Search Results (108)

The COVID-19 pandemic exacerbated structural, social, economic, and racial inequalities affecting immigrant, refugee, and asylum-seeking men—vulnerable populations often overlooked in men’s health research. This study investigated the health conditions of immigrant, refugee, and asylum-seeking men during the COVID-19 pandemic. A scoping review was conducted following Joanna Briggs Institute guidance, and a qualitative lexical analysis (text-mining of standardized study syntheses) was performed in IRaMuTeQ using similarity analysis, descending hierarchical classification, and factorial correspondence analysis. We identified 93 studies published between 2020 and 2023 across 35 countries. The evidence highlighted vaccine hesitancy, high epidemiological risks (infection, hospitalization, and mortality), barriers to accessing services and information, socioeconomic vulnerabilities, psychological distress (e.g., anxiety and depression), and structural inequalities. Findings were synthesized into four integrated thematic categories emphasizing the role of gender constructs in help-seeking and gaps in governmental responses. Most studies focused on immigrants, with limited evidence on refugees and especially asylum seekers; therefore, conclusions should be interpreted cautiously for these groups. Overall, the review underscores the urgency of multisectoral interventions, universal access to healthcare regardless of migration status, culturally and linguistically appropriate outreach, and gender-sensitive primary care strategies to support inclusive and resilient health systems. Full article

Eosinophilia is a valuable biomarker for estimating the likelihood of parasitic infection in immigrants from tropical or subtropical regions. This study aimed to evaluate the frequency and etiology of imported eosinophilia in patients attending the Tropical Medicine Unit (TMU) of Salamanca, Spain, between 2008 and 2023. A total of 773 immigrant patients were assessed: 450 (58.2%) from Africa, 306 (39.6%) from Latin America, and 17 (2.2%) from Asia. Eosinophilia was observed in 338 patients (43.7%), of whom 15 (4.4%) had noninfectious causes. Among the remaining 323 evaluated for infections, 171 (52.9%) presented with relative eosinophilia and 152 (47.1%) presented with absolute eosinophilia. A specific diagnosis was reached in 49.2% of the cases, most commonly filariasis (12.1%), strongyloidiasis (9.9%), and schistosomiasis (4.6%): 58 patients had coinfections. In conclusion, eosinophilia is common among migrants and represents a valuable biomarker for helminthiasis. Despite protocolized evaluation, nearly half of the cases remain undiagnosed. The most frequent etiologies were filariasis, strongyloidiasis, and schistosomiasis, with African patients having the highest probability of diagnosis. Improved diagnostic approaches, including tests for less common parasites, may reduce uncertainty and enhance clinical management. Full article

Racialised minority populations were disproportionately affected by COVID-19 and saw the highest rate of COVID-19 infections and mortality. Low socioeconomic status, working as frontline workers, temporary employment, precarious immigration status and pre-existing medical conditions were factors that contributed to disadvantaged experiences. This systematic review looked at the impact of COVID-19 on racialised minority populations globally, recognising their experiences, perspectives and the effects on their physical and mental health. Eight electronic databases were searched (MEDLINE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Social Sciences Citation Index (SSCI), Social Policy and Practice (SPP), Applied Social Sciences Index and Abstracts (ASSIA), MedRxiv and Research Square) for English language qualitative studies. Reference lists of relevant literature reviews and reference lists of articles were hand-searched for additional potentially relevant articles. Duplicates were removed, and articles were screened for titles and abstracts, followed by full-text screening. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the included studies (n = 70). Data were synthesised using thematic synthesis. Seven major and three minor themes were identified. The major themes related to (i) children and young people’s experiences of COVID-19; (ii) exacerbated pre-existing disparities relating to income, employment and housing security, health insurance and immigration status; (iii) lack of knowledge and information about COVID-19 and COVID-19 misinformation; (iv) racial history of medicine and treatment of racialised populations; (v) contemporary experiences of racism; (vi) impact on physical and mental health and wellbeing; (vii) concerns about safety at work. Minor themes related to (a) experiences of intercommunity mutual aid; (b) adherence to preventative guidance/COVID-19 restrictions; (c) the role of faith. Research needs to focus on developing and testing interventions that support transformation of social, cultural and economic systems towards equity of access to healthcare and healthcare knowledge. Research should be cognisant of interventions that have worked in shifting the equity dial in the past, implement these and use them to inform new approaches. Policy and practice should be mechanisms for enabling the implementation of interventions. Full article

