Kentikelenis Alexander, Karanikolos Marina, Williams Gemma, Mladovsky Philipa, King Lawrence, Pharris Anastasia, Suk Jonathan E, Hatzakis Angelos, McKee Martin, Noori Teymur, Stuckler David
1 Department of Sociology, University of Cambridge, Cambridge, UK
2 European Observatory on Health Systems and Policies, London School of Hygiene and Tropical Medicine, London, UK.
Eur J Public Health. 2015 Dec;25(6):937-44. doi: 10.1093/eurpub/ckv151. Epub 2015 Aug 28.
It is not well understood how economic crises affect infectious disease incidence and prevalence, particularly among vulnerable groups. Using a susceptible-infected-recovered framework, we systematically reviewed literature on the impact of the economic crises on infectious disease risks in migrants in Europe, focusing principally on HIV, TB, hepatitis and other STIs.
We conducted two searches in PubMed/Medline, Web of Science, Cochrane Library, Google Scholar, websites of key organizations and grey literature to identify how economic changes affect migrant populations and infectious disease. We perform a narrative synthesis in order to map critical pathways and identify hypotheses for subsequent research.
The systematic review on links between economic crises and migrant health identified 653 studies through database searching; only seven met the inclusion criteria. Fourteen items were identified through further searches. The systematic review on links between economic crises and infectious disease identified 480 studies through database searching; 19 met the inclusion criteria. Eight items were identified through further searches. The reviews show that migrant populations in Europe appear disproportionately at risk of specific infectious diseases, and that economic crises and subsequent responses have tended to exacerbate such risks. Recessions lead to unemployment, impoverishment and other risk factors that can be linked to the transmissibility of disease among migrants. Austerity measures that lead to cuts in prevention and treatment programmes further exacerbate infectious disease risks among migrants. Non-governmental health service providers occasionally stepped in to cater to specific populations that include migrants.
There is evidence that migrants are especially vulnerable to infectious disease during economic crises. Ring-fenced funding of prevention programs, including screening and treatment, is important for addressing this vulnerability.
经济危机如何影响传染病的发病率和流行率，尤其是弱势群体中的情况，目前尚不清楚。我们使用易感-感染-康复模型，系统回顾了关于经济危机对欧洲移民传染病风险影响的文献，主要关注艾滋病毒、结核病、肝炎和其他性传播感染。
我们在PubMed/Medline、科学网、考克兰图书馆、谷歌学术、主要组织网站和灰色文献中进行了两次检索，以确定经济变化如何影响移民群体和传染病。我们进行了叙述性综合分析，以梳理关键途径并确定后续研究的假设。
关于经济危机与移民健康之间联系的系统评价通过数据库检索确定了653项研究；只有7项符合纳入标准。通过进一步检索确定了14项。关于经济危机与传染病之间联系的系统评价通过数据库检索确定了480项研究；19项符合纳入标准。通过进一步检索确定了8项。评价表明，欧洲的移民群体似乎在特定传染病方面面临着不成比例的风险，而且经济危机及其后续应对措施往往加剧了这种风险。经济衰退导致失业、贫困和其他风险因素，这些因素可能与疾病在移民中的传播有关。导致预防和治疗项目削减的紧缩措施进一步加剧了移民中的传染病风险。非政府卫生服务提供者偶尔会介入，为包括移民在内的特定人群提供服务。
有证据表明，移民在经济危机期间特别容易感染传染病。为预防项目（包括筛查和治疗）提供专项资金对于应对这种脆弱性很重要。
