A Single-Center #Experience with a #Pregnant #Immigrant #Population and #Zika Virus Serologic #Screening in #NYC (Am J Perinatol., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Am J Perinatol. 2019 May 30. doi: 10.1055/s-0039-1688819. [Epub ahead of print]

A Single-Center Experience with a Pregnant Immigrant Population and Zika Virus Serologic Screening in New York City.

Merriam AA1, Nhan-Chang CL1, Huerta-Bogdan BI1, Wapner R1, Gyamfi-Bannerman C1.

Author information: 1 Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York, New York.

 

Abstract

OBJECTIVE:

Our institution is in an area of New York City with a large population of immigrants from Zika virus endemic areas. With the recent Zika virus outbreak, we sought to examine our center’s experience with screening for Zika virus and outcomes among patients who tested positive for the disease during pregnancy.

STUDY DESIGN:

We performed a chart review of all pregnant patients who tested positive (positive serum or urine polymerase chain reaction [PCR]) or presumed positive (immunoglobulin M [IgM] enzyme-linked immunosorbent assay [ELISA] positive or IgM ELISA equivocal with positive plaque reduction neutralization test) for Zika virus. All tests were performed by the Department of Health (DOH) and followed Centers for Disease Control and Prevention guidelines in effect at the time of specimen collection. Testing of cord blood, placenta, and/or neonatal blood were/was performed by the DOH for New York County. Prenatal ultrasounds for fetal head size and surveillance for calcifications were performed by maternal-fetal medicine specialists. Infant head ultrasound results were included when available.

RESULTS:

Between March 2016 and April 2017, 70 pregnant patients were positive or presumed positive for Zika infection during pregnancy. Of those, 16 women had positive urine or serum PCR and the remaining 54 were presumed positive. Among positive cases, five women tested positive via urine PCR only, nine women tested positive via serum PCR only, and two women had both positive urine and serum PCR. Fifteen of 67 infants (22%) born during the study period were born to mothers with positive urine or serum PCR testing. Sixty-five newborns were clinically normal with normal head measurements. Of the intracranial ultrasound performed, one infant had a grade 1 intraventricular hemorrhage, four had incidental choroid plexus cysts, and one had severe ventriculomegaly that was also noted antenatally. There were 2 positive and 15 equivocal infant serum IgM samples and 1 positive placental PCR from these pregnancies. There were four pregnancy terminations and two cases with fetal anomalies in this population that were split evenly between patients who tested positive and those who tested presumed positive for Zika virus during pregnancy.

CONCLUSION:

We found no differences in pregnancy or neonatal outcomes between women who tested positive and presumed positive for Zika virus during pregnancy. Testing of infants and placenta tissue after delivery was largely inconclusive. Improvement in testing for Zika virus infection is needed to determine which pregnancies are at risk for congenital anomalies. Further research is still needed to determine which children are at risk for poor neurodevelopmental outcomes related to Zika virus and how to best coordinate care among the immigrant population during a new disease epidemic.

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

PMID: 31146294 DOI: 10.1055/s-0039-1688819

Keywords: Zika Virus; Zika Congenital Syndrome; Pregnancy; USA; NYC; Serology.

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#Refugee and #migrant #health in the #European Region (Lancet, summary)

[Source: The Lancet, full page: (LINK). Summary, edited.]

Refugee and migrant health in the European Region

Ryoko Takahashi, Krista Kruja, Soorej Jose Puthoopparambil, Santino Severoni

Published: May 20, 2019 / DOI: https://doi.org/10.1016/S0140-6736(19)30282-X

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WHO is the respected authority in leading the production and use of core evidence for public health decision making.1 The Health Evidence Network (HEN) is an information service for public health decision makers in the WHO European Region and supports them to use the best available evidence.

(…)

We declare no competing interests.

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Article Info

Published: May 20, 2019

Identification: DOI: https://doi.org/10.1016/S0140-6736(19)30282-X

Copyright © 2019 Elsevier Ltd. All rights reserved.

Keywords: Migrants; Society; Politics; European Region; Public Health.

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#Privatisation of #immigration #detention facilities (Lancet, summary)

[Source: The Lancet, full page: (LINK). Summary, edited.]

Privatisation of immigration detention facilities

Altaf Saadi, Lello Tesema

Published: May 20, 2019 / DOI: https://doi.org/10.1016/S0140-6736(19)30351-4

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In December, 2018, two Guatemalan children, a 7-year-old girl and an 8-year-old boy, died while detained in immigration custody in the USA. Their tragic deaths should raise alarm about the dangerously substandard medical and mental health care at US immigration detention facilities.

(…)

We declare no competing interests.

