCarthy, Anne E. ; Weld, Leisa H. ; Barnett, Elizabeth D. ; So, Heidi ; Coyle, Christina M. ; Greenaway, Christina ; Stauffer, William ; Leder, Karin ; Lopez-Velez, Rogelio ; Gautret, Phillipe ; Castelli, Francesco ; Jenks, Nancy ; Walker, Patricia F. ; Loutan, Louis ; Cetron, Martin. / Spectrum of illness in international migrants seen at geosentinel clinics in 1997-2009, part 2 : Migrants resettled internationally and evaluated for specific health concerns. In: Clinical Infectious Diseases. 2013 ; Vol. 56, No. 7. pp. 925-933.
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abstract = "Background. Increasing international migration may challenge healthcare providers unfamiliar with acute and long latency infections and diseases common in this population. This study defines health conditions encountered in a large heterogenous group of migrants. Methods. Migrants seen at GeoSentinel clinics for any reason, other than those seen at clinics only providing comprehensive protocol-based health screening soon after arrival, were included. Proportionate morbidity for syndromes and diagnoses by country or region of origin were determined and compared. Results. A total of 7629 migrants from 153 countries were seen at 41 GeoSentinel clinics in 19 countries. Most (59{\%}) were adults aged 19-39 years; 11{\%} were children. Most (58{\%}) were seen >1 year after arrival; 27{\%} were seen after >5 years. The most common diagnoses were latent tuberculosis (22{\%}), viral hepatitis (17{\%}), active tuberculosis (10{\%}), human immunodeficiency virus (HIV)/AIDS (7{\%}), malaria (7{\%}), schistosomiasis (6{\%}), and strongyloidiasis (5{\%}); 5{\%} were reported healthy. Twenty percent were hospitalized (24{\%} for active tuberculosis and 21{\%} for febrile illness [83{\%} due to malaria]), and 13 died. Tuberculosis diagnoses and HIV/AIDS were reported from all regions, strongyloidiasis from most regions, and chronic hepatitis B virus (HBV) particularly in Asian immigrants. Regional diagnoses included schistosomiasis (Africa) and Chagas disease (Americas). Conclusions. Eliciting a migration history is important at every encounter; migrant patients may have acute illness or chronic conditions related to exposure in their country of origin. Early detection and treatment, particularly for diagnoses related to tuberculosis, HBV, Strongyloides, and schistosomiasis, may improve outcomes. Policy makers should consider expansion of refugee screening programs to include all migrants.",
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