Background: Enterobiasis, caused by Enterobius vermicularis, is recognized as a common intestinal helminthiasis worldwide. Despite multiple surveys in Thailand, no pooled synthesis at the country level has been carried out to evaluate prevalence patterns, temporal trends, or vulnerable groups. Therefore, this systematic review and meta-analysis were undertaken to provide an updated and comprehensive estimate of the prevalence of E. vermicularis in Thailand and to identify high-risk populations for targeted interventions. Methods: The systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO: CRD420251053217). Studies reporting E. vermicularis infection in Thailand were systematically searched in international and Thai databases. Pooled prevalence and odds ratios (ORs) were calculated using random-effects models. Subgroup analyses and meta-regression were performed according to year, region, age, population type, and diagnostic method. Results: A total of 56 studies, including 52,765 participants, were analyzed. The overall pooled prevalence was estimated at 3.6% (95% confidence interval [CI]: 2.1–5.9%), with a decline observed in the subgroup analysis by publication year, from 4.75% in 2000–2009 to 1.15% in 2020–2023. The highest prevalence was reported in Central Thailand (7.93%). High infection rates were found among immigrant children (25.2%), hilltribe children (19.9%), Karen students (15.5%), and children in orphanages (11.4%). A markedly higher prevalence was detected by the Scotch tape method compared with direct smear/concentration (12.9% vs. 0.33%). No significant difference in infection risk was observed between males and females (OR = 1.03, p = 0.65). Conclusions: The pooled prevalence of E. vermicularis in Thailand was estimated at 3.6%, but this figure should be interpreted with caution due to high heterogeneity across studies. More meaningful insights were identified in subgroup analyses, which revealed a temporal decline in prevalence, geographic clustering in Central Thailand, and disproportionately high infection rates among socioeconomically disadvantaged child populations. No statistically significant association was found between gender and risk of infection. These patterns underscore the need for targeted screening, deworming, and hygiene interventions, along with the standardized use of the Scotch tape technique for accurate surveillance and comparability of future studies. Full article

The COVID-19 pandemic disrupted progress towards global HCV elimination goals by interrupting essential health services in Canada and globally. We aimed to evaluate the effect of the pandemic on hepatitis C virus (HCV) testing rates in a population-based cohort study in Ontario using health administrative data. All residents with records of either HCV antibody or ribonucleic acid (RNA) tests were included. Monthly testing rate per 1000 population were compared during the pre-pandemic (01/01/2015–29/02/2020) and pandemic (01/03/2020–31/12/2022) periods using interrupted time series models, stratified by sex, homelessness, human immunodeficiency virus (HIV), and immigration status, and people who inject drugs (PWID). The HCV testing rate followed a statistically significant upward trend before the pandemic, dropping at its onset with 1.38/1000 fewer individuals initiating testing monthly. Compared to counterfactual estimates, the observed monthly number of people tested per 1000 population was lower by 1.41 (95% CI: 1.18–1.64) in 2020 (May–Dec), 1.17 (95% CI: 0.99–1.36) in 2021, and 1.41 (95% CI: 1.22–1.59) in 2022, corresponding to relative reductions of 47%, 34%, and 41%, respectively. Testing rates remained below expected levels across all subgroups throughout 2020–2022, with the greatest absolute declines observed among people co-infected with HIV, people experiencing homelessness, and PWID. Tailored, equity-focused interventions are needed to address these persistent gaps in HCV testing, without which Canada’s progress toward its 2030 elimination targets remains at risk. Full article

