High HIV Prevalence among Asylum Seekers Who Gave Birth in the Netherlands: A Nationwide Study Based on Antenatal HIV Tests

Goosen, Simone; Hoebe, Christian J. P. A.; Waldhober, Q.; Kunst, Anton E.

doi:10.1371/journal.pone.0134724

Cited by 19 publications

(25 citation statements)

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“…In one of these studies, mother-to-child transmission rate of HIV was 9.8% among AS in The Netherlands ( n = 80 births to HIV-positive asylum seeking women). All children who were HIV-positive at birth were born before the implementation of universal HIV screening in 2004 31 …”

Section: Resultsmentioning

confidence: 99%

Maternal and perinatal outcomes of asylum seekers and undocumented migrants in Europe: a systematic review

Gieles

Tankink

Midde

et al. 2019

European Journal of Public Health

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Background Asylum seekers (AS) and undocumented migrants (UM) are at risk of adverse pregnancy outcomes due to adverse health determinants and compromised maternal healthcare access and service quality. Considering recent migratory patterns and the absence of a robust overview, a systematic review was conducted on maternal and perinatal outcomes in AS and UM in Europe. Methods Systematic literature searches were performed in MEDLINE and EMBASE (until 1 May 2017), complemented by a grey literature search (until 1 June 2017). Primary research articles reporting on any maternal or perinatal outcome, published between 2007 and 2017 in English/Dutch were eligible for inclusion. Review protocols were registered on Prospero: CRD42017062375 and CRD42017062477. Due to heterogeneity in study populations and outcomes, results were synthesized narratively. Results Of 4652 peer-reviewed articles and 145 grey literature sources screened, 11 were included from 4 European countries. Several studies reported adverse outcomes including higher maternal mortality (AS), severe acute maternal morbidity (AS), preterm birth (UM) and low birthweight (UM). Risk of bias was generally acceptable, although the limited number and quality of some studies preclude definite conclusions. Conclusion Limited evidence is available on pregnancy outcomes in AS and UM in Europe. The adverse outcomes reported imply that removing barriers to high-quality maternal care should be a priority. More research focussing on migrant subpopulations, considering potential risk factors such as ethnicity and legal status, is needed to guide policy and optimize care.

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Section: Resultsmentioning

confidence: 99%

Maternal and perinatal outcomes of asylum seekers and undocumented migrants in Europe: a systematic review

Gieles

Tankink

Midde

et al. 2019

European Journal of Public Health

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“…28 29 The high HIV prevalence among pregnant asylum seekers from sub-Saharan Africa underlines the importance of offering all newly arriving asylum seekers from high prevalence areas a voluntary HIV test. 30 Women in the Netherlands may have benefited from antenatal screening, in which HIV is routinely tested, 31 since the odds of late presentation for women were comparable to MSM.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with presenting late or with advanced HIV disease in the Netherlands, 1996–2014: results from a national observational cohort

et al. 2016

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ObjectivesEarly testing for HIV and entry into care are crucial to optimise treatment outcomes of HIV-infected patients and to prevent spread of HIV. We examined risk factors for presentation with late or advanced disease in HIV-infected patients in the Netherlands.MethodsHIV-infected patients registered in care between January 1996 and June 2014 were selected from the ATHENA national observational HIV cohort. Risk factors for late presentation and advanced disease were analysed by multivariable logistic regression. Furthermore, geographical differences and time trends were examined.ResultsOf 20 965 patients, 53% presented with late-stage HIV infection, and 35% had advanced disease. Late presentation decreased from 62% (1996) to 42% (2013), while advanced disease decreased from 46% to 26%. Late presentation only declined significantly among men having sex with men (MSM; p <0.001), but not among heterosexual males (p=0.08) and females (p=0.73). Factors associated with late presentation were: heterosexual male (adjusted OR (aOR), 1.59; 95% CI 1.44 to 1.75 vs MSM), injecting drug use (2.00; CI 1.69 to 2.38), age ≥50 years (1.46; CI 1.33 to 1.60 vs 30–49 years), region of origin (South-East Asia 2.14; 1.80 to 2.54, sub-Saharan Africa 2.11; 1.88 to 2.36, Surinam 1.59; 1.37 to 1.84, Caribbean 1.31; 1.13 to 1.53, Latin America 1.23; 1.04 to 1.46 vs the Netherlands), and location of HIV diagnosis (hospital 3.27; 2.94 to 3.63, general practitioner 1.66; 1.50 to 1.83, antenatal screening 1.76; 1.38 to 2.34 vs sexually transmitted infection clinic). No association was found for socioeconomic status or level of urbanisation. Compared with Amsterdam, 2 regions had higher adjusted odds and 2 regions had lower odds of late presentation. Results were highly similar for advanced disease.ConclusionsAlthough the overall rate of late presentation is declining in the Netherlands, targeted programmes to reduce late HIV diagnoses remain needed for all risk groups, but should be prioritised for heterosexual males, migrant populations, people aged ≥50 years and certain regions in the Netherlands.

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“…Among African pregnant women, the prevalence rate was 3.4% compared with 0.04% in women from other regions. Women arriving without a partner and unaccompanied minors had higher HIV prevalence rates 12…”

Section: Health Concerns In Refugee Childrenmentioning

confidence: 99%

Health needs of refugee children identified on arrival in reception countries: a systematic review and meta-analysis

Baauw

Holthe²,

Slattery

et al. 2019

bmjpo

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BackgroundThe worldwide number of refugees has considerably increased due to ongoing wars, national instability, political persecution and food insecurity. In Europe, about one-third of all refugees are children, an increasing number of which are travelling alone. There are often no systematic medical health assessments for these refugee children on entry in reception countries despite the fact that they are recognised as an at-risk population due to increased burden of physical and mental health conditions. We aimed to perform a systematic review of the literature to describe the health status of refugee children on entering reception countries.MethodsA systematic search of published literature was conducted using the terms refugee, immigrant or migrant, medical or health, and screening.ResultsOf the 3487 potentially relevant papers, 53 population-based studies were included in this review. This systematic review showed that refugee children exhibit high estimated prevalence rates for anaemia (14%), haemoglobinopathies (4%), chronic hepatitis B (3%), latent tuberculosis infection (11%) and vitamin D deficiency (45%) on entry in reception countries. Approximately one-third of refugee children had intestinal infection. Nutritional problems ranged from wasting and stunting to obesity.ConclusionsRefugee children entering reception countries should receive comprehensive health assessments based on the outcomes of this systematic review, national budgets, cost-effectiveness and personal factors of the refugees. The health assessment should be tailored to individual child health needs depending on preflight, flight and postarrival conditions.A paradigm shift that places focus on child health and development will help this vulnerable group of children integrate into their new environments.PROSPEROregistrationnumber122561.

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High HIV Prevalence among Asylum Seekers Who Gave Birth in the Netherlands: A Nationwide Study Based on Antenatal HIV Tests

Cited by 19 publications

References 25 publications

Maternal and perinatal outcomes of asylum seekers and undocumented migrants in Europe: a systematic review

Maternal and perinatal outcomes of asylum seekers and undocumented migrants in Europe: a systematic review

Factors associated with presenting late or with advanced HIV disease in the Netherlands, 1996–2014: results from a national observational cohort

Health needs of refugee children identified on arrival in reception countries: a systematic review and meta-analysis

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