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Article Info

Published: May 20, 2019

Identification: DOI: https://doi.org/10.1016/S0140-6736(19)30351-4

Copyright © 2019 Elsevier Ltd. All rights reserved.

Keywords: USA; Society; Politics; Migrants; Racism; Public Health.

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#Immigration in #Italy: the #medical #community’s role in #human #rights (Lancet, summary)

[Source: The Lancet, full page: (LINK). Summary, edited.]

Immigration in Italy: the medical community’s role in human rights

Raffaella Casolino

Published: May 20, 2019 / DOI: https://doi.org/10.1016/S0140-6736(19)30216-8

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Italy has been witnessing a rapid escalation towards racism and xenophobia since the new government came into power in June, 2018. On Nov 27, 2018, the lower house of the Italian Parliament approved the Decree-Law on Immigration and Security, which includes measures that would abolish humanitarian protection status for migrants, block asylum seekers from accessing reception centres focusing on social inclusion, and extend the duration of detention in return centres and hotspots. These measures fundamentally undermine international human rights principles. The day after approval, the Deputy Prime Minister and Minister of the Interior declared that Italy would not sign the UN Global Compact for Safe, Orderly and Regular Migration or take part in an intergovernmental conference in Marrakech, Morocco, on Dec 10, 2018.

(…)

I declare no competing interests.

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Reference

UN Human Rights, Office of the high commissioner. Legal changes and climate of hatred threaten migrants’ rights in Italy, say UN experts. URL: https://www.ohchr.org/en/NewsEvents/Pages/DisplayNews.aspx?NewsID=23908&LangID=E | Date: Nov 21, 2018 | Date accessed: November 28, 2018

 

Article Info

Published: May 20, 2019

Identification: DOI: https://doi.org/10.1016/S0140-6736(19)30216-8

Copyright © 2019 Elsevier Ltd. All rights reserved.

Keywords: Public Health; Society; Politics; Italy; Migrants; Racism.

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“Heal Thyself.”—An Argument for Granting #Asylum to #HCWs Persecuted During the 2014 West #African #Ebola #Crisis (SMU Law Rev., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

SMU Law Rev. 2018;71(4):1153-79.

“Heal Thyself.”—An Argument for Granting Asylum to Healthcare Workers Persecuted During the 2014 West African Ebola Crisis.

Echols B1.

Author information: 1 Southern Methodist University, Dedman School of Law. bechols@smu.edu

 

Abstract

This article argues for a change in United States asylum policy at a time when change is needed most. Those seeking asylum must prove that they fear persecution in their home country based on one of five protected categories and that their government is the persecutor or is unable to control the actions of the persecutors. Multiple articles have recognized that the “particular social group” is the most difficult category of asylum seeker to analyze. Not only do the standards for particular social groups (PSGs) vary among circuit courts, but judicial consistency is lacking. This article focuses on a particular PSG, healthcare workers from recently Ebola-stricken West Africa. During the 2014 Ebola crisis, these healthcare workers faced discrimination and violence due to their association with western medicine. Hospitals were frequently threatened and ransacked. Multiple accounts of violence against local and international healthcare workers were recorded by Doctors Against Borders, the Centers for Disease Control, and the international media. However, because of the inconsistencies in asylum law and the ever-present political influence in what originates as a humanitarian process, it is unlikely for these PSGs to be found asylum-eligible. This highlights the need for a more consistent and humanitarian-based asylum policy with less political influence.

PMID: 30648831

Keywords: Ebola; Migrants; Society; USA; African Region.

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#Health #impacts of #parental #migration on left-behind #children and adolescents: a systematic review and meta-analysis (Lancet, abstract)

[Source: The Lancet, full page: (LINK). Abstract, edited.]

Health impacts of parental migration on left-behind children and adolescents: a systematic review and meta-analysis

Gracia Fellmeth, MSc †, Kelly Rose-Clarke, MBPhD †, Chenyue Zhao, PhD, Laura K Busert, MSc, Yunting Zheng, MSc, Alessandro Massazza, MSc, Hacer Sonmez, BSc, Ben Eder, MBChB, Alice Blewitt, MSc, Wachiraya Lertgrai, MSc, Miriam Orcutt, MBBS, Katharina Ricci, BA Hons, Olaa Mohamed-Ahmed, MSc, Rachel Burns, MSc, Duleeka Knipe, PhD, Sally Hargreaves, FRCPE, Prof Therese Hesketh, PhD, Charles Opondo, PhD, Delan Devakumar, PhD

Open Access / Published: December 05, 2018 / DOI: https://doi.org/10.1016/S0140-6736(18)32558-3

 

Summary

Background

Globally, a growing number of children and adolescents are left behind when parents migrate. We investigated the effect of parental migration on the health of left behind-children and adolescents in low-income and middle-income countries (LMICs).

