Silva Luisa, Al-Oraibi Amani, Nanakali Shajwan, Gogoi Mayuri, Hassan Osama, Al-Sharabi Isra, Sahare Pankhuri, Pareek Manish, Qureshi Irtiza, Nellums Laura B
Lifeorgdivision and Population Health, School of Medicine, University of Nottingham, Nottingham, UK.
Department of Respiratory Sciences, University of Leicester, Leicester, UK.
BMC Public Health. 2025 May 15;25(1):1794. doi: 10.1186/s12889-025-22384-1.
In recent years, migration to and within Europe has increased. Human mobility has been hypothesised as a contributing factor towards antimicrobial resistance (AMR). However, there is limited evidence to explain how migration contributes towards antibiotic resistance. More qualitative research regarding migrants' perspectives of antibiotic use is needed to understand this complex interaction. The aim of this study was to explore experiences of antibiotic use and healthcare access among migrants in the UK, and how this might influence the risk of AMR.
Adult migrants were purposively recruited through community organisations, collaborators, online platforms and snowball sampling representing different migrant statuses, countries of origin and ethnicities. Semi-structured interviews were conducted online, by phone or face-to-face, in participants' preferred languages, between March and July 2022 exploring antibiotic use and healthcare access. Data were analysed thematically and the study was informed by a Project Advisory Committee, with members from Doctors of the World and professionals who were previously refugees or asylum seekers.
Twenty-seven migrants (17 males and 10 females), aged 21-60, from 17 different countries were interviewed. Four main themes were generated: 1) Uncharted territory: navigating a new healthcare system (sub-themes (a) access to care during journey, (b) difficult access to healthcare in the UK and (c) comparison between different healthcare systems); 2) Preserving the sense of agency and decision-making around antibiotic use, 3) Self-perpetuating cycle (sub-themes - (a) co-infections; (b) using alarming symptoms or "red-flags" and (c) taking antibiotics due to previous similar symptoms or persisting symptoms), and 4) The fragile state of the patient-doctor relationship.
These findings give useful insight into barriers faced by migrants when trying to access healthcare services both en route and after arriving in the UK, as well as their attitudes and behaviours in relation to antibiotics. Results also shed light on the complexity of factors contributing to health-seeking behaviour and antibiotic use, and how these may vary depending on previous experiences. We discuss implications for future research and practice, and how current policies may need to evolve to better support and reduce possible risk factors for AMR in migrant communities.
近年来，移民到欧洲以及在欧洲内部的迁移有所增加。人们推测人口流动是导致抗菌药物耐药性（AMR）的一个因素。然而，关于移民如何导致抗生素耐药性的证据有限。需要更多关于移民对抗生素使用看法的定性研究来理解这种复杂的相互作用。本研究的目的是探讨英国移民使用抗生素和获得医疗保健的经历，以及这可能如何影响抗菌药物耐药性风险。
通过社区组织、合作伙伴、在线平台和滚雪球抽样，有目的地招募代表不同移民身份、原籍国和种族的成年移民。2022年3月至7月期间，以参与者喜欢的语言，通过在线、电话或面对面的方式进行半结构化访谈，探讨抗生素使用和医疗保健获取情况。对数据进行了主题分析，该研究由一个项目咨询委员会提供信息，委员会成员包括世界医生组织的医生以及曾是难民或寻求庇护者的专业人员。
采访了来自17个不同国家的27名移民（17名男性和10名女性），年龄在21至60岁之间。产生了四个主要主题：1）未知领域：在新的医疗体系中摸索（子主题：(a) 旅程中的医疗服务获取；(b) 在英国难以获得医疗保健；(c) 不同医疗体系之间的比较）；2）在抗生素使用方面保持自主意识和决策能力；3）自我延续的循环（子主题：(a) 合并感染；(b) 使用警示症状或“危险信号”；(c) 因以前类似症状或持续症状而服用抗生素）；4）医患关系的脆弱状态。
这些发现为移民在抵达英国途中及抵达后试图获得医疗服务时所面临的障碍，以及他们对抗生素的态度和行为提供了有益的见解。研究结果还揭示了导致就医行为和抗生素使用的因素的复杂性以及这些因素如何因以往经历而有所不同。我们讨论了对未来研究和实践的启示，以及当前政策可能需要如何演变以更好地支持并降低移民社区中抗菌药物耐药性的潜在风险因素。
