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Article ; Online: Linkage to Care Is Important and Necessary When Identifying Infections in Migrants

Manish Pareek / Teymur Noori / Sally Hargreaves / Maria van den Muijsenbergh

International Journal of Environmental Research and Public Health, Vol 15, Iss 7, p

2018 Volume 1550

Abstract: Migration is an important driver of population dynamics in Europe. Although migrants are generally healthy, subgroups of migrants are at increased risk of a range of infectious diseases. Early identification of infections is important as it prevents ... ...

Abstract	Migration is an important driver of population dynamics in Europe. Although migrants are generally healthy, subgroups of migrants are at increased risk of a range of infectious diseases. Early identification of infections is important as it prevents morbidity and mortality. However, identifying infections needs to be supported by appropriate systems to link individuals to specialist care where they can receive further diagnostic tests and clinical management. In this commentary we will discuss the importance of linkage to care and how to minimise attrition in clinical pathways.
Keywords	migration ; health ; infection ; linkage ; care ; Medicine ; R
Language	English
Publishing date	2018-07-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Social and behavioural determinants of syphilis

Ana Mendez-Lopez / David Stuckler / Ulrich Marcus / Ford Hickson / Teymur Noori / Robert N. Whittaker / Klaus Jansen / Asuncion Diaz / Lukasz Henszel / Annie Velter / Jan C. Semenza / Axel J. Schmidt

The Lancet Regional Health. Europe, Vol 22, Iss , Pp 100483- (2022)

Modelling based on repeated cross-sectional surveys from 2010 and 2017 among 278,256 men who have sex with men in 31 European countries

2022

Abstract: Summary: Background: Syphilis case notifications among men-who-have-sex-with-men (MSM) have increased markedly over the past two decades in Europe. We tested several potential factors for this resurgence. Methods: Self-reported data from two cross- ... ...

Abstract	Summary: Background: Syphilis case notifications among men-who-have-sex-with-men (MSM) have increased markedly over the past two decades in Europe. We tested several potential factors for this resurgence. Methods: Self-reported data from two cross-sectional waves of the European MSM Internet Survey (EMIS-2010 and EMIS-2017, N = 278,256 participants living in 31 European countries) were used to fit multivariable hierarchical logistic regression models designed to evaluate potential social, behavioural, and interventional determinants of syphilis diagnosis. Additional multivariable hierarchical negative binomial models investigated determinants of the number of non-steady male condomless anal intercourse (CAI) partners. We tested the hypothesis that more CAI and syphilis-screening are associated with syphilis resurgence, both linked to use of pre-exposure prophylaxis (PrEP). Findings: Between 2010 and 2017, incidence of syphilis diagnosis in the previous 12 months rose from 2.33% (95%CI: 2.26–2.40) of respondents reporting a syphilis diagnosis in 2010 compared with 4.54% (95%CI: 4.42–4.66) in 2017. Major factors contributing to syphilis diagnosis were living with diagnosed HIV (adjusted odds ratio (aOR) 2.67, 95%CI: 2.32–3.07), each additional non-steady male CAI partner (aOR 1.01, 95%CI: 1.01–1.01), recency of STI-screening (previous month vs no screening, aOR 25.76, 95%CI: 18.23–36.41), selling sex (aOR 1.45, 95%CI: 1.27–1.65), and PrEP use (aOR 3.02, 95%CI: 2.30–3.96). Living with diagnosed HIV (adjusted incidence rate ratio (aIRR) 3.91, 95%CI: 3.77–4.05), selling sex (aIRR 4.39, 95%CI: 4.19–4.59), and PrEP use (aIRR 5.82, 95%CI: 5.29–6.41) were associated with a higher number of non-steady male CAI partners. The association between PrEP use and increased chance of syphilis diagnosis was mediated by STI-screening recency and number of non-steady male CAI partners, both substantially higher in 2017 compared to 2010. Interpretation: Syphilis cases are concentrated in three MSM population groups: HIV-diagnosed, ...
Keywords	Men who have sex with men ; MSM ; Homosexual ; Syphilis ; Europe ; STI-screening ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2022-11-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Monitoring progress towards elimination of hepatitis B and C in the EU/EEA.