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States (U.S.) and a major contributor to several cancers, including cervical, anal, penile, and oropharyngeal cancers. Although a safe and effective vaccine is available, HPV vaccination rates remain suboptimal, particularly among racial, ethnic, and immigrant minority groups. This study explored multiple factors, such as cultural, social, and structural influences, influencing HPV vaccine decision-making among Cape Verdean immigrant parents in the U.S., a population currently underrepresented in HPV research. Methods: Qualitative study using individual, in-depth interviews with Cape Verdean immigrant parents of children aged 11 to 17 years living in the U.S. Interviews were transcribed verbatim and analyzed thematically using the social ecological model (SEM) to identify barriers and facilitators at the intrapersonal, interpersonal, organizational, community, and policy levels. Results: Forty-five Cape Verdean parents (27 mothers, 18 fathers) participated. Fathers were significantly older than mothers (50.0 vs. 41.1 years, p = 0.05). Most were married or partnered (60%), had at least a high school education (84.4%), and reported annual household incomes of US$50,000 or more (66.7%), with no significant gender differences. Nearly all spoke Creole at home (95.6%). Fathers had lower acculturation than mothers (p = 0.05), reflecting less adaptation to U.S. norms and language use. Most parents had limited knowledge of HPV and the vaccine, with gendered beliefs and misconceptions about risk. Only seven mothers (25.9%) reported receiving a provider recommendation; all indicated that their children had initiated vaccination (1 dose or more). Mothers were the primary decision-makers, though joint decision-making was common. Trust in providers was high, but poor communication and the lack of culturally and linguistically appropriate materials limited informed decision-making. Stigma, misinformation, and cultural taboos restricted open dialogue. Trusted sources of information included schools, churches, and Cape Verdean organizations. While parents valued the U.S. healthcare system, they noted gaps in public health messaging and provider engagement. Conclusions: Findings revealed that HPV vaccine uptake and hesitancy among Cape Verdean immigrant parents in the U.S. were influenced by individual beliefs, family dynamics, healthcare provider interactions, cultural norms, and structural barriers. These findings highlight the need for multilevel strategies such as culturally tailored education, community engagement, and improved provider communication to support informed vaccination decisions in this population. Full article

The global impact of HIV is especially significant when diagnoses are made in advanced stages. While strategies exist to mitigate late presentations, Ecuador’s 2018–2022 strategic plan has not yet been evaluated. This study assesses the prevalence and implications of late and advanced HIV presentations in Ecuador, using data from a reference hospital in Quito. A cross-sectional analysis of 436 medical records of people living with HIV from the “Hospital de Especialidades Eugenio Espejo” was conducted between November 2015 and February 2020. The data were divided into “Pre-Plan” and “Post-Plan” periods for comparative analysis. The mean CD4 T count showed a non-statistically significant increase in the post-plan period (January 2018–February 2020). Notably, 65.1% of patients presented late, and 39.4% had advanced disease. Demographic data indicated that 89.9% were men, and 54.1% were under 30 years of age. No characteristics were identified that were associated with advanced late presentation of HIV infection. Sexual orientation data revealed that 69.1% identified as homosexual or bisexual. A predominance of late and advanced presenters was identified in the post-plan period, associated with being employed (p < 0.05) and being drug users (p < 0.001). There was also a greater incidence of late presenters among immigrants in the post-plan period (p = 0.045). Despite the implementation of Ecuador’s 2018–2022 strategic plan for HIV, substantial challenges in reducing late presentations remain. This study suggests that early diagnoses have not significantly improved. Employed patients and drug users were more likely to present late, with drug users also accounting for many advanced cases. This study highlights the need for more focused and targeted strategies to supplement the existing plan. Full article

