Gellert G A
Arizona Department of Health Services, Phoenix 85015.
Soc Sci Med. 1993 Dec;37(12):1489-99. doi: 10.1016/0277-9536(93)90183-5.
The epidemiology and policy implications of communicable disease (CD) transmission associated with international migration have received little systematic study. This is a review of clinical and epidemiological reports in search of strategies to assess and manage the impact of international migration on the transmission of CDs. The economics and demography of migration from less developed to industrialized nations is considered. Migration-related transmission should differentiate between actual transmission as opposed to geographic relocation of disease. Limitations of current screening and disease prevention strategies are discussed. Social and ecological processes through which migration can contribute to increased CD transmission are described, including placement in refugee camps, unclear legal status of migrants in recipient nations, and temporary return migration. Strategies for non-discriminatory and non-punitive control of migration-related CDs, needed changes in clinical practice, and complexities presented by CDs of long latency (such as HIV infection) are reviewed.
与国际移民相关的传染病传播的流行病学及政策影响鲜有系统研究。本文综述临床及流行病学报告，旨在探寻评估及管控国际移民对传染病传播影响的策略。文中考量了从欠发达国家向工业化国家移民的经济及人口统计学因素。与移民相关的传播应区分实际传播与疾病的地理转移。讨论了当前筛查及疾病预防策略的局限性。描述了移民可能导致传染病传播增加的社会及生态过程，包括安置在难民营、移民在接收国的法律地位不明以及临时返乡移民。综述了对与移民相关传染病进行非歧视性和非惩罚性控制的策略、临床实践所需的改变以及潜伏期长的传染病（如艾滋病毒感染）所带来的复杂性。