PLOS Global Public Health, Vol 2, Iss 8, p e

2022 Volume 0000841

Abstract: This paper presents data on selected indicators to show progress towards elimination goals and targets for hepatitis B and hepatitis C in the 31 countries of the European Union (EU) and European Economic Area (EEA). A monitoring system was developed by ... ...

Abstract	This paper presents data on selected indicators to show progress towards elimination goals and targets for hepatitis B and hepatitis C in the 31 countries of the European Union (EU) and European Economic Area (EEA). A monitoring system was developed by the European Centre for Disease Prevention and Control, which combined newly collected data from EU/EEA countries along with relevant data from existing sources. Data for 2017 were collected from the EU/EEA countries via an online survey. All countries provided responses. In 2017, most countries reporting data had not reached prevention targets for childhood hepatitis B vaccination and for harm reduction services targeting people who inject drugs (PWID). Four of 12 countries had met the target for proportion of people living with chronic HBV diagnosed and seven of 16 met this target for hepatitis C. Data on diagnosed cases treated were lacking for hepatitis B. Of 12 countries reporting treatment data for hepatitis B, only Iceland met the target. This first collection of data across the EU/EEA highlighted major issues with data completeness and quality and in the indicators that were used, which impairs a clear overview of progress towards the elimination of hepatitis. The available data, whilst incomplete, suggest that as of 2017, the majority of the EU/EEA countries were far from meeting most of the 2020 targets, in particular those relating to harm reduction and diagnosis. It is critical to improve the data collected in order to develop more effective services for hepatitis prevention, diagnosis, and treatment that are needed in order to meet the 2030 elimination targets.
Keywords	Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Health system capacity to report on indicators fostering integrated people-centred HIV care

Kelly Safreed-Harmon / Jane Anderson / Natasha Azzopardi-Muscat / Antonella d'Arminio Monforte / Meaghan Kall / Teymur Noori / Kholoud Porter / Jeffrey Lazarus

International Journal of Integrated Care, Vol 19, Iss

findings from six European countries

2019 Volume 4

Abstract: Introduction: Effective antiretroviral treatment has greatly increased life expectancy for people living with HIV (PLHIV). However, PLHIV have higher levels of multimorbidity than the general population. Integrated people-centred health services are ... ...

Abstract	Introduction: Effective antiretroviral treatment has greatly increased life expectancy for people living with HIV (PLHIV). However, PLHIV have higher levels of multimorbidity than the general population. Integrated people-centred health services are needed to effectively manage non-AIDS comorbidities and to achieve good health-related quality of life (HRQoL). This study assesses national health system capacity to monitor indicators that are relevant to the changing focus of HIV care. Methods: Through desk research and expert consultation we determined that health-related concerns for PLHIV in Europe include certain non-AIDS comorbidities, HRQoL, discrimination within health systems and unmet psychosocial needs. We created a 56-item English-language survey to assess whether health systems currently report on these issues as part of routine HIV monitoring or whether they have the capacity to do so. One leading HIV expert completed the survey in each of six countries: Estonia, Italy, the Netherlands, Slovenia, Sweden and Turkey. Data collection took place in April–June 2018. We compiled results in Microsoft Excel and performed descriptive analyses. Results: Bone loss, cardiovascular disease, drug dependence, non-AIDS malignancies and renal disease were reported to be the most comprehensively monitored comorbidities (Table 1). Five countries could potentially report on leading causes of death among PLHIV, while two could potentially report on leading causes of hospital admission (data not shown). Respondents from three countries indicated capacity to report on the HRQoL of PLHIV. Two countries could report on the percentage of PLHIV denied health services because of HIV status, while none appeared to have indicators for monitoring psychosocial service provision. Discussion: National HIV monitoring programmes across study countries have greater capacity to report on some non-AIDS comorbidities than others. The conditions that are most widely monitored may be those for which monitoring could be expanded most easily in ...
Keywords	comorbidities ; health systems monitoring ; hiv ; integrated care ; Medicine (General) ; R5-920
Subject code	360
Language	English
Publishing date	2019-08-01T00:00:00Z
Publisher	Ubiquity Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Ability to Monitor National Responses to the HIV Epidemic “Beyond Viral Suppression”

Kelly Safreed-Harmon / Meaghan Kall / Jane Anderson / Natasha Azzopardi-Muscat / Georg M. N. Behrens / Antonella d'Arminio Monforte / Udi Davidovich / Teymur Noori / Jeffrey V. Lazarus

Frontiers in Public Health, Vol

Findings From Six European Countries

2020 Volume 8

Abstract: Objective: With more people living with HIV (PLHIV) ageing into their 50s and beyond in settings where antiretroviral therapy is widely available, non-AIDS comorbidities and health-related quality of life (HRQoL) are becoming major challenges. ... ...

