Abstract
The objective of this paper was to systematically review the literature on the prevalence of selected infectious diseases among migrants/refugees of African origin and to provide policy makers and health care professionals with evidence-based information. We pursued a systematic review and meta-analysis to determine the prevalence of six selected infectious diseases (i.e., syphilis, helminthiasis, schistosomiasis, intestinal protozoa infections, hepatitis B, and hepatitis C) among migrants/refugees of African origin. Three electronic databases (i.e., PubMed, EMBASE, and ISI Web of Science) were searched without language restrictions. Relevant data were extracted and random-effects meta-analyses conducted. Only adjusted estimates were analyzed to help account for heterogeneity and potential confounding. We assessed the quality of evidence using the GRADE approach. The results were stratified by geographical region. Ninety-six studies were included. The evidence was of low quality due to the small numbers of countries, infectious diseases, and participants included. African migrants/refugees had median (with 95% confidence interval [95% CI]) prevalence for syphilis, helminthiasis, schistosomiasis, intestinal protozoa infection, hepatitis B, and hepatitis C of 6.0% [95% CI: 2.0–7.0%], 13.0% [95% CI: 9.5–14.5%], 14.0% [95% CI: 13.0–17.0%], 15.0% [95% CI: 10.5–21.0%], 10.0% [95% CI: 6.0–14.0%], and 3.0% [95% CI: 1.0–4.0%], respectively. We found high heterogeneity regardless of the disease (I 2; minimum 97.5%, maximum 99.7%). The relatively high prevalence of some infectious diseases among African migrants/refugees warrants for systematic screening. The large heterogeneity of the available published data does not allow for stratifying such screening programs according to the geographical origin of African migrants/refugees.
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References
United Nations (2016) International Migration Report 2015. Available online at: http://www.un.org/en/development/desa/population/migration/publications/migrationreport/docs/MigrationReport2015_Highlights.pdf. Accessed 31 May 2017
United Nations High Commissioner for Refugees (UNHCR) (2017) Global Trends. Forced displacement in 2016. Available online at: http://www.unhcr.org/globaltrends2016. Accessed 26 Jun 2017
Theuring S, Friedrich-Jänicke B, Pörtner K, Trebesch I, Durst A, Dieckmann S et al (2016) Screening for infectious diseases among unaccompanied minor refugees in Berlin, 2014–2015. Eur J Epidemiol 31(7):707–710
Chernet A, Kling K, Sydow V, Kuenzli E, Hatz C, Utzinger J et al (2017) Accuracy of diagnostic tests for Schistosoma mansoni infection in asymptomatic Eritrean refugees: serology and point-of-care circulating cathodic antigen against stool microscopy. Clin Infect Dis 65(4):568–574
Goldenberger D, Claas GJ, Bloch-Infanger C, Breidthardt T, Suter B, Martínez M et al (2015) Louse-borne relapsing fever (Borrelia recurrentis) in an Eritrean refugee arriving in Switzerland, August 2015. Euro Surveill 20(32):2–5
Roggelin L, Tappe D, Noack B, Addo MM, Tannich E, Rothe C (2016) Sharp increase of imported Plasmodium vivax malaria seen in migrants from Eritrea in Hamburg, Germany. Malar J 15:325
Jaton L, Pillonel T, Jaton K, Dory E, Prod’hom G, Blanc DS et al (2016) Common skin infection due to Panton–Valentine leucocidin-producing Staphylococcus aureus strains in asylum seekers from Eritrea: a genome-based investigation of a suspected outbreak. Clin Microbiol Infect 22(8):739.e5–739.e8
