Screening Program for Imported Diseases in Immigrant Women: Analysis and Implications from a Gender-Oriented Perspective

Am J Trop Med Hyg. 2020 Jul;103(1):480-484. doi: 10.4269/ajtmh.19-0687. Epub 2020 Apr 23.

Abstract

The female immigrant population is especially vulnerable to imported diseases. We describe the results of a prospective screening program for imported diseases performed in immigrant female patients. The protocol included tests for HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), Treponema pallidum, Trypanosoma cruzi, Strongyloides stercoralis and Schistosoma spp., intestinal parasites, malaria, and the detection of microfilaremia, according to the patient's origin. Six hundred eleven patients were studied. The most frequent imported diseases were intestinal parasitosis (39.4%), followed by syphilis (14.6%), HIV infection (9%), chronic HCV (5%), and HBV (3.3%). Most of the cases of HIV (78%) and HBV (85%) were diagnosed in patients aged between 16 and 45 years. Hepatitis C virus appeared mostly in patients in the 46- to 65-year range (P = 0.001; odds ratio [OD]: 3.667 [1.741-7.724]) or older than 65 years (P = 0.0001; OR: 26.350 [7.509-92.463]). Syphilis was diagnosed more frequently in patients older than 46 years (P = 0.0001; OR: 4.273 [2.649-6.893]). Multivariate analysis confirmed a greater presence of HCV infection (P = 0.049) and syphilis (P = 0.0001) in patients aged between 46 and 65 years. In 15.4% of patients, screening did not find any pathology. These data show a high prevalence of imported diseases in the female immigrant population, which may have serious consequences in terms of morbimortality and vertical transmission. Our results encourage the establishment of policies of active screening both in women of childbearing age and within the specific pregnancy screening programs.

MeSH terms

  • Adolescent
  • Adult
  • Africa / ethnology
  • Aged
  • Central America / ethnology
  • Chagas Disease / diagnosis
  • Chagas Disease / epidemiology
  • Communicable Diseases, Imported / diagnosis*
  • Communicable Diseases, Imported / epidemiology
  • Emigrants and Immigrants / statistics & numerical data*
  • Female
  • Filariasis / diagnosis
  • Filariasis / epidemiology
  • HIV Infections / diagnosis
  • HIV Infections / epidemiology
  • Hepatitis B, Chronic / diagnosis
  • Hepatitis B, Chronic / epidemiology
  • Hepatitis C, Chronic / diagnosis
  • Hepatitis C, Chronic / epidemiology
  • Humans
  • Infectious Disease Transmission, Vertical
  • Intestinal Diseases, Parasitic / diagnosis
  • Intestinal Diseases, Parasitic / epidemiology
  • Malaria / diagnosis
  • Malaria / epidemiology
  • Mass Screening
  • Middle Aged
  • Prevalence
  • Schistosomiasis / diagnosis
  • Schistosomiasis / epidemiology
  • South America / ethnology
  • Spain / epidemiology
  • Strongyloidiasis / diagnosis
  • Strongyloidiasis / epidemiology
  • Syphilis / diagnosis
  • Syphilis / epidemiology
  • Tuberculosis / diagnosis
  • Tuberculosis / epidemiology
  • Women*
  • Young Adult