Active Infections Uncommon Among Migrants to the U.S.

Latent tuberculosis was the most common diagnosis among 7792 migrants who were screened at GeoSentinel clinics in Boston and Minnesota; active infections were uncommon.

Knowledge of migrants' health conditions can be helpful for clinicians and public health officials, as well as for policymakers. Toward this end, researchers analyzed data from migrants who underwent screening at two GeoSentinel clinics in the U.S. — one in Massachusetts and one in Minnesota — from March 1997 through November 2009. Among these 7792 migrants, >80% were refugees and 60% were from Myanmar, Somalia, Bosnia-Herzegovina, Haiti, or Liberia.

The most common health-related conditions were latent tuberculosis (TB; 43%), dental caries (32%), eosinophilia (15%), and anemia (11%). Giardiasis was seen in 7%, hepatitis B virus infection in 6%, and strongyloidiasis and amebiasis each in 2%. Diseases diagnosed in ≤1% included HIV/AIDS, active TB, schistosomiasis, filariasis, and syphilis. Health conditions varied by country of origin. For example, latent TB was diagnosed in ≥50% of migrants from the Caribbean, Eastern Europe, and West Africa but in only 27% of those from Southeast Asia. On the other hand, eosinophilia — a possible marker for helminthic diseases — was seen in 29% of migrants from Southeast Asia but in only 3% of those from Eastern Europe.

Comment

Only two clinics were sampled, and the findings with regard to country of origin and underlying diseases may be different in migrants arriving in other regions of the U.S. As the authors note, predeparture screening seems to have resulted in a low number of active infections. However, the prevalence of latent disease, particularly TB, was relatively high.

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Citation(s):

Barnett ED et al. Spectrum of illness in international migrants seen at GeoSentinel clinics in 1997–2009, Part 1: US-bound migrants evaluated by comprehensive protocol-based health assessment. Clin Infect Dis 2013 Apr 1; 56:913. (http://dx.doi.org/10.1093/cid/cis1015)