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移民女性入境疾病筛查项目:基于性别视角的分析与启示。

Screening Program for Imported Diseases in Immigrant Women: Analysis and Implications from a Gender-Oriented Perspective.

机构信息

1Microbiology Unit, Hospital Universitario Central de Asturias, Oviedo, Spain.

2Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.

出版信息

Am J Trop Med Hyg. 2020 Jul;103(1):480-484. doi: 10.4269/ajtmh.19-0687. Epub 2020 Apr 23.

Abstract

The female immigrant population is especially vulnerable to imported diseases. We describe the results of a prospective screening program for imported diseases performed in immigrant female patients. The protocol included tests for HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), , , and spp., intestinal parasites, malaria, and the detection of microfilaremia, according to the patient's origin. Six hundred eleven patients were studied. The most frequent imported diseases were intestinal parasitosis (39.4%), followed by syphilis (14.6%), HIV infection (9%), chronic HCV (5%), and HBV (3.3%). Most of the cases of HIV (78%) and HBV (85%) were diagnosed in patients aged between 16 and 45 years. Hepatitis C virus appeared mostly in patients in the 46- to 65-year range ( = 0.001; odds ratio [OD]: 3.667 [1.741-7.724]) or older than 65 years ( = 0.0001; OR: 26.350 [7.509-92.463]). Syphilis was diagnosed more frequently in patients older than 46 years ( = 0.0001; OR: 4.273 [2.649-6.893]). Multivariate analysis confirmed a greater presence of HCV infection ( = 0.049) and syphilis ( = 0.0001) in patients aged between 46 and 65 years. In 15.4% of patients, screening did not find any pathology. These data show a high prevalence of imported diseases in the female immigrant population, which may have serious consequences in terms of morbimortality and vertical transmission. Our results encourage the establishment of policies of active screening both in women of childbearing age and within the specific pregnancy screening programs.

摘要

移民女性群体特别容易受到输入性疾病的影响。我们描述了一项针对移民女性患者的输入性疾病前瞻性筛查计划的结果。该方案根据患者原籍国的情况,包括 HIV、乙型肝炎病毒 (HBV)、丙型肝炎病毒 (HCV)、梅毒螺旋体、杜克雷嗜血杆菌、肠道寄生虫、疟疾以及微丝蚴检测等项目。共研究了 611 名患者。最常见的输入性疾病是肠道寄生虫病(39.4%),其次是梅毒(14.6%)、HIV 感染(9%)、慢性 HCV(5%)和 HBV(3.3%)。大多数 HIV(78%)和 HBV(85%)病例均诊断于 16 至 45 岁的患者中。丙型肝炎病毒主要出现在 46 至 65 岁的患者中( = 0.001;比值比 [OR]:3.667 [1.741-7.724])或年龄大于 65 岁的患者中( = 0.0001;OR:26.350 [7.509-92.463])。梅毒则更多地出现在年龄大于 46 岁的患者中( = 0.0001;OR:4.273 [2.649-6.893])。多变量分析证实,46 至 65 岁的患者中 HCV 感染( = 0.049)和梅毒( = 0.0001)的发生率更高。15.4%的患者筛查未发现任何病理。这些数据表明,移民女性群体中输入性疾病的流行率很高,这可能对发病率和死亡率以及垂直传播产生严重后果。我们的研究结果鼓励制定积极筛查的政策,不仅针对育龄妇女,还包括特定的妊娠筛查计划。

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