Giorgi Rossi Paolo, Riccardo Flavia, Pezzarossi Annamaria, Ballotari Paola, Dente Maria Grazia, Napoli Christian, Chiarenza Antonio, Velasco Munoz Cesar, Noori Teymur, Declich Silvia
Interinstitutional Epidemiology Unit, AUSL Reggio Emilia, 42122 Reggio Emilia, Italy.
Arcispedale Santa Maria Nuova-IRCCS, 42123 Reggio Emilia, Italy.
Int J Environ Res Public Health. 2017 Jul 5;14(7):720. doi: 10.3390/ijerph14070720.
We conducted a scoping review of literature to improve our understanding of the accuracy of infectious disease monitoring in migrants in the Europe. We searched PubMed for papers relevant to the topic including: case reports, observational and experimental studies, reviews, guidelines or policy documents; published after 1994. We identified 532 papers, 27 of which were included in the review. Legislation and right to access health care influence both the accuracy of rates and risk measures under estimating the at risk population, i.e., the denominator. Furthermore, the number of reported cases, i.e., the numerator, may also include cases not accounted for in the denominator. Both biases lead to an overestimated disease occurrence. Restriction to healthcare access and low responsiveness may cause under-detection of cases, however a quantification of this phenomenon has not been produced. On the contrary, screening for asymptomatic diseases increases ascertainment leading to increased detection of cases. Incompleteness of denominator data underestimates the at-risk population. In conclusion, most studies show a lower probability of under-reporting infectious diseases in migrants compared with native populations.
我们对文献进行了范围综述，以增进对欧洲移民传染病监测准确性的理解。我们在PubMed上搜索了与该主题相关的论文，包括：病例报告、观察性和实验性研究、综述、指南或政策文件；发表于1994年之后。我们识别出532篇论文，其中27篇被纳入综述。立法和获得医疗保健的权利既影响发病率的准确性，也影响对风险人群（即分母）估计不足时的风险衡量。此外，报告病例数（即分子）可能也包括分母中未计算在内的病例。这两种偏差都会导致疾病发生率被高估。获得医疗保健的限制和低反应性可能导致病例漏报，然而尚未对这一现象进行量化。相反，无症状疾病筛查会增加病例确诊率，从而导致病例检出增加。分母数据不完整会低估风险人群。总之，大多数研究表明，与本地人群相比，移民中传染病漏报的可能性较低。