Abstract	Objective: With more people living with HIV (PLHIV) ageing into their 50s and beyond in settings where antiretroviral therapy is widely available, non-AIDS comorbidities and health-related quality of life (HRQoL) are becoming major challenges. Information is needed about whether national HIV monitoring programmes have evolved to reflect the changing focus of HIV care.Methods: We created a 56-item English-language survey to assess whether health systems report on common health-related issues for people with HIV including physical and mental health comorbidities, HRQoL, psychosocial needs, and fertility desires. One expert was identified via purposive sampling in each of six countries (Estonia, Italy, the Netherlands, Slovenia, Sweden, and Turkey) and was asked to participate in the survey.Results: Three respondents reported that the current monitoring systems in their countries do not monitor any of four specified aspects of 10 comorbidities including bone loss, cardiovascular disease, and neurocognitive disorders. Two respondents stated that their countries potentially can report on leading causes of hospital admission among PLHIV, and five on leading cases of death. In three countries, respondents reported that there was the ability to report on the HRQoL of PLHIV. In two countries, respondents provided data on the percentage of PLHIV denied health services because of HIV status in the past 12 months.Conclusions: This study identified areas for potential HIV monitoring improvements in six European countries in relation to comorbidities, HRQoL, discrimination within health systems, and other issues associated with the changing nature of the HIV epidemic. It also indicated that some countries either currently monitor or have the ability to monitor some of these issues. There are opportunities for health information systems in European countries to expand the scope of their HIV monitoring in order to support decision-making about how the long-term health-related needs of PLHIV can best be met.
Keywords	comorbidity ; Europe ; health-related quality of life ; HIV ; indicator ; monitoring ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2020-03-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Accessibility and Acceptability of Infectious Disease Interventions Among Migrants in the EU/EEA

Matt Driedger / Alain Mayhew / Vivian Welch / Eric Agbata / Doug Gruner / Christina Greenaway / Teymur Noori / Monica Sandu / Thierry Sangou / Christine Mathew / Harneel Kaur / Manish Pareek / Kevin Pottie

International Journal of Environmental Research and Public Health, Vol 15, Iss 11, p

A CERQual Systematic Review

2018 Volume 2329

Abstract: In the EU/EEA, subgroups of international migrants have an increased prevalence of certain infectious diseases. The objective of this study was to examine migrants’ acceptability, value placed on outcomes, and accessibility of infectious disease ... ...

Abstract	In the EU/EEA, subgroups of international migrants have an increased prevalence of certain infectious diseases. The objective of this study was to examine migrants’ acceptability, value placed on outcomes, and accessibility of infectious disease interventions. We conducted a systematic review of qualitative reviews adhering to the PRISMA reporting guidelines. We searched MEDLINE, EMBASE, CINAHL, DARE, and CDSR, and assessed review quality using AMSTAR. We conducted a framework analysis based on the Health Beliefs Model, which was used to organize our preliminary findings with respect to the beliefs that underlie preventive health behavior, including knowledge of risk factors, perceived susceptibility, severity and barriers, and cues to action. We assessed confidence in findings using an adapted GRADE CERQual tool. We included 11 qualitative systematic reviews from 2111 articles. In these studies, migrants report several facilitators to public health interventions. Acceptability depended on migrants’ relationship with healthcare practitioners, knowledge of the disease, and degree of disease-related stigma. Facilitators to public health interventions relevant for migrant populations may provide clues for implementation. Trust, cultural sensitivity, and communication skills also have implications for linkage to care and public health practitioner education. Recommendations from practitioners continue to play a key role in the acceptance of infectious disease interventions.
Keywords	access to care ; disease prevention ; public health ; stigma ; refugees ; migrants ; Medicine ; R
Subject code	306
Language	English
Publishing date	2018-10-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Screening for Infectious Diseases among Newly Arrived Migrants in EU/EEA Countries—Varying Practices but Consensus on the Utility of Screening

