Padovese V, Egidi A M, Melillo T Fenech, Farrugia B, Carabot P, Didero D, Costanzo G, Mirisola C
National Institute for Health, Migration and Poverty (NIHMP), Via di San Gallicano 25/A, Rome 00153, Italy.
J Public Health (Oxf). 2014 Mar;36(1):22-7. doi: 10.1093/pubmed/fdt036. Epub 2013 Apr 4.
In the last few years, Malta has witnessed increasing immigration flows from the Libyan coasts. Public health policies are focused on screening migrants for tuberculosis, whereas no systematic actions against STIs are implemented. The aim of this study is to define the epidemiological profile of asylum seekers in Malta as regards syphilis, hepatitis B, C and latent tuberculosis, thus supporting screening policies.
Five hundred migrants living in open centres were screened between December 2010 and June 2011.
83.2% of people was from Somalia, 81.2% males, average age 26.5 years. The tuberculin skin test (TST) was positive in 225 migrants (45%). Latent syphilis was diagnosed in 11 migrants, hepatitis C in 3 and 31 migrants were HBsAg positive.
Systematic screening for asymptomatic migrants in Malta is not recommended for hepatitis C and syphilis, given the low prevalence observed. On the contrary, it should be considered for hepatitis B. TST could be indicated as the first step of a two step screening for migrants from countries with high TB incidence. Efficacy and cost-effectiveness could be achieved by further targeting screening to specific subgroups at higher risk of reactivation, such as people living with HIV and subjects affected by chronic diseases.
在过去几年中，马耳他见证了来自利比亚海岸的移民潮不断增加。公共卫生政策侧重于对移民进行结核病筛查，而未实施针对性传播感染的系统性行动。本研究的目的是确定马耳他寻求庇护者在梅毒、乙型肝炎、丙型肝炎和潜伏性结核病方面的流行病学特征，从而支持筛查政策。
在2010年12月至2011年6月期间，对居住在开放中心的500名移民进行了筛查。
83.2%的人来自索马里，81.2%为男性，平均年龄26.5岁。225名移民（45%）的结核菌素皮肤试验（TST）呈阳性。11名移民被诊断为潜伏梅毒，3名患有丙型肝炎，31名移民乙肝表面抗原（HBsAg）呈阳性。
鉴于观察到的低患病率，不建议对马耳他无症状移民进行丙型肝炎和梅毒的系统性筛查。相反，应考虑对乙型肝炎进行筛查。对于来自结核病高发国家的移民，TST可作为两步筛查的第一步。通过进一步将筛查目标对准具有更高再激活风险的特定亚组，如艾滋病毒感染者和慢性病患者，可实现有效性和成本效益。