The article presents integrative research of the perlodid genus Perlodinella in Qinghai Province, northwestern China. P. tatunga Wu, 1973 is considered a junior synonym of P. kozlovi Klapálek, 1912, with a further description of intraspecific morphological variability, while P. unimacula Klapálek, 1912 is considered to be nomen dubium. The COI barcodes of the three valid species in Qinghai, P. epiproctalis (Zwick, 1997), P. kozlovi Klapálek, 1912, and P. microlobata Wu, 1938 are firstly sequenced, enabling adult–larva matching and the analysis of genetic diversity. The larval morphology of P. kozlovi and P. microlobata is described for the first time. Additionally, the biology, ecological adaptability, and fungal infections of Perlodinella are firstly recorded with an environment-related comparison. The discussion of the origin and immigration of the genus is also provided. Full article

Coxiella burnetii is a significant infectious pathogen that causes Q fever. Q fever is thought to be uncommon in the US and most human cases are believed to occur in agricultural livestock workers. However, the extent of US community exposure to C. burnetii is not known with certainty. Using nationally representative 2003–2004 US National Health and Nutrition Examination Survey serologic, demographic, and occupational history data, the magnitude of US adult general population exposure to C. burnetii, excluding agricultural-sector workers, was estimated. Exposure was defined as positive serum IgG antibodies in an immunofluorescence assay (e.g., current or past infection). A total of 3.0% (95% CI: 2.0–4.4) of the US population met the criteria for C. burnetii exposure, representing some 6.2 million persons. Overall, 86.9% (95% CI: 75.5–98.4) of the seropositive persons had no lifetime history of work in the agricultural sector (5.5 million persons). This was consistently true across all US demographic groups: aged 20–59 years, 87.3%; aged 60+ years, 85.7%; men, 86.1%; women, 87.6%; non-Hispanic Whites, 82%; non-Hispanic Blacks, 95.8%; Mexican Americans, 89.4%; immigrants from Mexico, 83.5%; and other immigrants, 96.8%. As a proportion of C. burnetii infections result in acute Q fever and chronic Q fever conveys significant mortality, the community-level risks to the general public may be significant. It is recommended that a 6-year sample of the most recent NHANES stored sera be analyzed to determine the current community C. burnetii exposure rates. Also, analyzing an additional 2005–2008 stored sera sample would provide an opportunity to assess the time trends and long-term health impacts. Full article

Background/Objective: Epstein-Barr Virus (EBV) infection can be associated with lymphocytic hematological malignancies, including systemic Epstein-Barr virus-positive T-cell lymphoma of childhood (SEBVTCL). A common complication of EBV infection, hemophagocytic lymphohistiocytosis (HLH), is a life-threatening condition of immune activation present in virtually all cases of SEBVTCL that requires urgent treatment, as this malignancy can be rapidly fatal. Abnormal karyotypes have been strongly associated with SEBVTCL as a distinguishing feature from HLH in the literature. Here, we discuss the diagnostic challenges and social complications in the case of an unaccompanied minor immigrant patient with a highly complex karyotype diagnosed with SEBVTCL with associated HLH. Methods: Laboratory testing confirmed the presence of EBV+ HLH and cytogenetic analysis was performed to investigate a neoplastic process in this patient, confirming SEBVTCL. Chromosomal microarray (CMA) was performed to try to clarify the complex findings by chromosome analysis but demonstrated normal results. Results: Chromosome analysis demonstrated a highly complex hypertriploid clone that confirmed the diagnosis of SEBVTCL. After declining treatment, the patient was discharged to his guardian against medical advice and succumbed to his disease shortly after. Conclusions: SEBVTCL can be challenging to diagnose due to the similarity in clinical and pathological presentations. In virtually all cases reported in the literature, an abnormal karyotype has been reported to be the most important prognostic factor. We propose that in cases with diagnostic ambiguity, an abnormal karyotype can help favor SEBVTCL over EBV+ HLH. Full article