Tommi Kärki / Christian Napoli / Flavia Riccardo / Massimo Fabiani / Maria Grazia Dente / Manuel Carballo / Teymur Noori / Silvia Declich

International Journal of Environmental Research and Public Health, Vol 11, Iss 10, Pp 11004-

2014 Volume 11014

Abstract: Screening is one possible tool for monitoring infectious diseases among migrants. However, there is limited information on screening programmes targeted for newly arrived migrants in EU/EEA countries. Our aim was to investigate the implementation, ... ...

Abstract	Screening is one possible tool for monitoring infectious diseases among migrants. However, there is limited information on screening programmes targeted for newly arrived migrants in EU/EEA countries. Our aim was to investigate the implementation, practices and usefulness of these programmes. We conducted a survey among country experts from EU/EEA countries and Switzerland, asking whether their countries had implemented screening programmes. We also estimated the association between the implementation of these programmes and the rate of asylum-seekers in the population. Of the countries, 16 (59%) had implemented screening programmes and 15 (56%) had national guidelines. The rate of asylum-seekers was associated with implementation of screening programmes (p = 0.014). Screening was performed most often for tuberculosis; most commonly on holding level, and was targeted to specific migrant groups in over half of the countries performing screening. Twenty-five of all the country experts (96%) considered screening among migrants useful, and 24 (92%) would welcome EU level guidelines for screening. The implementation of screening programmes varied, and the practices were different among countries. Our survey suggests, that establishing EU level guidelines for screening would be useful, although they would have to take into account differences between individual countries.
Keywords	ening ; immigration ; refugees ; migrants ; infectious diseases ; Medicine ; R
Language	English
Publishing date	2014-10-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Factors Influencing the Accuracy of Infectious Disease Reporting in Migrants

Paolo Giorgi Rossi / Flavia Riccardo / Annamaria Pezzarossi / Paola Ballotari / Maria Grazia Dente / Christian Napoli / Antonio Chiarenza / Cesar Velasco Munoz / Teymur Noori / Silvia Declich

International Journal of Environmental Research and Public Health, Vol 14, Iss 7, p

A Scoping Review

2017 Volume 720

Abstract: We conducted a scoping review of literature to improve our understanding of the accuracy of infectious disease monitoring in migrants in the Europe. We searched PubMed for papers relevant to the topic including: case reports, observational and ... ...

Abstract	We conducted a scoping review of literature to improve our understanding of the accuracy of infectious disease monitoring in migrants in the Europe. We searched PubMed for papers relevant to the topic including: case reports, observational and experimental studies, reviews, guidelines or policy documents; published after 1994. We identified 532 papers, 27 of which were included in the review. Legislation and right to access health care influence both the accuracy of rates and risk measures under estimating the at risk population, i.e., the denominator. Furthermore, the number of reported cases, i.e., the numerator, may also include cases not accounted for in the denominator. Both biases lead to an overestimated disease occurrence. Restriction to healthcare access and low responsiveness may cause under-detection of cases, however a quantification of this phenomenon has not been produced. On the contrary, screening for asymptomatic diseases increases ascertainment leading to increased detection of cases. Incompleteness of denominator data underestimates the at-risk population. In conclusion, most studies show a lower probability of under-reporting infectious diseases in migrants compared with native populations.
Keywords	migrant health ; infectious diseases ; surveillance ; under-reporting ; Medicine ; R
Subject code	610
Language	English
Publishing date	2017-07-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Effectiveness and Cost-Effectiveness of Screening for HIV in Migrants in the EU/EEA

Kevin Pottie / Tamara Lotfi / Lama Kilzar / Pamela Howeiss / Nesrine Rizk / Elie A. Akl / Sonia Dias / Beverly-Ann Biggs / Robin Christensen / Prinon Rahman / Olivia Magwood / Anh Tran / Nick Rowbotham / Anastasia Pharris / Teymur Noori / Manish Pareek / Rachael Morton

International Journal of Environmental Research and Public Health, Vol 15, Iss 8, p

A Systematic Review

2018 Volume 1700

Abstract: Migrants, defined as individuals who move from their country of origin to another, account for 40% of newly-diagnosed cases of human immunodeficiency virus (HIV) in the European Union/European Economic Area (EU/EEA). Populations at high risk for HIV ... ...

