Journal Article > ReviewFull Text
J Migr Health. 2020 December 31; Volume 3; 100041.; DOI:10.1016/j.jmh.2021.100041
Hayward SE, Deal A, Cheng C, Crawshaw A, Orcutt M, et al.
J Migr Health. 2020 December 31; Volume 3; 100041.; DOI:10.1016/j.jmh.2021.100041
BACKGROUND
Migrants in high-income countries may be at increased risk of COVID-19 due to their health and social circumstances, yet the extent to which they are affected and their predisposing risk factors are not clearly understood. We did a systematic review to assess clinical outcomes of COVID-19 in migrant populations, indirect health and social impacts, and to determine key risk factors.
METHODS
We did a systematic review following PRISMA guidelines (PROSPERO CRD42020222135). We searched multiple databases to 18/11/2020 for peer-reviewed and grey literature on migrants (foreign-born) and COVID-19 in 82 high-income countries. We used our international networks to source national datasets and grey literature. Data were extracted on primary outcomes (cases, hospitalisations, deaths) and we evaluated secondary outcomes on indirect health and social impacts and risk factors using narrative synthesis.
RESULTS
3016 data sources were screened with 158 from 15 countries included in the analysis (35 data sources for primary outcomes: cases [21], hospitalisations [4]; deaths [15]; 123 for secondary outcomes). We found that migrants are at increased risk of infection and are disproportionately represented among COVID-19 cases. Available datasets suggest a similarly disproportionate representation of migrants in reported COVID-19 deaths, as well as increased all-cause mortality in migrants in some countries in 2020. Undocumented migrants, migrant health and care workers, and migrants housed in camps have been especially affected. Migrants experience risk factors including high-risk occupations, overcrowded accommodation, and barriers to healthcare including inadequate information, language barriers, and reduced entitlement.
CONCLUSIONS
Migrants in high-income countries are at high risk of exposure to, and infection with, COVID-19. These data are of immediate relevance to national public health and policy responses to the pandemic. Robust data on testing uptake and clinical outcomes in migrants, and barriers and facilitators to COVID-19 vaccination, are urgently needed, alongside strengthening engagement with diverse migrant groups.
Migrants in high-income countries may be at increased risk of COVID-19 due to their health and social circumstances, yet the extent to which they are affected and their predisposing risk factors are not clearly understood. We did a systematic review to assess clinical outcomes of COVID-19 in migrant populations, indirect health and social impacts, and to determine key risk factors.
METHODS
We did a systematic review following PRISMA guidelines (PROSPERO CRD42020222135). We searched multiple databases to 18/11/2020 for peer-reviewed and grey literature on migrants (foreign-born) and COVID-19 in 82 high-income countries. We used our international networks to source national datasets and grey literature. Data were extracted on primary outcomes (cases, hospitalisations, deaths) and we evaluated secondary outcomes on indirect health and social impacts and risk factors using narrative synthesis.
RESULTS
3016 data sources were screened with 158 from 15 countries included in the analysis (35 data sources for primary outcomes: cases [21], hospitalisations [4]; deaths [15]; 123 for secondary outcomes). We found that migrants are at increased risk of infection and are disproportionately represented among COVID-19 cases. Available datasets suggest a similarly disproportionate representation of migrants in reported COVID-19 deaths, as well as increased all-cause mortality in migrants in some countries in 2020. Undocumented migrants, migrant health and care workers, and migrants housed in camps have been especially affected. Migrants experience risk factors including high-risk occupations, overcrowded accommodation, and barriers to healthcare including inadequate information, language barriers, and reduced entitlement.
CONCLUSIONS
Migrants in high-income countries are at high risk of exposure to, and infection with, COVID-19. These data are of immediate relevance to national public health and policy responses to the pandemic. Robust data on testing uptake and clinical outcomes in migrants, and barriers and facilitators to COVID-19 vaccination, are urgently needed, alongside strengthening engagement with diverse migrant groups.
Journal Article > CommentaryFull Text
Lancet. 2003 December 1; Volume 362; S30-S31.; DOI:10.1016/s0140-6736(03)15066-0
Hehenkamp A, Hargreaves S
Lancet. 2003 December 1; Volume 362; S30-S31.; DOI:10.1016/s0140-6736(03)15066-0
Journal Article > EditorialFull Text
BMJ. 2020 March 26; DOI:10.1136/bmj.m1213.
Hargreaves S, Kumar BN, McKee M, Jones LM, Veizis A
BMJ. 2020 March 26; DOI:10.1136/bmj.m1213.