Daw MA, El-Bouzedi A, Ahmed MO, Dau AA, Agnan MM, Drah AM et al (2016) Prevalence of human immune deficiency virus in immigrants crossing to Europe from north and Sub-Saharan Africa. Travel Med Infect Dis 14(6):637–638
Kramer MA, van Veen MG, Op de Coul ELM, Coutinho RA, Prins M (2014) Do sexual risk behaviour, risk perception and testing behaviour differ across generations of migrants? Eur J Public Health 24(1):134–138
Tanser F, Bärnighausen T, Vandormael A, Dobra A (2015) HIV treatment cascade in migrants and mobile populations. Curr Opin HIV AIDS 10(6):430–438
Fu SS, McFall M, Saxon AJ, Beckham JC, Carmody TP, Baker DG et al (2007) Post-traumatic stress disorder and smoking: a systematic review. Nicotine Tob Res 9(11):1071–1084
Buhmann CB (2014) Traumatized refugees: morbidity, treatment and predictors of outcome. Dan Med J 61(8):B4871
Slobodin O, de Jong JTVM (2015) Mental health interventions for traumatized asylum seekers and refugees: What do we know about their efficacy? Int J Soc Psychiatry 61(1):17–26
Alpak G, Unal A, Bulbul F, Sagaltici E, Bez Y, Altindag A et al (2015) Post-traumatic stress disorder among Syrian refugees in Turkey: a cross-sectional study. Int J Psychiatry Clin Pract 19(1):45–50
Schouler-Ocak M, Aichberger MC, Penka S, Kluge U, Heinz A (2015) Mental disorders of immigrants in Germany. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 58(6):527–532
Bogic M, Njoku A, Priebe S (2015) Long-term mental health of war-refugees: a systematic literature review. BMC Int Health Hum Rights 15:29
Lolk M, Byberg S, Carlsson J, Norredam M (2016) Somatic comorbidity among migrants with posttraumatic stress disorder and depression—a prospective cohort study. BMC Psychiatry 16(1):447
Utzinger J, Becker SL, Knopp S, Blum J, Neumayr AL, Keiser J et al (2012) Neglected tropical diseases: diagnosis, clinical management, treatment and control. Swiss Med Wkly 142:w13727
Cuenca-Gómez JA, Salas-Coronas J, Soriano-Pérez MJ, Vázquez-Villegas J, Lozano-Serrano AB, Cabezas-Fernández MT (2016) Viral hepatitis and immigration: a challenge for the healthcare system. Rev Clin Esp 216(5):248–252
Kärki T, Napoli C, Riccardo F, Fabiani M, Dente MG, Carballo M et al (2014) Screening for infectious diseases among newly arrived migrants in EU/EEA countries—varying practices but consensus on the utility of screening. Int J Environ Res Public Health 11(10):11004–11014
Israel H, Richter RR (2011) A guide to understanding meta-analysis. J Orthop Sports Phys Ther 41(7):496–504
Sedgwick P (2015) How to read a forest plot in a meta-analysis. BMJ 351:h4028
BMJ (2017) What is GRADE? Available online at: http://clinicalevidence.bmj.com/x/set/static/ebm/learn/665072.html. Accessed 2 Oct 2017
Pullan RL, Brooker SJ (2012) The global limits and population at risk of soil-transmitted helminth infections in 2010. Parasit Vectors 5:81
Strunz EC, Addiss DG, Stocks ME, Ogden S, Utzinger J, Freeman MC (2014) Water, sanitation, hygiene, and soil-transmitted helminth infection: a systematic review and meta-analysis. PLoS Med 11(3):e1001620
Lai Y-S, Biedermann P, Ekpo UF, Garba A, Mathieu E, Midzi N et al (2015) Spatial distribution of schistosomiasis and treatment needs in sub-Saharan Africa: a systematic review and geostatistical analysis. Lancet Infect Dis 15(8):927–940
Colley DG, Bustinduy AL, Secor WE, King CH (2014) Human schistosomiasis. Lancet 383(9936):2253–2264
Knopp S, Mgeni AF, Khamis IS, Steinmann P, Stothard JR, Rollinson D et al (2008) Diagnosis of soil-transmitted helminths in the era of preventive chemotherapy: effect of multiple stool sampling and use of different diagnostic techniques. PLoS Negl Trop Dis 2(11):e331