Methods

For this systematic review and meta-analysis we searched MEDLINE, Embase, CINAHL, the Cochrane Library, Web of Science, PsychINFO, Global Index Medicus, Scopus, and Popline from inception to April 27, 2017, without language restrictions, for observational studies investigating the effects of parental migration on nutrition, mental health, unintentional injuries, infectious disease, substance use, unprotected sex, early pregnancy, and abuse in left-behind children (aged 0–19 years) in LMICs. We excluded studies in which less than 50% of participants were aged 0–19 years, the mean or median age of participants was more than 19 years, fewer than 50% of parents had migrated for more than 6 months, or the mean or median duration of migration was less than 6 months. We screened studies using systematic review software and extracted summary estimates from published reports independently. The main outcomes were risk and prevalence of health outcomes, including nutrition (stunting, wasting, underweight, overweight and obesity, low birthweight, and anaemia), mental health (depressive disorder, anxiety disorder, conduct disorders, self-harm, and suicide), unintentional injuries, substance use, abuse, and infectious disease. We calculated pooled risk ratios (RRs) and standardised mean differences (SMDs) using random-effects models. This study is registered with PROSPERO, number CRD42017064871.

Findings

Our search identified 10 284 records, of which 111 studies were included for analysis, including a total of 264 967 children (n=106 167 left-behind children and adolescents; n=158 800 children and adolescents of non-migrant parents). 91 studies were done in China and focused on effects of internal labour migration. Compared with children of non-migrants, left-behind children had increased risk of depression and higher depression scores (RR 1·52 [95% CI 1·27–1·82]; SMD 0·16 [0·10–0·21]), anxiety (RR 1·85 [1·36–2·53]; SMD 0·18 [0·11–0·26]), suicidal ideation (RR 1·70 [1·28–2·26]), conduct disorder (SMD 0·16 [0·04–0·28]), substance use (RR 1·24 [1·00–1·52]), wasting (RR 1·13 [1·02–1·24]) and stunting (RR 1·12 [1·00–1·26]). No differences were identified between left-behind children and children of non-migrants for other nutrition outcomes, unintentional injury, abuse, or diarrhoea. No studies reported outcomes for other infectious diseases, self-harm, unprotected sex, or early pregnancy. Study quality varied across the included studies, with 43% of studies at high or unclear risk of bias across five or more domains.

Interpretation

Parental migration is detrimental to the health of left-behind children and adolescents, with no evidence of any benefit. Policy makers and health-care professionals need to take action to improve the health of these young people.

Funding

Wellcome Trust.

Keywords: Migrants; Society; Public Health.

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The #UCL – #Lancet #Commission on #Migration and #Health: the health of a world on the move (Lancet, abstract)

[Source: The Lancet, full page: (LINK). Abstract, edited.]

The UCL–Lancet Commission on Migration and Health: the health of a world on the move

Prof Ibrahim Abubakar, FRCP  *, Robert W Aldridge, PhD *, Delan Devakumar, PhD *, Miriam Orcutt, MSc *, Rachel Burns, MSc, Prof Mauricio L Barreto, MD, Poonam Dhavan, MPH, Fouad M Fouad, MD, Prof Nora Groce, PhD, Prof Yan Guo, PhD, Sally Hargreaves, FRCPE, Michael Knipper, MD, Prof J Jaime Miranda, MD, Prof Nyovani Madise, PhD, Prof Bernadette Kumar, DrPhilos, Davide Mosca, MD †, Prof Terry McGovern, JD, Leonard Rubenstein, LLM, Prof Peter Sammonds, PhD, Prof Susan M Sawyer, MD, Kabir Sheikh, PhD, Prof Stephen Tollman, PhD, Prof Paul Spiegel, MD, Prof Cathy Zimmerman, PhD * on behalf of theUCL–Lancet Commission on Migration and Health ‡

Published: December 05, 2018 / DOI: https://doi.org/10.1016/S0140-6736(18)32114-7

 

Abstract

With one billion people on the move or having moved in 2018, migration is a global reality, which has also become a political lightning rod. Although estimates indicate that the majority of global migration occurs within low-income and middle-income countries (LMICs), the most prominent dialogue focuses almost exclusively on migration from LMICs to high-income countries (HICs). Nowadays, populist discourse demonises the very same individuals who uphold economies, bolster social services, and contribute to health services in both origin and destination locations. Those in positions of political and economic power continue to restrict or publicly condemn migration to promote their own interests. Meanwhile nationalist movements assert so-called cultural sovereignty by delineating an us versus them rhetoric, creating a moral emergency.

Keywords: Migrants; Society; Public Health.

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