Pulmonary Diseases in Refugees and Migrants in Europe

Abstract

More than 2 million people fleeing conflict, persecution, and poverty applied for asylum between 2015 and 2016 in the European Union. Due to this, medical practitioners in recipient countries may be facing a broader spectrum of conditions and unusual presentations not previously encountered, including a wide range of infections with pulmonary involvement. Tuberculosis is known to be more common in migrants and has been covered broadly in other publications. The scope of this review was to provide an overview of exotic infections with pulmonary involvement that could be encountered in refugees and migrants and to briefly describe their epidemiology, diagnosis, and management. As refugees and migrants travel from numerous countries and continents, it is important to be aware of the various organisms that might cause disease according to the country of origin. Some of these diseases are very rare and geographically restricted to certain regions, while others have a more cosmopolitan distribution. Also, the spectrum of severity of these infections can vary from very benign to severe and even life-threatening. We will also describe infectious and noninfectious complications that can be associated with HIV infection as some migrants might originate from high HIV prevalence countries in sub-Saharan Africa. As the diagnosis and treatment of these diseases can be challenging in certain situations, patients with suspected infection might require referral to specialized centers with experience in their management. Additionally, a brief description of noncommunicable pulmonary diseases will be provided.

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

“…In fact, migrants are vulnerable to antimicrobial resistance, susceptible to influenza for low levels of vaccination, and subject to different pulmonary infections and parasitic diseases such as strongyloidiasis and paragonimiasis. Prevalence in migrants often refers to the endemic situation in countries of origin [33].…”

“…Finally, for all areas of origin, very low rates in mental illness and psychological distress were observed, despite these being considered a major problem for asylum seekers and migrants in general [10,33,35]. Nevertheless, different studies showed a struggle in treating these conditions and an inadequate utilisation of care structures.…”

The Burden of COPD Due to Ozone Exposure in Germany

“…Although this is a common approach to estimate exposure, it is a greatly simplified method, especially because the length of stay differs between people. Furthermore, there is potential for misclassification of exposure because movements of people in and out of an area are not or only incompletely taken into account; this applies especially to migrants where the COPD rate can be particularly high as the result of the situation in their home countries (28).…”

New Insights on Acute and Chronic Schistosomiasis: Do We Need a Redefinition?

“…First, the proportion of patients with CS diagnosed with pulmonary nodules in this cohort was much higher than previously described in the literature, namely six of the 120 (5%) CS cases diagnosed over a period of 18 months, compared with 18 cases overall reported in the literature since the 1960s [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. These results were so unexpected that some other authors defined it as 'a new clinical entity' related to CS [33]. Worthy of note, another four cases of pulmonary nodules in CS were afterwards detected in the same center [34]; moreover, a case series of 17 cases [35] and other single cases were reported [36][37][38].…”