Health Reports and Studies Department, Madrid Regional Health Affairs Authority, Madrid, Spain.
Eur J Public Health. 2012 Dec;22(6):792-6. doi: 10.1093/eurpub/ckr171. Epub 2011 Dec 8.
Some immigrants and refugees might be more vulnerable than other groups to pandemic influenza because of pre-existing health and social disparities, migration history and living conditions. The objective of this study was to compare, between the immigrant and autochtonous population, the incidence and characteristics of influenza cases consulting in primary care (PC) and severe influenza cases.
Descriptive cross-sectional study of influenza episodes registered in PC and severe influenza cases reported between 1 May 2009 and 22 May 2010, by gender and origin. Age-adjusted rates were calculated and the association between origin and chronic pathology, pregnancy, delay in admission to hospital and admission to intensive care units (ICU) was analyzed by logistic regression and generalized linear models.
The influenza rate in PC, adjusted by age, was lower for immigrant population (2396.3, 95% confidence interval (95% CI) 2362.5-2430.0 vs. 2795.9, 95% CI 2780.4-2811.5 per 100, 000). The difference between severe influenza rates by origin was not statistically significant. Chronic conditions were less common in immigrant population. In severe influenza cases, pregnancy was more common in immigrant women, and the probability of admission to ICU was higher in men from Central and Eastern Europe (prevalence ratio (PR) 8.44, 95% CI 2.81-25.40) and North African women (PR 3.30, 95% CI 1.09-10.05).
Differences in influenza rates were detected by origin. This information could be useful for new pandemic wave management purposes, in addition to targetting future investigations. Pandemic influenza preparedness and response plans should incorporate specific actions to improve immigrants' access to health services and to decrease cultural barriers.
由于先前存在的健康和社会差异、移民历史和生活条件，一些移民和难民可能比其他群体更容易受到大流行性流感的影响。本研究的目的是比较初级保健（PC）就诊的流感病例和严重流感病例在移民和本地产人群中的发病率和特征。
对 2009 年 5 月 1 日至 2010 年 5 月 22 日期间在 PC 登记的流感发作和报告的严重流感病例进行描述性横断面研究，按性别和来源进行划分。计算了年龄调整后的发病率，并通过逻辑回归和广义线性模型分析了来源与慢性病理、妊娠、住院延迟和入住重症监护病房（ICU）之间的关联。
按年龄调整的 PC 流感发病率，移民人群较低（2396.3，95%置信区间（95%CI）2362.5-2430.0 与 2795.9，95%CI 2780.4-2811.5/100,000）。不同来源的严重流感发病率差异无统计学意义。慢性疾病在移民人群中较少见。在严重流感病例中，移民妇女妊娠更为常见，中欧和东欧（流行率比（PR）8.44，95%CI 2.81-25.40）和北非妇女（PR 3.30，95%CI 1.09-10.05）的男性入住 ICU 的概率更高。
根据来源检测到流感发病率的差异。除了为未来的调查提供目标外，这些信息对于新的大流行波管理目的可能很有用。大流行性流感的防备和应对计划应纳入改善移民获得卫生服务的具体行动，并减少文化障碍。
