Suchergebnisse

Abstract Currently, migrants and other mobile individuals, such as migrant workers and asylum seekers, are an expanding global population of growing social, demographic and political importance. Disparities often exist between a migrant population's place of origin and its destination, particularly with relation to health determinants. The effects of those disparities can be observed at both individual and population levels. Migration across health and disease disparities influences the epidemiology of certain diseases globally and in nations receiving migrants. While specific disease-based outcomes may vary between migrant group and location, general epidemiological principles may be applied to any situation where numbers of individuals move between differences in disease prevalence. Traditionally, migration health activities have been designed for national application and lack an integrated international perspective. Present and future health challenges related to migration may be more effectively addressed through collaborative global undertakings. This paper reviews the epidemiological relationships resulting from health disparities bridged by migration and describes the growing role of migration and population mobility in global disease epidemiology. The implications for national and international health policy and program planning are presented.

The need to rapidly transport refugees, displaced as a result of evolving complex humanitarian emergencies creates challenges for those refugee-receiving nations that require formaI immigration medical screening of these populations. Balancing the need to expediently resettle the refugees with these legislative and regulatory medical requirements can be logistically and operationally difficult. During the 1999 Kosovo crisis, the Humanitarian Evacuation Programme from the Former Yugoslav Republic of Macedonia rapidly moved large numbers of Kosovar Albanian refugees to nations with existing formal immigration medical screening requirements. This paper describes the successful management and delivery of immigration health services during this complicated international event. ; La nécessité de transporter rapidement les réfugiés déplacés à cause d'urgences humanitaires complexes à évolution rapide représenteun défi pour les nations receveuses de réfugiés requérant un tamisage médical routinier de sa population immigrante. Des points de vue logistique et opérationnel, il peut s'avérer fort difficile pour ces états de concilier la nécessité de relocaliser rapidement les réfugiés avec les exigences de leurs lois et règlements en matière médicale et sanitaire. Lors de la crise du Kosovo de 1999, le Programme d'Évacuation Humanitaire de l'ancienne république yougoslave de Macédoine déplaça rapidement un grand nombre de réfugiés albanais kosovars vers des nations requérant formellement un tamisage médical de sa population immigrante. Cet article décrit la gestion et la distribution réussies de services de santé à l'immigration au cours de cet événement international complexe.

BACKGROUND: Tuberculosis (TB) in migrants is an ongoing challenge in several low TB incidence countries since a large proportion of TB in these countries occurs in migrants from high incidence countries. To meet these challenges, several countries utilize TB screening programs. The programs attempt to identify and treat those with active and/or infectious stages of the disease. In addition, screening is used to identify and manage those with latent or inactive disease after arrival. Between nations, considerable variation exists in the methods used in migration-associated TB screening. The present study aimed to compare the TB immigration medical examination requirements in selected countries of high immigration and low TB incidence rates. METHODS: Descriptive study of immigration TB screening programs. RESULTS: 16 out of 18 eligible countries responded to the written standardized survey and phone interview. Comparisons in specific areas of TB immigration screening programs included authorities responsible for TB screening, the primary objectives of the TB screening program, the yield of detection of active TB disease, screening details and aspects of follow up for inactive pulmonary TB. No two countries had the same approach to TB screening among migrants. Important differences, common practices, common problems, evidence or lack of evidence for program specifics were noted. CONCLUSIONS: In spite of common goals, there is great diversity in the processes and practices designed to mitigate the impact of migration-associated TB among nations that screen migrants for the disease. The long-term goal in decreasing migration-related introduction of TB from high to low incidence countries remains diminishing the prevalence of the disease in those high incidence locations. In the meantime, existing or planned migration screening programs for TB can be made more efficient and evidenced based. Cooperation among countries doing research in the areas outlined in this study should facilitate the development of improved screening programs. ; The study was funded by Citizenship and Immigration Canada (CIC). The funders had no role in study design, data collection and analysis, or preparation of the manuscript. The corresponding author has obtained approval from CIC to publish this paper. This paper represents the views of the authors and does not necessarily reflect the opinions of Citizenship and Immigration Canada, the Public Health Agency of Canada or the Government of Canada. This paper does not represent the views of any of the Governments or Ministries affiliated with the authors of this study and represents solely the views of the authors. Dr. S. Miyano contributed to the acquisition of the data and as such we feel he is entitled to authorship but, despite our extensive efforts, we were unable to contact him to approve the final content of this manuscript and his authorship. Therefore, we acknowledge his contribution here. ; Sí