Heywood Anita E, Castelli Francesco, Greenaway Christina
School of Public Health and Community Medicine, Faculty of Medicine, UNSW Sydney, Sydney, Australia.
University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, Italy.
Curr Infect Dis Rep. 2019 Nov 16;21(12):48. doi: 10.1007/s11908-019-0705-6.
International migration is a global phenomenon that is growing in scope, complexity and impact. The inaugural International Society of Travel Medicine (ISTM) International Conference on Migration Health provided a forum to discuss scientific evidence on the broad issues relevant to migration health. This review summarises the key health issues, with a focus on infectious diseases, current effective strategies and future considerations presented at this forum and in the recent literature.
Migrants face health disparities for both communicable and non-communicable diseases. Their heightened infectious disease risks, compared to host populations, are related to pre-migration exposures, the circumstances of the migration journey and the receptivity and access to health services in their receiving countries. While the prevalence of infectious diseases identified through screening programmes are generally low, delays in diagnosis and treatment for a range of treatable infectious diseases result in higher morbidity and mortality among migrants. Barriers to care in host countries occur at the patient, provider and health systems levels. Coordinated and inclusive health services, healthcare systems and health policies, responsive to patient diversity reduce these barriers. Structural barriers to healthcare provision impede equitable care to migrants and refugees. Public health and medical professionals have a role in advocating for policy reforms.
国际移民是一种全球现象,其规模、复杂性和影响都在不断扩大。首届国际旅行医学协会(ISTM)移民健康国际会议提供了一个论坛,以讨论与移民健康相关的广泛问题的科学证据。本综述总结了关键的健康问题,重点关注传染病、当前有效的策略以及在该论坛和近期文献中提出的未来考量。
移民在传染病和非传染病方面都面临健康差距。与东道国人口相比,他们更高的传染病风险与移民前的接触、移民旅程的情况以及他们在接收国获得医疗服务的接受程度和机会有关。虽然通过筛查计划发现的传染病患病率普遍较低,但一系列可治疗传染病的诊断和治疗延迟导致移民中更高的发病率和死亡率。东道国的医疗保健障碍出现在患者、提供者和卫生系统层面。协调和包容性的卫生服务、医疗保健系统和卫生政策,对患者多样性做出响应,可减少这些障碍。提供医疗保健的结构性障碍阻碍了对移民和难民的公平医疗。公共卫生和医学专业人员在倡导政策改革方面发挥着作用。