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公共卫生问题和来自乌克兰冲突地区移民的健康约定:法国实践指南。

Public health issues and health rendezvous for migrants from conflict zones in Ukraine: A French practice guideline.

机构信息

Société de pathologie infectieuse de langue française, Paris, France; Centre d'investigation clinique Antilles-Guyane, CIC INSERM 1424, DRISP, centre hospitalier de Cayenne, Cayenne, French Guyana; Centre hospitalier universitaire Avicenne, AP-HP, hôpitaux universitaires Paris Seine-Saint-Denis, université Sorbonne Paris Nord, UFR SMBH, Bobigny, France; Institut convergences et migration, Aubervilliers, France.

Haut Conseil de la santé publique, Paris, France.

出版信息

Infect Dis Now. 2022 Jun;52(4):193-201. doi: 10.1016/j.idnow.2022.04.006. Epub 2022 Apr 26.

Abstract

Given the number of people leaving the war zone in Ukraine and arriving in France, the French high council for public health (HCSP) has drawn up a number of recommendations. The experts have taken into account the vulnerability of migrant populations, which is exacerbated by (a) promiscuity that increases the risk of exposure to infectious agents; (b) the psychological consequences of conflict, family separation and exile; (c) prevalence in Ukraine of communicable diseases such as (possibly multi-resistant) tuberculosis, HIV and HCV; (d) low vaccination coverage (risk of circulation of poliovirus) and (e) the risk of spreading infectious diseases (Covid-19, measles…). Consequently, experts recommend that priority be given to: (i) Initial (immediate) reception, which will help to provide emergency care and to assess immediate needs (psychological disorders, risk of medication breakdown and risk of infection); (ii) Other priority measures (vaccination catch-up, including vaccination against SARS-CoV-2 and mandatory vaccination for children's entry into school, screening for post-traumatic stress disorder and tuberculosis) must be implemented as soon as feasible. At this stage, it is imperative: To ensure coordination and access to information throughout the country, by providing medico-social support (opening of social rights and access to care); To digitize medical data for the purposes of traceability; To use professional interpreting and/or health facilitators, or else, if necessary, digital translation tools. (iii) Finally, experts stress the need for vigilance in terms of management, conservation of social rights and continuity of care after the initial period, and organization of a "health rendezvous" within four months of a migrant's entering the country.

摘要

鉴于离开乌克兰战区并抵达法国的人数众多,法国公共卫生高级理事会 (HCSP) 制定了一些建议。专家们考虑到了移民人口的脆弱性,这因以下因素而加剧:(a) 增加接触传染病原体风险的滥交行为;(b) 冲突、家庭分离和流亡带来的心理后果;(c) 乌克兰传染病(可能是耐多药)的流行,如结核病、HIV 和 HCV;(d) 疫苗接种覆盖率低(脊髓灰质炎病毒传播风险)和 (e) 传染病传播风险(Covid-19、麻疹等)。因此,专家建议优先考虑:(i) 初步(立即)接待,这将有助于提供紧急护理并评估紧急需求(心理障碍、药物中断风险和感染风险);(ii) 尽快实施其他优先措施(疫苗接种补种,包括针对 SARS-CoV-2 的疫苗接种和儿童入学强制性疫苗接种、创伤后应激障碍和结核病筛查)。在现阶段,必须:确保在全国范围内协调和获取信息,提供医疗社会支持(开放社会权利和获得护理);为了可追溯性而对医疗数据进行数字化;使用专业口译员和/或卫生促进者,或者在必要时使用数字翻译工具。(iii) 最后,专家强调需要在管理、社会权利的保存和初始阶段后的护理连续性方面保持警惕,并在移民进入该国后的四个月内组织一次“健康约会”。

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