Kolitha Wickramage, Lawrence O. Gostin, Eric Friedman, Phusit Prakongsai, Rapeepong Suphanchaimat, Charles Hui, Patrick Duigan, Eliana Barragan, and David R. Harper
Health and Human Rights Journal June 2018 Vol 20 number 1, 251-258.
The Migration, Health, and Development Research Initiative
Post-Doctoral Fellowship in the Epidemiology of Migration and Health
Posting Date: October 16, 2018
Closing Date: Review of applications will begin on December 1, 2018. The position will remain open until a suitable candidate is found.
For more information:
Hanefeld, J., Vearey, J. and Lunt, N. on behalf of the Researchers on Migration, Mobility and Health Group
The Lancet 2017; 389 2358-2359
Summary
With 1 billion people on the move globally—more than 244 million of whom have crossed international borders – and a recognised need to strengthen efforts towards universal health coverage, developing a better understanding of how to respond to the complex interactions between migration, mobility, and health is vital.
At the 2nd Global Consultation on Migrant Health in Sri Lanka earlier this year, a group of global experts in health and migration discussed the progress and shortfalls in attaining the actions set out in the 2008 World Health Assembly (WHA) Resolution on the Health of Migrants.
An anticipated outcome from the 2017 consultation is a “roadmap towards research and policy dialogue milestones”. At the 70th WHA in May, 2017, migration and health were discussed with delegates requesting the WHO’s Director-General to provide guidance to countries on promoting the health of refugees and migrants, with a draft global action to be considered at the 72nd WHA in 2019.
The specific challenges we have encountered in our fieldwork in migration contexts highlight the need for better evidence to improve health-system responses to migration, mobility, and health. We have identified five core areas in which action is needed to support the development of a global research agenda on migration, mobility, and health.
Vearey, J., Modisenyane, M. and Hunter-Adams, J.
South African Health Review 27(1) 89 – 98
Alison F. Crawshaw, Manish Pareek, John Were, Steffen Schillinger, Olga Gorbacheva, Kolitha P. Wickramage, Sema Mandal, Valerie Delpech, Noel Gill, Hilary Kirkbride, and Dominik Zenner
Abstract
Background
The UK, like a number of other countries, has a refugee resettlement programme. External factors, such as higher prevalence of infectious diseases in the country of origin and circumstances of travel, are likely to increase the infectious disease risk of refugees, but published data is scarce. The International Organization for Migration carries out and collates data on standardised pre-entry health assessments (HA), including testing for infectious diseases, on all UK refugee applicants as part of the resettlement programme. From this data, we report the yield of selected infectious diseases (tuberculosis (TB), HIV, syphilis, hepatitis B and hepatitis C) and key risk factors with the aim of informing public health policy.
Methods
We examined a large cohort of refugees (n = 18,418) who underwent a comprehensive pre-entry HA between March 2013 and August 2017. We calculated yields of infectious diseases stratified by nationality and compared these with published (mostly WHO) estimates. We assessed factors associated with case positivity in univariable and multivariable logistic regression analysis.
Results
The number of refugees included in the analysis varied by disease (range 8506–9759). Overall yields were notably high for hepatitis B (188 cases; 2.04%, 95% CI 1.77–2.35%), while yields were below 1% for active TB (9 cases; 92 per 100,000, 48–177), HIV (31 cases; 0.4%, 0.3–0.5%), syphilis (23 cases; 0.24%, 0.15–0.36%) and hepatitis C (38 cases; 0.41%, 0.30–0.57%), and varied widely by nationality. In multivariable analysis, sub-Saharan African nationality was a risk factor for several infections (HIV: OR 51.72, 20.67–129.39; syphilis: OR 4.24, 1.21–24.82; hepatitis B: OR 4.37, 2.91–6.41). Hepatitis B (OR 2.23, 1.05–4.76) and hepatitis C (OR 5.19, 1.70–15.88) were associated with history of blood transfusion. Syphilis (OR 3.27, 1.07–9.95) was associated with history of torture, whereas HIV (OR 1521.54, 342.76–6754.23) and hepatitis B (OR 7.65, 2.33–25.18) were associated with sexually transmitted infection. Syphilis was associated with HIV (OR 10.27, 1.30–81.40).
Conclusions
Testing refugees in an overseas setting through a systematic HA identified patients with a range of infectious diseases. Our results reflect similar patterns found in other programmes and indicate that the yields for infectious diseases vary by region and nationality. This information may help in designing a more targeted approach to testing, which has already started in the UK programme. Further work is needed to refine how best to identify infections in refugees, taking these factors into account.
Kolitha Wickramage, Lawrence O. Gostin, Eric Friedman, Phusit Prakongsai, Rapeepong Suphanchaimat, Charles Hui, Patrick Duigan, Eliana Barragan, and David R. Harper
Health and Human Rights Journal June 2018 Vol 20 number 1, 251-258.
Pottie K, Mayhew A, Morton R, Greenaway C, Akl EA, Rahman P, Zenner D , Pareek M, Tugwell P, Welch V, Meerpohl J, Alonso-Coello P, Hui C, Biggs BA, Requena-Méndez A, Agbata E, Noori T, Schünemann HJ.
BMJ Open 7 (9), e014608. 2017
https://bmjopen.bmj.com/content/7/9/e014608
Zachary White, John Painter, Paul Douglas, Ibrahim Abubaker, Howard Njoo, Chris Archibald, Jessica Halvers, John Robson, Drew Posey
Tuberculosis Research and Treatment; Volume 2017
https://doi.org/10.11552017/8567893
Dara M, Sulis G, Centis G, D’Ambrosio L, de Vries G, Douglas P, Garcia D, Jansen N, Zuroweste E, Migliori GB
Int J Tuberc Lung Dis. 2017 Jul 1;21(7):727-736.
https://doi.org/10.5588/ijtld.16.0940