Abstract	Migrants, defined as individuals who move from their country of origin to another, account for 40% of newly-diagnosed cases of human immunodeficiency virus (HIV) in the European Union/European Economic Area (EU/EEA). Populations at high risk for HIV include migrants, from countries or living in neighbourhoods where HIV is prevalent, and those participating in high risk behaviour. These migrants are at risk of low CD4 counts at diagnosis, increased morbidity, mortality, and onward transmission. The aim of this systematic review is to evaluate the effectiveness and cost-effectiveness of HIV testing strategies in migrant populations and to estimate their effect on testing uptake, mortality, and resource requirements. Following a systematic overview, we included four systematic reviews on the effectiveness of strategies in non-migrant populations and inferred their effect on migrant populations, as well as eight individual studies on cost-effectiveness/resource requirements. We assessed the certainty of our results using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The systematic reviews reported that HIV tests are highly accurate (rapid test >90% sensitivity, Western blot and ELISA >99% sensitivity). A meta-analysis showed that rapid testing approaches improve the access and uptake of testing (risk ratio = 2.95, 95% CI: 1.69 to 5.16), and were associated with a lower incidence of HIV in the middle-aged women subgroup among marginalised populations at a high risk of HIV exposure and HIV related stigma. Economic evidence on rapid counselling and testing identified strategic advantages with rapid tests. In conclusion, community-based rapid testing programmes may have the potential to improve uptake of HIV testing among migrant populations across a range of EU/EEA settings.
Keywords	HIV ; AIDS ; stigma ; refugees ; migrants ; Medicine ; R
Subject code	310
Language	English
Publishing date	2018-08-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Effectiveness and Cost-Effectiveness of Hepatitis C Screening for Migrants in the EU/EEA

Christina Greenaway / Iuliia Makarenko / Claire Nour Abou Chakra / Balqis Alabdulkarim / Robin Christensen / Adam Palayew / Anh Tran / Lukas Staub / Manish Pareek / Joerg J. Meerpohl / Teymur Noori / Irene Veldhuijzen / Kevin Pottie / Francesco Castelli / Rachael L. Morton

International Journal of Environmental Research and Public Health, Vol 15, Iss 9, p

A Systematic Review

2018 Volume 2013

Abstract: Chronic hepatitis C (HCV) is a public health priority in the European Union/European Economic Area (EU/EEA) and is a leading cause of chronic liver disease and liver cancer. Migrants account for a disproportionate number of HCV cases in the EU/EEA (mean ... ...

Abstract	Chronic hepatitis C (HCV) is a public health priority in the European Union/European Economic Area (EU/EEA) and is a leading cause of chronic liver disease and liver cancer. Migrants account for a disproportionate number of HCV cases in the EU/EEA (mean 14% of cases and >50% of cases in some countries). We conducted two systematic reviews (SR) to estimate the effectiveness and cost-effectiveness of HCV screening for migrants living in the EU/EEA. We found that screening tests for HCV are highly sensitive and specific. Clinical trials report direct acting antiviral (DAA) therapies are well-tolerated in a wide range of populations and cure almost all cases (>95%) and lead to an 85% lower risk of developing hepatocellular carcinoma and an 80% lower risk of all-cause mortality. At 2015 costs, DAA based regimens were only moderately cost-effective and as a result less than 30% of people with HCV had been screened and less 5% of all HCV cases had been treated in the EU/EEA in 2015. Migrants face additional barriers in linkage to care and treatment due to several patient, practitioner, and health system barriers. Although decreasing HCV costs have made treatment more accessible in the EU/EEA, HCV elimination will only be possible in the region if health systems include and treat migrants for HCV.
Keywords	hepatitis C ; screening ; migrants ; viral hepatitis elimination ; European Union ; Medicine ; R
Subject code	360
Language	English
Publishing date	2018-09-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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