Health assessment for migrants and asylum seekers upon arrival and while hosted in reception centres: Italian guidelines.


Journal

Health policy (Amsterdam, Netherlands)
ISSN: 1872-6054
Titre abrégé: Health Policy
Pays: Ireland
ID NLM: 8409431

Informations de publication

Date de publication:
03 2021
Historique:
received: 14 02 2020
revised: 15 12 2020
accepted: 17 12 2020
pubmed: 20 1 2021
medline: 5 8 2021
entrez: 19 1 2021
Statut: ppublish

Résumé

During 2016-17, national guidelines were developed in order to provide evidence-based recommendations on health assessments for migrants and asylum seekers upon their arrival in Italy. Scientific literature published between 2005 and 2016 was searched in different databases. A free search was also performed on international organizations' websites in order to identify additional relevant documents. A multidisciplinary panel discussed the resulting evidence and formulated recommendations. Evidence-based recommendations were formulated: signs and symptoms of specific diseases should to be actively searched for active TB, malaria, STI, intestinal parasites, diabetes, anaemia. In case of other health conditions (latent TB, HIV, HBV, HCV, STI, strongyloides, schistosoma, diabetes), testing should be offered to asymptomatic subjects coming from endemic areas or exposed to risk factors. Mass screening is recommended for anaemia and hypertension; a pregnancy test should be considered, while inclusion in cervical cancer screening and vaccination programs is recommended. A modulated, progressive approach was developed, covering an initial evaluation during rescue operations, a full medical examination at first line reception stage and the referral to national health services during second line reception. It is important to produce and periodically update guidelines on these issues and local peculiarities should be taken into account in their design and implementation. Guidelines can not only support economic sustainability, but also counteract stigmatization dynamics.

Sections du résumé

BACKGROUND
During 2016-17, national guidelines were developed in order to provide evidence-based recommendations on health assessments for migrants and asylum seekers upon their arrival in Italy.
METHODS
Scientific literature published between 2005 and 2016 was searched in different databases. A free search was also performed on international organizations' websites in order to identify additional relevant documents. A multidisciplinary panel discussed the resulting evidence and formulated recommendations.
RESULTS
Evidence-based recommendations were formulated: signs and symptoms of specific diseases should to be actively searched for active TB, malaria, STI, intestinal parasites, diabetes, anaemia. In case of other health conditions (latent TB, HIV, HBV, HCV, STI, strongyloides, schistosoma, diabetes), testing should be offered to asymptomatic subjects coming from endemic areas or exposed to risk factors. Mass screening is recommended for anaemia and hypertension; a pregnancy test should be considered, while inclusion in cervical cancer screening and vaccination programs is recommended. A modulated, progressive approach was developed, covering an initial evaluation during rescue operations, a full medical examination at first line reception stage and the referral to national health services during second line reception.
CONCLUSIONS
It is important to produce and periodically update guidelines on these issues and local peculiarities should be taken into account in their design and implementation. Guidelines can not only support economic sustainability, but also counteract stigmatization dynamics.

Identifiants

pubmed: 33461797
pii: S0168-8510(20)30321-3
doi: 10.1016/j.healthpol.2020.12.010
pii:
doi:

Types de publication

Journal Article

Langues

eng

Pagination

393-405

Informations de copyright

Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors report no declarations of interest.

Auteurs

Maria Elena Tosti (ME)

National Center for Global Health, National Institute of Health (Istituto Superiore di Sanità ISS), Rome, Italy. Electronic address: mariaelena.tosti@iss.it.

Maurizio Marceca (M)

Italian Society of Migration Medicine (Società Italiana di Medicina delle Migrazioni - SIMM), Italy; Department of Public Health and Infectious Diseases (Dipartimento di Sanità Pubblica e Malattie Infettive DSPMI), University of Rome "La Sapienza", Rome, Italy. Electronic address: maurizio.marceca@uniroma1.it.

Erica Eugeni (E)

National Institute for Health, Migration and Poverty (Istituto Nazionale per la promozione della salute delle popolazioni Migranti e per il contrasto delle malattie della Povertà INMP), Rome, Italy. Electronic address: erica.eugeni@inmp.it.

Franca D'Angelo (F)

National Center for Global Health, National Institute of Health (Istituto Superiore di Sanità ISS), Rome, Italy. Electronic address: franca.dangelo@iss.it.

Salvatore Geraci (S)

Italian Society of Migration Medicine (Società Italiana di Medicina delle Migrazioni - SIMM), Italy. Electronic address: s.geraci@areasanitaria.it.

Silvia Declich (S)

National Center for Global Health, National Institute of Health (Istituto Superiore di Sanità ISS), Rome, Italy. Electronic address: silvia.declich@iss.it.

Maurella Della Seta (M)

Knowledge Service, Documentation and Library, National Institute of Health (Istituto Superiore di Sanità ISS), Rome, Italy. Electronic address: maurella.dellaseta@iss.it.

Luigina Ferrigno (L)

National Center for Global Health, National Institute of Health (Istituto Superiore di Sanità ISS), Rome, Italy. Electronic address: luigina.ferrigno@iss.it.

Rosalia Marrone (R)

National Institute for Health, Migration and Poverty (Istituto Nazionale per la promozione della salute delle popolazioni Migranti e per il contrasto delle malattie della Povertà INMP), Rome, Italy. Electronic address: rosalia.marrone@inmp.it.

Chiara Pajno (C)

National Institute for Health, Migration and Poverty (Istituto Nazionale per la promozione della salute delle popolazioni Migranti e per il contrasto delle malattie della Povertà INMP), Rome, Italy. Electronic address: chiara.pajno@inmp.it.

Scilla Pizzarelli (S)

Knowledge Service, Documentation and Library, National Institute of Health (Istituto Superiore di Sanità ISS), Rome, Italy. Electronic address: scilla.pizzarelli@iss.it.

Annalisa Rosso (A)

Department of Public Health and Infectious Diseases (Dipartimento di Sanità Pubblica e Malattie Infettive DSPMI), University of Rome "La Sapienza", Rome, Italy; Local Health Unit Roma 2, Rome, Italy. Electronic address: annalisa.rosso@aslroma2.it.

Giulia De Ponte (G)

National Center for Global Health, National Institute of Health (Istituto Superiore di Sanità ISS), Rome, Italy. Electronic address: giulia.deponte@iss.it.

Concetta Mirisola (C)

National Institute for Health, Migration and Poverty (Istituto Nazionale per la promozione della salute delle popolazioni Migranti e per il contrasto delle malattie della Povertà INMP), Rome, Italy. Electronic address: concetta.mirisola@inmp.it.

Giovanni Baglio (G)

National Institute for Health, Migration and Poverty (Istituto Nazionale per la promozione della salute delle popolazioni Migranti e per il contrasto delle malattie della Povertà INMP), Rome, Italy. Electronic address: giovanni.baglio@inmp.it.

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