Background: Pregnant people in Canada during the pandemic faced complex decision-making related to COVID-19 exposure risks and the safety of mitigation measures, including vaccines. To help inform future infectious disease–health promotion, we assessed pandemic pregnancy experiences and COVID-19 risk mitigation strategies. Methods: Respondents, pregnant at any time after January 2020 in Canada, completed an online, cross-sectional, descriptive survey from September 2021 to February 2022. Logistic regression was used to identify predictive factors associated with COVID-19 vaccine uptake and history of infection. Results: A purposive sample of predominantly non-racialized, high socioeconomic status women (n = 564), 58.2% primigravid during the pandemic, reported high COVID-19 vaccine uptake (87.4%). Educational attainment beyond high school predicted COVID-19 vaccination (college AOR: 2.72, CI: 1.24–5.94, p < 0.001; university AOR 4.01, CI: 1.91–8.40, p < 0.001; post-graduate university AOR: 7.31, CI: 2.84–18.81, p < 0.001). Immigrant status reduced the likelihood of COVID-19 vaccination (AOR: 0.20; CI: 0.09–0.49, p < 0.001). Racialized participants were 2.78-fold more likely to report infection (CI:1.19–6.50, p = 0.018). Conclusions: COVID-19 vaccination uptake was very high; however, vaccine hesitancy was evident among immigrants, with racialized participants more likely to report a history of COVID-19 infection. Tailored public health messaging using a health equity lens may yield more robust vaccine uptake for future infectious respiratory disease outbreaks. Full article

Background: Increasing evidence shows that the COVID-19 pandemic has disproportionately impacted certain populations, particularly those facing structural marginalization, such as immigrants and refugees. Additionally, research highlights that structurally marginalized populations living with chronic conditions, such as cancer and/or mental health and addiction (MH&A) disorders, are more vulnerable to the adverse effects of COVID-19. These individuals face higher susceptibility to infection and worse health outcomes, including increased rates of hospitalization, severe illness, and death. To better understand the challenges faced by people living at the intersection of social and clinical disadvantages, we organized a series of Think Tank sessions to engage stakeholders in exploring barriers and identifying community-based solutions for immigrants and refugees living with cancer and/or MH&A disorders during the current and future pandemics. Objectives: Our main objectives were to gauge how earlier findings resonated with stakeholders, to identify any gaps in the work, and to co-develop actionable solutions to safeguard health and well-being during COVID-19 and future crises. Methods: Two virtual Think Tank sessions were held in September 2023 as integrative knowledge exchange forums. The Cancer Think Tank was attended by 40 participants, while the MH&A disorders Think Tank included 41 participants. Each group comprised immigrants and refugees living with or affected by cancer (in the Cancer Think Tank) or MH&A disorders (in the MH&A disorders Think Tank), alongside service providers, policymakers, and researchers from Ontario. This paper presents the key discussions and outcomes of these sessions. Results: Participants identified and prioritized actionable strategies during the Think Tank sessions. In the Cancer Think Tank, participants emphasized the importance of leveraging foreign-trained healthcare providers to address workforce shortages, creating clinical health ambassadors to bridge gaps in care, and connecting immigrants with healthcare providers immediately upon their arrival in Canada. In the MH&A disorders Think Tank, participants highlighted the need to remove silos by fostering intersectoral collaboration, empowering communities and building capacity to support mental health, and moving away from one-size-fits-all approaches to develop tailored interventions that better address diverse needs. Conclusions: The Think Tank sessions enhanced our understanding of how the COVID-19 pandemic has impacted immigrants and refugees living with cancer and/or MH&A disorders. The insights gained informed a series of actionable recommendations to address the unique needs of these populations during the current pandemic and in future public health crises. Full article

