[Barriers and facilitators to access to healthcare among asylum seekers from Eritrea and Afghanistan in the canton of Vaud, Switzerland]. / Facilitateurs et barrières pour l'accès aux soins chez les requérants d'asile du canton de Vaud en Suisse et recommandations.

Introduction : In the context of an upsurge in the number of asylum seekers arriving in Switzerland in 2015, caregivers encountered new issues.Background : We lack local studies that simultaneously analyze asylum seekers' experiences of the healthcare system and the perceptions of health professionals in contact with asylum seekers.Objectives : To assess the health problems of this population in order to gain a better understanding of their specific needs and to implement best practice interventions in order to improve access to care and efficiency of care.Methods : A qualitative study with twenty interviews, either one-to-one or in groups, with Eritrean and Afghan ASs, and three focus groups with registered nurses, interpreters, and emergency department professionals.Results : The main results concern access to healthcare in the country of origin, expectations about the living conditions in Switzerland, the effects of migration on health, cultural beliefs on physical health and psychiatry, visits to the emergency department, reasons for missed appointments, and peer support.Discussion : Information, trust, and time are the main issues identified to optimize access to care.Conclusion : Our results allow for a better understanding of specific needs and health interventions for Afghan and Eritrean ASs. Recommendations for practice were issued.

Migration in patients with early psychosis: A 3-year prospective follow-up study.

Early psychosis programs treat high ratios of migrants, given they display higher rates of psychosis. Studies on this topic are limited and less is known about outcomes. The aim of this study was to compare the premorbid, baseline and outcome profile of patients according to migration (M) and migration in psychosocial adversity (MA) in order to explore if there were differences suggesting particular needs in terms of treatment. 257 early psychosis patients aged 18-35 years old were followed-up over 36 months. MA (29.6%) and M (17.9%) were compared to patients who were born in Switzerland (NM). At entry to the program, MA patients had poorer functional levels and higher symptom intensity. MA patients were more likely to report past exposure to trauma. While M patients have similar outcome compared to NM patients, MA patients were less likely to reach symptom remission, displayed lower functioning and were more likely to relapse. Results suggests that migration in adversity is a potential determinant of functional impairment in early psychosis. While patients who migrated in other contexts have a better outcome, patients who experienced migration in adversity have specific needs considering they are less integrated and more likely to have been exposed to trauma.

[European migrant crisis and reemergence of infections in Switzerland]. / Crise migratoire et résurgence d'infections en Suisse.

Current conflicts in some regions of the world give rise to massive immigration waves. Consequently, some infections that had nearly disappeared in Europe nowadays re-emerge. They are related to the epidemiology of the refugees' origin, but also to the epidemiology of the country crossed during migration. Hygiene conditions, often precarious during the journey, favor their transmission. Thus, cases of louse borne relapsing fever and diphtheria emerge in Europe and in Switzerland since 2074 whereas cutaneous Panton-Valen tine Staphylococcus aureus infection are more commonly observed nowadays.