Formenti Beatrice, Benoni Roberto, Testa Jacopo, Bertoli Giulia, Stroffolini Giacomo, Pizzi Maria Grazia, Menzaghi Barbara, Ronzoni Niccolò, Magro Paola, Hamad Issa El, Scolari Carla, Spinetti Angiola, Zaltron Serena, Castelli Francesco, Marchese Valentina, Matteelli Alberto
Division of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy.
UNESCO Chair in Training and Empowering Human Resources for Health Development in Resource-Limited Countries, University of Brescia, Brescia, Italy.
J Migr Health. 2025 Jan 28;11:100307. doi: 10.1016/j.jmh.2025.100307. eCollection 2025.
Viral hepatitis is a leading cause of mortality and a global public health challenge that, until recently, has been largely neglected as a health priority. This study describes the prevalence of viral hepatitis B and C in asylum seekers and refugees who participated in screening across three cities in Northern Italy. The analysis highlights significant pitfalls in linkage and retention in care, as well as factors associated with continuing or discontinuing the healthcare pathways, controlling for WHO Region of origin, gender, age and study site. Hospital records provided demographic and clinical data. Screening for HBV, HCV, and HIV was conducted, followed by clinical management and vaccination where appropriate. Multinomial logistic regression identified distinct care pathways. Of 1,514 participants, 80.2 % underwent screening, with 87.3 % testing negative for all infections. For those with chronic infections, 20.8 % missed their first infectious disease consultation, and only 39.3 % were retained in care after one year. Among the 591 individuals (55.8 % of the total) eligible for HBV vaccination, 10.0 % (59 out of 591) actually received the vaccine. Seven distinct care pathways were identified, where significant differences were observed based on the region of origin and the specific study site, highlighting the impact of local healthcare infrastructure and support systems. This study highlights the critical need for innovative, intersectoral and community-based approaches that are responsive to migrants' needs and perspectives. Key recommendations include enhancing linkage to care, improving followup strategies, and establishing a robust national and European network to ensure continuity of care and to integrate public health efforts across the entire care pathway and deliver fair and equitable healthcare..
病毒性肝炎是导致死亡的主要原因，也是一项全球性公共卫生挑战，直到最近，它在很大程度上一直被忽视，未被列为卫生工作重点。本研究描述了参与意大利北部三个城市筛查的寻求庇护者和难民中乙型和丙型病毒性肝炎的流行情况。分析突出了护理衔接和留存方面的重大缺陷，以及与继续或中断医疗途径相关的因素，同时控制了原籍世界卫生组织区域、性别、年龄和研究地点。医院记录提供了人口统计学和临床数据。对乙肝病毒、丙肝病毒和艾滋病毒进行了筛查，随后进行了适当的临床管理和疫苗接种。多项逻辑回归确定了不同的护理途径。在1514名参与者中，80.2%接受了筛查，其中87.3%所有感染检测均为阴性。对于慢性感染患者，20.8%错过了首次传染病咨询，一年后只有39.3%仍在接受护理。在591名有资格接种乙肝疫苗的个体（占总数的55.8%）中，10.0%（591人中的59人）实际接种了疫苗。确定了七种不同的护理途径，根据原籍地区和具体研究地点观察到了显著差异，突出了当地医疗基础设施和支持系统的影响。本研究强调迫切需要采取创新、跨部门和基于社区的方法，以满足移民的需求和观点。主要建议包括加强护理衔接、改进随访策略，以及建立一个强大的国家和欧洲网络，以确保护理的连续性，并整合整个护理途径中的公共卫生工作，提供公平公正的医疗服务。
