Weissman A M
Brown University Program in Family Medicine, Memorial Hospital of Rhode Island, Pawtucket 02860.
J Am Board Fam Pract. 1994 Jul-Aug;7(4):310-23.
The Central and South American immigrant population in the United States is large and growing. A review of the preventive health care needs of this population has not previously been done but would be helpful to clinicians caring for immigrants in this country.
Using MEDLINE, the literature related to immigrants and their health status was searched, using the key words "immigrant," "refugee," "South/Central/Latin America," "health status," "screening," "nutrition," "parasites," "stomach/gastric cancer," "children," and "psychological." The American Statistics Index and Index to International Statistics were also resources. The available literature was reviewed and led to the recommendations in this article.
Screening strategies for Latin American immigrants are discussed for intestinal parasites, tuberculosis, hepatitis B, schistosomiasis, leprosy, American trypanosomiasis (Chagas disease), malaria, human immunodeficiency virus (HIV) infection, cervical and gastric cancer, sickle cell trait, malnutrition, iron-deficiency anemia, incomplete immunizations, dental problems, psychological problems, impairment in the elderly, alcohol use, smoking, physical inactivity, and hypertension. There are not enough data to evaluate fully the screening strategies for most of these conditions, but recommendations are offered based on current knowledge.
Screening is recommended for intestinal parasites and schistosomiasis, tuberculosis, hepatitis B in prenatal patients, leprosy in immigrants from high-risk areas, yearly Papanicolaou smears, malnutrition, iron-deficiency anemia, incomplete immunizations, dental problems, history of violence, and depression. Screening for sickle cell trait in prenatal patients from South America and universal hepatitis B screening are less clearly indicated but could be appropriate. Screening for American trypanosomiasis (Chagas disease), malaria, and gastric cancer is not recommended. Screening for HIV infection, functional impairment in the elderly, alcohol use, cigarette smoking, physical inactivity, and hypertension should be the same as for the general population.
美国中南美洲移民人口众多且不断增长。此前尚未对该人群的预防性医疗保健需求进行过综述，但这对为该国移民提供护理的临床医生会有所帮助。
利用医学在线数据库（MEDLINE），以“移民”“难民”“南美洲/中美洲/拉丁美洲”“健康状况”“筛查”“营养”“寄生虫”“胃癌”“儿童”及“心理”等关键词搜索与移民及其健康状况相关的文献。美国统计索引和国际统计索引也是信息来源。对现有文献进行综述后得出本文中的建议。
讨论了针对拉丁美洲移民的筛查策略，涉及肠道寄生虫、结核病、乙型肝炎、血吸虫病、麻风病、美洲锥虫病（恰加斯病）、疟疾、人类免疫缺陷病毒（HIV）感染、宫颈癌和胃癌、镰状细胞性状、营养不良、缺铁性贫血、免疫接种不全、牙齿问题、心理问题、老年人功能障碍、饮酒、吸烟、缺乏运动及高血压。对于大多数这些情况，没有足够的数据来全面评估筛查策略，但根据现有知识提供了相关建议。
建议对肠道寄生虫和血吸虫病、结核病、产前患者的乙型肝炎、来自高危地区移民的麻风病、每年的巴氏涂片检查、营养不良、缺铁性贫血、免疫接种不全、牙齿问题、暴力史及抑郁症进行筛查。对来自南美洲的产前患者进行镰状细胞性状筛查和普遍的乙型肝炎筛查的指征不太明确，但可能是合适的。不建议对美洲锥虫病（恰加斯病）、疟疾和胃癌进行筛查。对HIV感染、老年人功能障碍、饮酒、吸烟、缺乏运动及高血压的筛查应与普通人群相同。
