Publication date: Feb 06, 2019
Human migration is increasing in magnitude and scope. The majority of migrants arriving in high income countries originate from countries with a high prevalence of infectious diseases. The risk and burden of infectious diseases are not equally distributed among migrant groups and varies with migration stage.
A broad literature review on the drivers for infectious diseases and associated health outcomes among migrants across different stages of migration was conducted. The aim was to provide practitioners with an overview of the key infectious disease risks at each stage to guide health promotion strategies.
A complex interaction of factors lead to infectious diseases and associated poor health outcomes among migrants. The most important drivers are the epidemiology of infectious diseases in their countries of origin, the circumstances and conditions of the migration journey, and barriers accessing health care post arrival. During the recent large waves of forced migration into Europe the primary health concerns on arrival were, psychological, traumatic and chronic non-communicable diseases. In the early settlement period, crowded and unhygienic living conditions in reception camps facilitated outbreaks of respiratory, gastrointestinal, skin infections and vaccine preventable diseases. After re-settlement, undetected and untreated latent infections due to tuberculosis, viral hepatitis, HIV, chronic helminthiasis and Chagas disease lead to poor health outcomes. Migrants are disproportionally affected by preventable travel related diseases such as malaria, typhoid and hepatitis due to poor uptake of pre-travel prophylaxis and vaccination. Infectious diseases among migrants can be decreased at all migration stages with health promotion strategies adapted to their specific needs and delivered in a linguistically and culturally sensitive manner.
Tailored health promotion and screening approaches and accessible and responsive health systems, regardless of legal status, will be needed at all migration stages to limit the burden and transmission of infectious diseases in the migrant population.
Greenaway, C. and Castelli, F. Infectious diseases at different stages of migration: an expert review. 04689. 2019 J Travel Med.
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