Maria Elena Tosti1, Maurizio Marceca2, Erica Eugeni3, Franca D'Angelo4, Salvatore Geraci5, Silvia Declich6, Maurella Della Seta7, Luigina Ferrigno8, Rosalia Marrone9, Chiara Pajno10, Scilla Pizzarelli11, Annalisa Rosso12, Giulia De Ponte13, Concetta Mirisola14, Giovanni Baglio15. 1. National Center for Global Health, National Institute of Health (Istituto Superiore di Sanità ISS), Rome, Italy. Electronic address: mariaelena.tosti@iss.it. 2. Italian Society of Migration Medicine (Società Italiana di Medicina delle Migrazioni - SIMM), Italy; Department of Public Health and Infectious Diseases (Dipartimento di Sanità Pubblica e Malattie Infettive DSPMI), University of Rome "La Sapienza", Rome, Italy. Electronic address: maurizio.marceca@uniroma1.it. 3. National Institute for Health, Migration and Poverty (Istituto Nazionale per la promozione della salute delle popolazioni Migranti e per il contrasto delle malattie della Povertà INMP), Rome, Italy. Electronic address: erica.eugeni@inmp.it. 4. National Center for Global Health, National Institute of Health (Istituto Superiore di Sanità ISS), Rome, Italy. Electronic address: franca.dangelo@iss.it. 5. Italian Society of Migration Medicine (Società Italiana di Medicina delle Migrazioni - SIMM), Italy. Electronic address: s.geraci@areasanitaria.it. 6. National Center for Global Health, National Institute of Health (Istituto Superiore di Sanità ISS), Rome, Italy. Electronic address: silvia.declich@iss.it. 7. Knowledge Service, Documentation and Library, National Institute of Health (Istituto Superiore di Sanità ISS), Rome, Italy. Electronic address: maurella.dellaseta@iss.it. 8. National Center for Global Health, National Institute of Health (Istituto Superiore di Sanità ISS), Rome, Italy. Electronic address: luigina.ferrigno@iss.it. 9. National Institute for Health, Migration and Poverty (Istituto Nazionale per la promozione della salute delle popolazioni Migranti e per il contrasto delle malattie della Povertà INMP), Rome, Italy. Electronic address: rosalia.marrone@inmp.it. 10. National Institute for Health, Migration and Poverty (Istituto Nazionale per la promozione della salute delle popolazioni Migranti e per il contrasto delle malattie della Povertà INMP), Rome, Italy. Electronic address: chiara.pajno@inmp.it. 11. Knowledge Service, Documentation and Library, National Institute of Health (Istituto Superiore di Sanità ISS), Rome, Italy. Electronic address: scilla.pizzarelli@iss.it. 12. Department of Public Health and Infectious Diseases (Dipartimento di Sanità Pubblica e Malattie Infettive DSPMI), University of Rome "La Sapienza", Rome, Italy; Local Health Unit Roma 2, Rome, Italy. Electronic address: annalisa.rosso@aslroma2.it. 13. National Center for Global Health, National Institute of Health (Istituto Superiore di Sanità ISS), Rome, Italy. Electronic address: giulia.deponte@iss.it. 14. National Institute for Health, Migration and Poverty (Istituto Nazionale per la promozione della salute delle popolazioni Migranti e per il contrasto delle malattie della Povertà INMP), Rome, Italy. Electronic address: concetta.mirisola@inmp.it. 15. National Institute for Health, Migration and Poverty (Istituto Nazionale per la promozione della salute delle popolazioni Migranti e per il contrasto delle malattie della Povertà INMP), Rome, Italy. Electronic address: giovanni.baglio@inmp.it.
Abstract
BACKGROUND: During 2016-17, national guidelines were developed in order to provide evidence-based recommendations on health assessments for migrants and asylum seekers upon their arrival in Italy. METHODS: Scientific literature published between 2005 and 2016 was searched in different databases. A free search was also performed on international organizations' websites in order to identify additional relevant documents. A multidisciplinary panel discussed the resulting evidence and formulated recommendations. RESULTS: Evidence-based recommendations were formulated: signs and symptoms of specific diseases should to be actively searched for active TB, malaria, STI, intestinal parasites, diabetes, anaemia. In case of other health conditions (latent TB, HIV, HBV, HCV, STI, strongyloides, schistosoma, diabetes), testing should be offered to asymptomatic subjects coming from endemic areas or exposed to risk factors. Mass screening is recommended for anaemia and hypertension; a pregnancy test should be considered, while inclusion in cervical cancer screening and vaccination programs is recommended. A modulated, progressive approach was developed, covering an initial evaluation during rescue operations, a full medical examination at first line reception stage and the referral to national health services during second line reception. CONCLUSIONS: It is important to produce and periodically update guidelines on these issues and local peculiarities should be taken into account in their design and implementation. Guidelines can not only support economic sustainability, but also counteract stigmatization dynamics.
BACKGROUND: During 2016-17, national guidelines were developed in order to provide evidence-based recommendations on health assessments for migrants and asylum seekers upon their arrival in Italy. METHODS: Scientific literature published between 2005 and 2016 was searched in different databases. A free search was also performed on international organizations' websites in order to identify additional relevant documents. A multidisciplinary panel discussed the resulting evidence and formulated recommendations. RESULTS: Evidence-based recommendations were formulated: signs and symptoms of specific diseases should to be actively searched for active TB, malaria, STI, intestinal parasites, diabetes, anaemia. In case of other health conditions (latent TB, HIV, HBV, HCV, STI, strongyloides, schistosoma, diabetes), testing should be offered to asymptomatic subjects coming from endemic areas or exposed to risk factors. Mass screening is recommended for anaemia and hypertension; a pregnancy test should be considered, while inclusion in cervical cancer screening and vaccination programs is recommended. A modulated, progressive approach was developed, covering an initial evaluation during rescue operations, a full medical examination at first line reception stage and the referral to national health services during second line reception. CONCLUSIONS: It is important to produce and periodically update guidelines on these issues and local peculiarities should be taken into account in their design and implementation. Guidelines can not only support economic sustainability, but also counteract stigmatization dynamics.
Authors: Silvia Stefania Longoni; Anna Beltrame; Marco Prato; John Stewart Spencer; Nicolo Bergamaschi; Andrea Clapasson; Aurora Parodi; Chiara Piubelli; Francesca Perandin Journal: Pathogens Date: 2022-08-09