Journal Article > Meta-AnalysisFull Text
Clin Infect Dis. 2016 January 6; Volume 62 (Issue 8); DOI:10.1093/cid/ciw001
Roberts TR, Cohn J, Bonner K, Hargreaves S
Clin Infect Dis. 2016 January 6; Volume 62 (Issue 8); DOI:10.1093/cid/ciw001
Despite immense progress in antiretroviral therapy (ART) scale-up, many people still lack access to basic standards of care, with our ability to meet the Joint United Nations Programme on HIV/AIDS 90-90-90 treatment targets for HIV/AIDS dependent on dramatic improvements in diagnostics. The World Health Organization recommends routine monitoring of ART effectiveness using viral load (VL) testing at 6 months and every 12 months, to monitor treatment adherence and minimize failure, and will publish its VL toolkit later this year. However, the cost and complexity of VL is preventing scale-up beyond developed countries and there is a lack of awareness among clinicians as to the long-term patient benefits and its role in prolonging the longevity of treatment programs. With developments in this diagnostic field rapidly evolving-including the recent improvements for accurately using dried blood spots and the imminent appearance to the market of point-of-care technologies offering decentralized diagnosis-we describe current barriers to VL testing in resource-limited settings. Effective scale-up can be achieved through health system and laboratory system strengthening and test price reductions, as well as tackling multiple programmatic and funding challenges.
Journal Article > CommentaryFull Text
Lancet. 2004 September 11; Volume 364 (Issue 9438); 1008.; DOI:10.1016/S0140-6736(04)17029-3
de Jong K, van der Kam S, Ford NP, Hargreaves S, van Oosten R, et al.
Lancet. 2004 September 11; Volume 364 (Issue 9438); 1008.; DOI:10.1016/S0140-6736(04)17029-3
Journal Article > Meta-AnalysisFull Text
PLOS One. 2012 August 30; Volume 7 (Issue 8); DOI:10.1371/journal.pone.0043953
Ford NP, Hargreaves S, Shanks L
PLOS One. 2012 August 30; Volume 7 (Issue 8); DOI:10.1371/journal.pone.0043953
Sepsis is one of the leading causes of childhood mortality, yet controversy surrounds the current treatment approach. We conducted a systematic review to assess the evidence base for fluid resuscitation in the treatment of children with shock due to sepsis or severe infection.
Journal Article > ReviewFull Text
J Travel Med. 2020 November 9; Volume 27 (Issue 7); DOI:10.1093/jtm/taaa113
Greenaway C, Hargreaves S, Barkati S, Coyle CM, Gobbi F, et al.
J Travel Med. 2020 November 9; Volume 27 (Issue 7); DOI:10.1093/jtm/taaa113
Journal Article > ResearchFull Text
Lancet. 2003 November 29; Volume 362 (Issue 9398); DOI:10.1016/S0140-6736(03)14918-5
Cox HS, Hargreaves S, Ismailov G
Lancet. 2003 November 29; Volume 362 (Issue 9398); DOI:10.1016/S0140-6736(03)14918-5
Journal Article > EditorialFull Text
BMJ. 2020 March 26; Volume 26 (Issue 368); m1213.; DOI:10.1136/bmj.m1213
Hargreaves S, Kumar BN, McKee M, Jones LM, Veizis A
BMJ. 2020 March 26; Volume 26 (Issue 368); m1213.; DOI:10.1136/bmj.m1213
Journal Article > ResearchFull Text
Antimicrob Resist Infect Control. 2018 September 20; Volume 7 (Issue 1); DOI:10.1186/s13756-018-0403-4
Abbas M, Aloudat T, Bartolomei J, Carballo M, Durieux-Paillard S, et al.
Antimicrob Resist Infect Control. 2018 September 20; Volume 7 (Issue 1); DOI:10.1186/s13756-018-0403-4
The 2015-2017 global migratory crisis saw unprecedented numbers of people on the move and tremendous diversity in terms of age, gender and medical requirements. This article focuses on key emerging public health issues around migrant populations and their interactions with host populations. Basic needs and rights of migrants and refugees are not always respected in regard to article 25 of the Universal Declaration of Human Rights and article 23 of the Refugee Convention. These are populations with varying degrees of vulnerability and needs in terms of protection, security, rights, and access to healthcare. Their health status, initially conditioned by the situation at the point of origin, is often jeopardised by adverse conditions along migratory paths and in intermediate and final destination countries. Due to their condition, forcibly displaced migrants and refugees face a triple burden of non-communicable diseases, infectious diseases, and mental health issues. There are specific challenges regarding chronic infectious and neglected tropical diseases, for which awareness in host countries is imperative. Health risks in terms of susceptibility to, and dissemination of, infectious diseases are not unidirectional. The response, including the humanitarian effort, whose aim is to guarantee access to basic needs (food, water and sanitation, healthcare), is gripped with numerous challenges. Evaluation of current policy shows insufficiency regarding the provision of basic needs to migrant populations, even in the countries that do the most. Governments around the world need to rise to the occasion and adopt policies that guarantee universal health coverage, for migrants and refugees, as well as host populations, in accordance with the UN Sustainable Development Goals. An expert consultation was carried out in the form of a pre-conference workshop during the 4th International Conference on Prevention and Infection Control (ICPIC) in Geneva, Switzerland, on 20 June 2017, the United Nations World Refugee Day.