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Impact of Coronavirus Pandemic on Tuberculosis and Other Imported Diseases Screening among Migrant Minors in Spain

Background: In recent decades, the increase in population movements has turned the focus to imported diseases. The COVID-19 pandemic has negatively impacted the access to health care systems, especially in highly vulnerable populations. We address the effects of the pandemic on the health screening...

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Autores principales: Mellado-Sola, Isabel, Rodríguez-Molino, Paula, Armas, Elisa-Andrea, Nogueira López, Javier, Falces-Romero, Iker, Rey, Cristina Calvo, Grasa Lozano, Carlos, Mellado, María José, López-Hortelano, Milagros García, Sainz, Talía
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9860880/
https://www.ncbi.nlm.nih.gov/pubmed/36668935
http://dx.doi.org/10.3390/tropicalmed8010028
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author Mellado-Sola, Isabel
Rodríguez-Molino, Paula
Armas, Elisa-Andrea
Nogueira López, Javier
Falces-Romero, Iker
Rey, Cristina Calvo
Grasa Lozano, Carlos
Mellado, María José
López-Hortelano, Milagros García
Sainz, Talía
author_facet Mellado-Sola, Isabel
Rodríguez-Molino, Paula
Armas, Elisa-Andrea
Nogueira López, Javier
Falces-Romero, Iker
Rey, Cristina Calvo
Grasa Lozano, Carlos
Mellado, María José
López-Hortelano, Milagros García
Sainz, Talía
author_sort Mellado-Sola, Isabel
collection PubMed
description Background: In recent decades, the increase in population movements has turned the focus to imported diseases. The COVID-19 pandemic has negatively impacted the access to health care systems, especially in highly vulnerable populations. We address the effects of the pandemic on the health screening of migrant unaccompanied minors (UM) in Spain. Method: Retrospective cross-sectional study including UM screened for imported diseases with a unified protocol at a pediatric reference unit for tropical and infectious diseases in Madrid, Spain. We compared the pre-pandemic (2018–2019) and post-pandemic periods (2020–2021). Results: A total of 192 minors were screened during the study period, with a drop in UM’s referral to our center in the post-pandemic years (140 in 2018–2019 vs. 52 in 2020–2021). Out of 192, 161 (83.9%) were diagnosed with at least one medical condition. The mean age was 16.8 years (SD 0.8) and 96.9% were males. Most cases were referred for a health exam; only 38% of children were symptomatic. Eosinophilia was present in 20.8%. The most common diagnosis were latent tuberculosis infection (LTBI) (72.9%), schistosomiasis (15.1%), toxocariasis (4.9%) and strongyloidiasis (4.9%). The prevalence of LTBI did not vary significantly (69.3% vs. 82.7%, p = 0.087). A total of 38% of the patients diagnosed with LTBI never started treatment or were lost to follow-up, as were two out of three patients with active pulmonary tuberculosis. Conclusions: In this series, the number of UM referred for health screening has dropped dramatically after the COVID pandemic, and two years after the beginning of the pandemic, access to care is still limited. Lost to follow-up rates are extremely high despite institutionalization. Specific resources, including multidisciplinary teams and accessible units are needed to improve diagnoses and linkage to care in this vulnerable population.
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spelling pubmed-98608802023-01-22 Impact of Coronavirus Pandemic on Tuberculosis and Other Imported Diseases Screening among Migrant Minors in Spain Mellado-Sola, Isabel Rodríguez-Molino, Paula Armas, Elisa-Andrea Nogueira López, Javier Falces-Romero, Iker Rey, Cristina Calvo Grasa Lozano, Carlos Mellado, María José López-Hortelano, Milagros García Sainz, Talía Trop Med Infect Dis Article Background: In recent decades, the increase in population movements has turned the focus to imported diseases. The COVID-19 pandemic has negatively impacted the access to health care systems, especially in highly vulnerable populations. We address the effects of the pandemic on the health screening of migrant unaccompanied minors (UM) in Spain. Method: Retrospective cross-sectional study including UM screened for imported diseases with a unified protocol at a pediatric reference unit for tropical and infectious diseases in Madrid, Spain. We compared the pre-pandemic (2018–2019) and post-pandemic periods (2020–2021). Results: A total of 192 minors were screened during the study period, with a drop in UM’s referral to our center in the post-pandemic years (140 in 2018–2019 vs. 52 in 2020–2021). Out of 192, 161 (83.9%) were diagnosed with at least one medical condition. The mean age was 16.8 years (SD 0.8) and 96.9% were males. Most cases were referred for a health exam; only 38% of children were symptomatic. Eosinophilia was present in 20.8%. The most common diagnosis were latent tuberculosis infection (LTBI) (72.9%), schistosomiasis (15.1%), toxocariasis (4.9%) and strongyloidiasis (4.9%). The prevalence of LTBI did not vary significantly (69.3% vs. 82.7%, p = 0.087). A total of 38% of the patients diagnosed with LTBI never started treatment or were lost to follow-up, as were two out of three patients with active pulmonary tuberculosis. Conclusions: In this series, the number of UM referred for health screening has dropped dramatically after the COVID pandemic, and two years after the beginning of the pandemic, access to care is still limited. Lost to follow-up rates are extremely high despite institutionalization. Specific resources, including multidisciplinary teams and accessible units are needed to improve diagnoses and linkage to care in this vulnerable population. MDPI 2022-12-29 /pmc/articles/PMC9860880/ /pubmed/36668935 http://dx.doi.org/10.3390/tropicalmed8010028 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Mellado-Sola, Isabel
Rodríguez-Molino, Paula
Armas, Elisa-Andrea
Nogueira López, Javier
Falces-Romero, Iker
Rey, Cristina Calvo
Grasa Lozano, Carlos
Mellado, María José
López-Hortelano, Milagros García
Sainz, Talía
Impact of Coronavirus Pandemic on Tuberculosis and Other Imported Diseases Screening among Migrant Minors in Spain
title Impact of Coronavirus Pandemic on Tuberculosis and Other Imported Diseases Screening among Migrant Minors in Spain
title_full Impact of Coronavirus Pandemic on Tuberculosis and Other Imported Diseases Screening among Migrant Minors in Spain
title_fullStr Impact of Coronavirus Pandemic on Tuberculosis and Other Imported Diseases Screening among Migrant Minors in Spain
title_full_unstemmed Impact of Coronavirus Pandemic on Tuberculosis and Other Imported Diseases Screening among Migrant Minors in Spain
title_short Impact of Coronavirus Pandemic on Tuberculosis and Other Imported Diseases Screening among Migrant Minors in Spain
title_sort impact of coronavirus pandemic on tuberculosis and other imported diseases screening among migrant minors in spain
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9860880/
https://www.ncbi.nlm.nih.gov/pubmed/36668935
http://dx.doi.org/10.3390/tropicalmed8010028
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