Health status assessment of a population of asylum seekers in Northern Italy.

BACKGROUND: Since 2011 Italy has faced an extraordinary increase in migrants arrivals, mainly from the Mediterranean route, one of the world's most dangerous journeys. The purpose of the present article is to provide a comprehensive picture of the migrants' health status in the "T. Fenoglio" centre, Settimo Torinese (Turin, Italy). METHODS: A retrospective cross-sectional study was conducted using data collected from June 2016 to May 2018 on adult migrants (over 18 years old) from Africa, Middle East and South East Asia (Bangladesh, Cambodia, India, Nepal). Data was collected through the migrants' medical records. Descriptive statistics were performed on socio-demographic variables. The diagnosed diseases were anonymously registered and classified according to the International Classification of Primary Care (ICPC-2). Conditional Inference Trees were used to perform a descriptive analysis of the sample and to detect the covariates with the strongest association with the variables Disease on arrival, Disease after arrival, ICPC on arrival and ICPC after arrival. RESULTS: Analyzed observations were 9 857. 81.8% were men, median age was 23 (Interquartile range: 20.0-27.4). 70.3% of the sample came from Sub-Saharan Africa. 2 365 individuals (24%) arrived at the centre with at least one disease. On arrival, skin (27.71%), respiratory (14.46%), digestive (14.73%) and generic diseases (20.88%) were the most frequent. During the stay respiratory diseases were the most common (25.70%). The highest probability of arriving with a disease occurred in 2018 and during the period September-November 2016, in particular for people from the Horn of Africa. During this period and also in the first half of 2017, skin diseases were the most reported. In seasons with lower prevalence of diseases on arrival the most common disease code was generic for both men and women (usually fever or trauma). CONCLUSIONS: This study provides information on the diverse diseases that affect the asylum seekers population. In our sample, the Horn of Africa was the most troubled area of arrival, with severe conditions frequently reported regarding skin diseases, in particular scabies. 2018 was the most critical year, especially for migrants from the Horn of Africa and Sub-Saharan Africa. During the stay at the camp, the prevalence of respiratory diseases increased. However, skin diseases remained the main issue for people from the Horn of Africa. Overall, the most reported diseases in the sample were dermatological, respiratory, digestive and generic diseases, both on arrival and during the stay. A better understanding of the health status of asylum seekers is an important factor to determine a more efficient reception and integration process and a better allocation of economic resources in the context of migrants' health care.

"Journey of hope": a study on sexual gender-based violence reported by asylum-seeking women during their journey to Europe.

OBJECTIVES: to describe sexual gender-based violence (SGBV) reported by asylum-seeking women during their journey from their country of origin to Italy, using data obtained from medical record of asylum seekers hosted between June 2016 and December 2017 at the "T. Fenoglio" Red Cross Reception Centre, one of the largest Italian regional hubs; to evaluate if, based on these data, it is possible to hypothesize an underreporting of SGBV from these women. DESIGN: cross-sectional study. SETTING AND PARTICIPANTS: 2,484 asylum-seeking females hosted in the centre for initial-reception of Piedmont and Valle d'Aosta regions (Northern Italy) between June 2016 and December 2017. MAIN OUTCOME MEASURES: prevalence of SGBV. RESULTS: among the women arrived at the centre, 46 reported being victim of SGBV during their journey to Italy (prevalence: 1.85%; 95%CI 1.39-2.46), 37 of which with reliable and verified data supported by health certification documentation (prevalence: 1.49%; 95%CI 1.08-2.05). Women who suffered SGBV have a higher prevalence of diseases than their counterpart (more blood, digestive, neurological, psychological, genital diseases, and AIDS), are more frequently pregnant, and asked more frequently for a voluntary interruption of pregnancy. CONCLUSIONS: the low prevalence of SGBV identified suggests that underreporting and under-recognition of the phenomenon are possible. This highlights the need to offer a psychological support to all migrant women at their arrival in the Italian hubs, also when they do not report violence.

[Prevalence of acid burns among asylum seekers hosted in an initial reception centre as an example of health assessment in a fragile population]. / La prevalenza di causticazioni in un centro di prima accoglienza per richiedenti asilo come esempio di valutazione sanitaria in una popolazione fragile.

OBJECTIVES: to evaluate the prevalence of acid burns among asylum seekers hosted in an initial reception centre and to evaluate if the prevalence is reduced after the introduction of the European Union (EU) regulation No. 29 (14th September 2016) that indirectly reduced the permanence time of the subjects on board of boats. DESIGN: cross-sectional study. SETTING AND PARTICIPANTS: 10,627 asylum seekers hosted in the centre for initial reception of Piedmont and Valle d'Aosta Regions (Northern Italy) between June 2016 and May 2017. MAIN OUTCOME MEASURES: frequencies of health problems and prevalence of second and third grade acid burns identified on arrival. RESULTS: among the asylum seekers coming to the centre, about 25% suffered at least from a mild disease, mainly cutaneous, respiratory, or digestive; 69 acid burns were identified (prevalence: 6.7‰, 95%CI 5.2-8.3), mainly located in the lower limbs and in the glutes. Median time between disembarkation and treatment is 2 days. Prevalence is significantly higher in women compared to men and a not-significant 20% reduction was observed comparing the situation before and after the introduction of the EU regulation No. 29. CONCLUSION: an assessment of the health status of asylum seekers that takes into account more than the identification of the rare life-threatening or infective diseases allows to take prompt action and to invest economical resources in the fields where they are more useful. This would facilitate a good health care for asylum seekers, that is the basis of an efficient functioning of services for integration.