Background: Exposure time to a tuberculosis (TB) index case may be a marker of a recent latent tuberculosis infection (LTBI) risk. The aim of this study was to determine the LTBI risk involved in immigrant contact based on exposure time to pulmonary TB index cases. Methods: We conducted a 30-month LTBI prevalence study of pulmonary TB immigrant contacts in Catalonia (1 January 2019–30 June 2021). Contacts with LTBI were identified by means of the tuberculin skin test and/or interferon gamma release assay. Variables associated with LTBI in contacts were analysed using adjusted OR (aOR) and 95% confidence interval (CI) values. Results: LTBI prevalence was 37.4% (939/2509). Prevalence was higher in men than women (40.6% versus 33.5%; p < 0.001), and in all age groups, relative to children <5 years (12.2%; p < 0.001)). Prevalence increased with exposure time to the index case; relative to <6 h/week exposure, LTBI risk was greater for both ≥6 h/day (aOR = 2.0; 95% CI: 1.5–2.6) and <6 h/day but ≥6 h/week (aOR = 1.6; 95% CI: 1.1–2.2). Conclusions: The LTBI risk in immigrant contacts increases with recent exposure time to the index case, and may suggest recent LTBI in immigrants. Full article

Background: The current economic and social crisis in Latin America has caused migration to the USA, bringing with it Public Health challenges due to the importation of various infectious diseases. Migrants, particularly those with chronic conditions, such as HIV infection and other sexually transmitted infections (STI), are at greater risk due to pharmacological interruption and access to medical care, so the timely detection of diseases acquired during their migration, such as malaria, is crucial to avoid health complications. Objective: To outline by a multidisciplinary approach (Infectology, Parasitology, Epidemiology, molecular Biology, Venereology, and Public Health) the diagnosis and management of a male case with malaria imported to Mexican territory, HIV chronic infection, and latent syphilis. Methods: A male migrant of Venezuelan nationality attended the Clínica Especializada Condesa Iztapalapa in Mexico City for health complications. A comprehensive analysis of laboratory and molecular tests was performed to confirm HIV infection. During the STI diagnostic algorithm, latent syphilis was detected and microscopic observation of blood smears revealed parasitic forms compatible with malaria. Standard and molecular tests were applied under the operational definition for malaria cases for identification, diagnosis, and treatment. Finally, study of clinical history and migration route by questioning for the investigation of the imported case was performed. Results: The immigrant was diagnosed with HIV chronic-stage infection with interrupted antiretroviral therapy (ART), latent syphilis, and malaria by Plasmodium vivax. The ART administered was chosen based on the possible drug interaction with antimalarials and genetic barrier to the HLA-B* allele. Finally, antimicrobial therapy against syphilis was penicillin. From the analysis of the migratory route, incubation time of imported malaria, and questioning, we speculated that the migrant acquired the P. vivax infection in Panama. Conclusions: This case highlights the complex health problems faced by migrants with HIV infection, particularly when they contract additional infections such as malaria during migration and highlights the need for comprehensive access to healthcare and ART, antimalarial and antimicrobial treatments to mitigate the health risks of this vulnerable population. Full article

This is the first systematic review and meta-analysis to estimate the prevalence of human T-lymphotropic virus 1 and 2 (HTLV-1 and 2) infections among immigrants and refugees worldwide. PubMed/MEDLINE, Scopus, EMBASE, Web of Science, and Virtual Health Library (VHL) databases were searched for studies published from their inception to 6 January 2023. A meta-analysis using a generalized linear mixed model with a random effect was performed for HTLV-1 and HTLV-2. Subgroup analyses were performed based on the decade of study, sample size, confirmatory methods, region of study, risk group, and region of origin. Of the 381 studies initially identified, 21 were included. The pooled prevalence of HTLV-1 and HTLV-2 was 1.28% (95% CI: 0.58, 2.81) and 0.11% (95% CI: 0.04, 0.33), respectively. HTLV-1 prevalence differed significantly by region of origin, with the highest prevalence among those from the Western Pacific Region (7.27%; 95% CI: 2.94, 16.83). The subgroup analysis also showed significant differences between the estimates of HTLV-1 considering the decade of study, sample size, and region of study. For HTLV-2, significant differences were shown in relation to sample size, confirmatory methods, and risk group. The higher HTLV-1 prevalence found deserves public health attention in immigrant and refugee-receiving non-endemic countries. Full article