Fédération nationale des associations solidaires d'action avec les tsiganes et les Gens du voyage (FNASAT - Gv), Paris, France.
Bordeaux Population Health, Université de Bordeaux, PHAReS, Centre Inserm U1219, Bordeaux, France.
Eur J Public Health. 2023 Dec 9;33(6):1194-1199. doi: 10.1093/eurpub/ckad175.
The poor health status of underserved populations is compounded by low vaccination uptake, leading to a greater risk of epidemics. On October 2017, a measles outbreak started in the southwest of France among under-vaccinated social groups, including Travellers. We aimed to describe the health status, healthcare use and child measles-mumps-rubella (MMR) vaccination coverage in Travellers according to their environmental and living conditions.
A cross-sectional study with a three-stage random sample design was conducted between October 2019 and March 2022 in the Nouvelle-Aquitaine region in France. Trained social workers administered face-to-face questionnaires to collect data on adults and children. Anthropometric measurements, vaccination records and data using an environmental exposure questionnaire were also collected.
The participation rate was high (73.6%), with 1030 adults and 337 children included. Concerning the adults, 36.6% had obesity, 14.4% reported diabetes, 24.7% hypertension and 14.4% major depression. The prevalence of major depression was significantly higher in adults living in precarious and unauthorized housing than in those with adequate housing (19.8 vs. 14.7%, P = 0.03). With regard to children, 45.3% had full (i.e. 2-dose) MMR vaccination coverage at 24 months and 17.9% had obesity. Finally, 74.5% of the households experienced housing insecurity, and 22.2% did not have a supply of drinking water.
Traveller children and adults faced deleterious environmental and living conditions potentially affecting their health, healthcare use and vaccination coverage. These results demonstrate the need for urgent interventions for underserved populations which take into account their specific needs.
服务不足人群的健康状况较差，加上疫苗接种率低，导致传染病爆发的风险更大。2017 年 10 月，法国西南部的一个麻疹疫情在未接种疫苗的社会群体中爆发，其中包括旅行者。我们旨在根据旅行者的环境和生活条件描述他们的健康状况、医疗保健利用情况和儿童麻疹-腮腺炎-风疹（MMR）疫苗接种覆盖率。
这是一项在 2019 年 10 月至 2022 年 3 月期间在法国新阿基坦地区进行的横断面研究，采用三阶段随机抽样设计。经过培训的社会工作者进行面对面问卷调查，以收集成年人和儿童的数据。还收集了人体测量数据、疫苗接种记录和使用环境暴露问卷的数据。
参与率很高（73.6%），共纳入 1030 名成年人和 337 名儿童。关于成年人，36.6%有肥胖症，14.4%有糖尿病，24.7%有高血压，14.4%有重度抑郁症。居住在不稳定和未经授权的住房中的成年人中重度抑郁症的患病率明显高于居住在有适当住房的成年人（19.8%比 14.7%，P=0.03）。至于儿童，24 个月时 45.3%有完全（即 2 剂）MMR 疫苗接种覆盖率，17.9%有肥胖症。最后，74.5%的家庭面临住房不安全问题，22.2%的家庭没有饮用水供应。
旅行者的儿童和成年人面临有害的环境和生活条件，这可能影响他们的健康、医疗保健利用和疫苗接种覆盖率。这些结果表明，需要为服务不足的人群提供紧急干预措施，以满足他们的特殊需求。
