Swiss Tropical and Public Health Institute, P.O. Box CH-4002, Basel, Switzerland.
University of Basel, Basel, Switzerland.
Eur J Clin Microbiol Infect Dis. 2018 Apr;37(4):605-619. doi: 10.1007/s10096-017-3126-1. Epub 2017 Oct 28.
The objective of this paper was to systematically review the literature on the prevalence of selected infectious diseases among migrants/refugees of African origin and to provide policy makers and health care professionals with evidence-based information. We pursued a systematic review and meta-analysis to determine the prevalence of six selected infectious diseases (i.e., syphilis, helminthiasis, schistosomiasis, intestinal protozoa infections, hepatitis B, and hepatitis C) among migrants/refugees of African origin. Three electronic databases (i.e., PubMed, EMBASE, and ISI Web of Science) were searched without language restrictions. Relevant data were extracted and random-effects meta-analyses conducted. Only adjusted estimates were analyzed to help account for heterogeneity and potential confounding. We assessed the quality of evidence using the GRADE approach. The results were stratified by geographical region. Ninety-six studies were included. The evidence was of low quality due to the small numbers of countries, infectious diseases, and participants included. African migrants/refugees had median (with 95% confidence interval [95% CI]) prevalence for syphilis, helminthiasis, schistosomiasis, intestinal protozoa infection, hepatitis B, and hepatitis C of 6.0% [95% CI: 2.0-7.0%], 13.0% [95% CI: 9.5-14.5%], 14.0% [95% CI: 13.0-17.0%], 15.0% [95% CI: 10.5-21.0%], 10.0% [95% CI: 6.0-14.0%], and 3.0% [95% CI: 1.0-4.0%], respectively. We found high heterogeneity regardless of the disease (I ; minimum 97.5%, maximum 99.7%). The relatively high prevalence of some infectious diseases among African migrants/refugees warrants for systematic screening. The large heterogeneity of the available published data does not allow for stratifying such screening programs according to the geographical origin of African migrants/refugees.
本文旨在系统回顾非洲裔移民/难民中特定传染病的流行情况,并为政策制定者和卫生保健专业人员提供循证信息。我们进行了系统回顾和荟萃分析,以确定非洲裔移民/难民中六种选定传染病(即梅毒、寄生虫感染、血吸虫病、肠道原生动物感染、乙型肝炎和丙型肝炎)的流行情况。我们在三个电子数据库(即 PubMed、EMBASE 和 ISI Web of Science)中进行了无语言限制的检索。提取相关数据并进行随机效应荟萃分析。仅分析了调整后的估计值,以帮助解释异质性和潜在的混杂因素。我们使用 GRADE 方法评估证据质量。结果按地理区域进行分层。共纳入 96 项研究。由于纳入的国家、传染病和参与者数量较少,证据质量较低。非洲移民/难民的梅毒、寄生虫感染、血吸虫病、肠道原生动物感染、乙型肝炎和丙型肝炎的中位数(95%置信区间[95%CI])流行率分别为 6.0%[95%CI:2.0-7.0%]、13.0%[95%CI:9.5-14.5%]、14.0%[95%CI:13.0-17.0%]、15.0%[95%CI:10.5-21.0%]、10.0%[95%CI:6.0-14.0%]和 3.0%[95%CI:1.0-4.0%]。无论疾病如何,我们都发现了高度的异质性(最小 97.5%,最大 99.7%)。非洲裔移民/难民中某些传染病的相对高流行率需要进行系统筛查。现有发表数据的高度异质性不允许根据非洲裔移民/难民的地理来源对这类筛查计划进行分层。