Effect of Infodemic Regarding the Illegal Sale of Medications on the Internet: Evaluation of Demand and Online Availability of Ivermectin during the COVID-19 Pandemic.

The COVID-19 pandemic and the related infodemic generated confusion and increased demand of various pharmaceuticals, ushering in the opportunity for illicit online vendors to fill a gap in the marketplace using potentially dangerous products. The aim of our study is to provide evidence regarding increased demand, online availability and consumer accessibility of ivermectin, an anthelmintic agent, without substantiated indications in reference to SARS-CoV-2. In our study, we combined infodemiology methodology aligned with search engine result assessment and website analytics to evaluate patient safety risks. Users' Google queries regarding ivermectin were trending and peaked during the last week of November 2020 and March 2021. Consumers more likely found links leading directly or indirectly (via redirection) to illegal online retailers representing nearly half (53.3%) of search engine result links regarding the first three result pages in December 2020 and topped off at 73.3% by March 2021. Illicit medicine retailers outnumbered and outranked their legitimate counterparts and dominated the first search engine results page. A vast majority (77.7%) of the identified online pharmacies were characteristically rogue; more than half (55.5%) offered prescription-only products without a valid medical prescription. Our results illustrate connection between infodemic and its consequences on the illicit online pharmacy market.

Strengthening Country Readiness for Pandemic-Related Mass Movement: Policy Lessons Learned.

The COVID-19 pandemic has thus far restricted the large movement of people; nonetheless, we cannot exclude the disruptive power of a virus with similar characteristics to COVID-19 affecting both high- and low-income countries, as a factor for future mass migrations. Indeed, the top 15 countries affected by COVID-19 host about 9 million refugees, and it is, therefore, important to investigate and strengthen the readiness of countries' health policies to ensure they are well equipped to deal with potential large influxes of 'epidemic-related refugees and migrants.' Using the Bardach Policy Framework as a tool for analysis, this article investigates the readiness of countries for a potential public health event (mass migration generated by future pandemics), therefore, aiming at a health response forecasting exercise. The article reviews the policies put in place by countries who faced large influxes of migrants between 2011 and 2015 (the policy-prolific years between the Arab Spring migration and the introduction of stringent measures in Europe) and new evidence generated in response to the COVID-19 pandemic (including the 'ECDC Guidance on infection prevention and control of COVID-19 in migrant and refugee reception and detention centres in the EU/EEA and the UK' and the 'WHO Lancet priority for dealing with migration and COVID-19') to formulate a policy option able to strengthen national system capacities for responding to influxes of epidemic-related migrants and the management of highly infectious diseases.

Improving asylum seekers' health awareness in a Hungarian refugee reception centre.

Due to its long border of the European Union Schengen Area, Hungary has long been affected by the rapidly growing inward migration towards the EU, which has become more acute in recent years. Inadequate access to healthcare among migrants has been widely reported and this may be due to a vast array of factors and may result in poorer health outcomes. Between August 2014 and April 2015 a questionnaire survey was conducted among migrants from a range of countries residing in the largest Hungarian refugee reception centre to establish participants' health knowledge and access to healthcare in Hungary (medical assessment, vaccination, etc.). The survey was complemented with an educational program which aimed to increase participants' awareness of healthcare provision and to promote the prevention of the infectious diseases that are common in Europe. The results showed that half the participants (52%) had no information of healthcare provision and the majority (61%) did not participate in any medical assessment since arriving in the reception centre. Since under-immunization may be a potential risk for the re-emergence of vaccine-preventable diseases for recipient countries, it was alarming that a significant proportion of African participants (21%) reported not having received any childhood vaccinations. Data demonstrated deficiencies in participants' health knowledge and also an urgent need to address mental health problems of arriving migrants. This article offers a valuable insight into the role of health educational interventions conducted for asylum seekers in refugee reception centres and discusses a number of practical application aspects for future educational programs.

[Primary care of refugees and migrants. Lesson learnt from the EUR-HUMAN project]. / Menekültek, migránsok az alapellátásban. Mit tanulhattunk az EUR-HUMAN projekt eredményeibol?

In 2015, local wars, starvation and misery in some Middle Eastern, Asian and African countries forced millions of people to leave their homelands. Many of these people migrated toward Europe, reaching Hungary as well. The refugee crisis created significant challenges for all national healthcare systems across Europe. Limited attention has been given to the extent to which health service provision for refugees and migrants has become a task for primary health care (PHC), which has been unprepared as a profession and pressured by the enormous workload. Hungarian primary care was involved only to an extent in the refugees' health care, as most of the migrants entering Hungary wanted to move forward to other countries. The need for evidence-based patient-centred interventions to assess refugee healthcare needs, and for training programmes for rapid capacity-building for integrated PHC was addressed by the EUropean Refugees - HUman Movement and Advisory Network (EUR-HUMAN) project, which 7 European countries developed together. The overall aim of the EUR-HUMAN project is to enhance the knowledge and expertise of European member states who accept refugees and migrants in addressing their health needs, safeguarding them from risks, while at the same time to minimize cross-border health risks. This initiative focuses on addressing the early arrival period, transition and longer-term settlement of refugees in European host countries. A primary objective of this project is to identify, design and assess interventions to improve PHC delivery for refugees and migrants with a focus on vulnerable groups. The structure, the main focus and outputs of the project are described and summarized in this paper, providing relevant information and access to educational materials for Hungarian (primary care) physicians. The EUR-HUMAN project was operated in 2016 under the auspices of the European Commission and funded by the Consumers, Health, Agriculture and Food Executive Agency (CHAFEA). Orv Hetil. 2018; 159(35): 1414-1422.

Perception of Occupational Risks and Practices of Self-protection from Infectious Diseases Among Workers in Contact with International Migrants at Hungary's Border.

OBJECTIVE: The purpose of the present study was to investigate employees' self-assessments of their occupational risks and health awareness as well as their perception of preventive methods. We also aimed to collect data on employees' perception of some selected alarming signs and symptoms that may encourage them to take further actions (such as separation and calling an ambulance). PARTICIPANTS AND METHODS: Between April and June 2013, an anonymous questionnaire survey was conducted with the participation of 70 employees working with migrants (both health-care and non-health-care staff) in 10 Hungarian settlements: 4 border crossing points along the eastern Schengen borderline, 3 asylum detention centers and 3 reception centers. RESULTS: Our results demonstrated an increased perception of certain biological and mental health hazards at work among those working with migrants: 63.7% of the health-care workers and even 37.3% of the non-health-care staff come into contact with human secretions (feces, urine, saliva) "frequently" or "sometimes". Self-assessed awareness of the signs and symptoms of infectious diseases was poor: only 12.8% of participants evaluated their awareness as "good" or "very good". Threat of verbal violence may be considered a common mental risk at work for participants: 35% "sometimes" or "frequently" and 5% "always" face verbal violence during their work. The most commonly used preventive measures against infectious diseases included the use of gloves, masks and disinfectants; these were generally available to 70 to 80% of the workers and properly applied. CONCLUSIONS: Our results indicate considerable deficiencies in the participants' preparedness in respect to their occupational health-related issues. Since it is essential for those having daily physical contact with migrants during their work to be properly informed about the occupational health hazards and consequences that may be associated with international migration, their training programs urgently require further development. More comprehensive knowledge may improve the preventive attitudes of employees, and conscious application of preventive measures may contribute to better public and occupation health safety.