Gartlehner G, West SL, Mansfield AJ, Poole C, Tant E, Lux LJ et al (2012) Clinical heterogeneity in systematic reviews and health technology assessments: synthesis of guidance documents and the literature. Int J Technol Assess Health Care 28(1):36–43
Melsen WG, Bootsma MCJ, Rovers MM, Bonten MJM (2014) The effects of clinical and statistical heterogeneity on the predictive values of results from meta-analyses. Clin Microbiol Infect 20(2):123–129
Higgins JPT, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327(7414):557–560
Ziegelbauer K, Speich B, Mäusezahl D, Bos R, Keiser J, Utzinger J (2012) Effect of sanitation on soil-transmitted helminth infection: systematic review and meta-analysis. PLoS Med 9(1):e1001162
World Health Organization (WHO). Country maps: schistosomiasis. Available online at: http://www.who.int/schistosomiasis/epidemiology/global_atlas_maps/en/. Accessed 2 Jun 2017
Khyatti M, Trimbitas R-D, Zouheir Y, Benani A, El Messaoudi M-D, Hemminki K (2014) Infectious diseases in North Africa and north African immigrants to Europe. Eur J Public Health 24(Suppl 1):47–56
Rossi C, Shrier I, Marshall L, Cnossen S, Schwartzman K, Klein MB et al (2012) Seroprevalence of chronic hepatitis B virus infection and prior immunity in immigrants and refugees: a systematic review and meta-analysis. PLoS One 7(9):e44611
Greenaway C, Thu Ma A, Kloda LA, Klein M, Cnossen S, Schwarzer G et al (2015) The seroprevalence of hepatitis C antibodies in immigrants and refugees from intermediate and high endemic countries: a systematic review and meta-analysis. PLoS One 10(11):e0141715
Napoli C, Dente MG, Kärki T, Riccardo F, Rossi P, Declich S et al (2015) Screening for infectious diseases among newly arrived migrants: experiences and practices in non-EU countries of the Mediterranean Basin and Black Sea. Int J Environ Res Public Health 12(12):15550–15558
Minodier P, Lamarre V, Carle M-E, Blais D, Ovetchkine P, Tapiero B (2010) Evaluation of a school-based program for diagnosis and treatment of latent tuberculosis infection in immigrant children. J Infect Public Health 3(2):67–75
Veldhuijzen IK, Toy M, Hahné SJM, De Wit GA, Schalm SW, de Man RA et al (2010) Screening and early treatment of migrants for chronic hepatitis B virus infection is cost-effective. Gastroenterology 138(2):522–530
Alvarez GG, Gushulak B, Abu Rumman K, Altpeter E, Chemtob D, Douglas P et al (2011) A comparative examination of tuberculosis immigration medical screening programs from selected countries with high immigration and low tuberculosis incidence rates. BMC Infect Dis 11:3
Urbanus AT, van Keep M, Matser AA, Rozenbaum MH, Weegink CJ, van den Hoek A et al (2013) Is adding HCV screening to the antenatal national screening program in Amsterdam, the Netherlands, cost-effective? PLoS One 8(8):e70319
Coker R, Bell A, Pitman R, Zellweger J-P, Heldal E, Hayward A et al (2006) Tuberculosis screening in migrants in selected European countries shows wide disparities. Eur Respir J 27(4):801–807
Zammarchi L, Casadei G, Strohmeyer M, Bartalesi F, Liendo C, Matteelli A et al (2015) A scoping review of cost-effectiveness of screening and treatment for latent tubercolosis infection in migrants from high-incidence countries. BMC Health Serv Res 15:412
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Chernet, A., Utzinger, J., Sydow, V. et al. Prevalence rates of six selected infectious diseases among African migrants and refugees: a systematic review and meta-analysis. Eur J Clin Microbiol Infect Dis 37, 605–619 (2018). https://doi.org/10.1007/s10096-017-3126-1
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DOI: https://doi.org/10.1007/s10096-017-3126-1