Navigating healthcare pathways: Cascade of prevention and care for chronic viral hepatitis in asylum seekers and refugees. A multicenter analysis in Northern Italy
Viral hepatitis is a leading cause of mortality and a global public health challenge that, until recently, has been largely neglected as a health priority. This study describes the prevalence of viral hepatitis B and C in asylum seekers and refugees who participated in screening across three cities...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-01-01
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| Series: | Journal of Migration and Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666623525000066 |
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| author | Beatrice Formenti Roberto Benoni Jacopo Testa Giulia Bertoli Giacomo Stroffolini Maria Grazia Pizzi Barbara Menzaghi Niccolò Ronzoni Paola Magro Issa El Hamad Carla Scolari Angiola Spinetti Serena Zaltron Francesco Castelli Valentina Marchese Alberto Matteelli |
| author_facet | Beatrice Formenti Roberto Benoni Jacopo Testa Giulia Bertoli Giacomo Stroffolini Maria Grazia Pizzi Barbara Menzaghi Niccolò Ronzoni Paola Magro Issa El Hamad Carla Scolari Angiola Spinetti Serena Zaltron Francesco Castelli Valentina Marchese Alberto Matteelli |
| author_sort | Beatrice Formenti |
| collection | DOAJ |
| description | Viral hepatitis is a leading cause of mortality and a global public health challenge that, until recently, has been largely neglected as a health priority. This study describes the prevalence of viral hepatitis B and C in asylum seekers and refugees who participated in screening across three cities in Northern Italy. The analysis highlights significant pitfalls in linkage and retention in care, as well as factors associated with continuing or discontinuing the healthcare pathways, controlling for WHO Region of origin, gender, age and study site. Hospital records provided demographic and clinical data. Screening for HBV, HCV, and HIV was conducted, followed by clinical management and vaccination where appropriate. Multinomial logistic regression identified distinct care pathways. Of 1,514 participants, 80.2 % underwent screening, with 87.3 % testing negative for all infections. For those with chronic infections, 20.8 % missed their first infectious disease consultation, and only 39.3 % were retained in care after one year. Among the 591 individuals (55.8 % of the total) eligible for HBV vaccination, 10.0 % (59 out of 591) actually received the vaccine. Seven distinct care pathways were identified, where significant differences were observed based on the region of origin and the specific study site, highlighting the impact of local healthcare infrastructure and support systems. This study highlights the critical need for innovative, intersectoral and community-based approaches that are responsive to migrants' needs and perspectives. Key recommendations include enhancing linkage to care, improving followup strategies, and establishing a robust national and European network to ensure continuity of care and to integrate public health efforts across the entire care pathway and deliver fair and equitable healthcare.. |
| format | Article |
| id | doaj-art-b6dafbca3c9b410294b137f6f9164695 |
| institution | Kabale University |
| issn | 2666-6235 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Migration and Health |
| spelling | doaj-art-b6dafbca3c9b410294b137f6f91646952025-02-05T04:32:42ZengElsevierJournal of Migration and Health2666-62352025-01-0111100307Navigating healthcare pathways: Cascade of prevention and care for chronic viral hepatitis in asylum seekers and refugees. A multicenter analysis in Northern ItalyBeatrice Formenti0Roberto Benoni1Jacopo Testa2Giulia Bertoli3Giacomo Stroffolini4Maria Grazia Pizzi5Barbara Menzaghi6Niccolò Ronzoni7Paola Magro8Issa El Hamad9Carla Scolari10Angiola Spinetti11Serena Zaltron12Francesco Castelli13Valentina Marchese14Alberto Matteelli15Division of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy; UNESCO Chair in Training and Empowering Human Resources for Health Development in Resource-Limited Countries, University of Brescia, Brescia, Italy; Italian Society of Migration Medicine (Società Italiana di Medicina delle Migrazioni - SIMM); Corresponding author at: Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy.Italian Society of Migration Medicine (Società Italiana di Medicina delle Migrazioni - SIMM); Public Health and Infectious Diseases Department, Sapienza University of Rome, Italy; National Center for Global Health, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, ItalyItalian Society of Migration Medicine (Società Italiana di Medicina delle Migrazioni - SIMM); Infectious Diseases Unit, ASST Valle Olona, Busto Arsizio Hospital, Busto Arsizio, ItalyDepartment of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, ItalyDepartment of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, ItalyInfectious Diseases Unit, ASST Valle Olona, Busto Arsizio Hospital, Busto Arsizio, ItalyInfectious Diseases Unit, ASST Valle Olona, Busto Arsizio Hospital, Busto Arsizio, ItalyDepartment of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, ItalyMigrants Clinic, Sexually Transmitted Infections Center, ASST Spedali Civili di Brescia, Brescia, ItalyDivision of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili Hospital, Brescia, ItalyMigrants Clinic, Sexually Transmitted Infections Center, ASST Spedali Civili di Brescia, Brescia, ItalyDivision of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili Hospital, Brescia, ItalyDivision of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili Hospital, Brescia, ItalyDivision of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy; UNESCO Chair in Training and Empowering Human Resources for Health Development in Resource-Limited Countries, University of Brescia, Brescia, Italy; Italian Society of Migration Medicine (Società Italiana di Medicina delle Migrazioni - SIMM)Division of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy; Italian Society of Migration Medicine (Società Italiana di Medicina delle Migrazioni - SIMM); Research Group Implementation Research, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, GermanyDivision of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili Hospital, Brescia, ItalyViral hepatitis is a leading cause of mortality and a global public health challenge that, until recently, has been largely neglected as a health priority. This study describes the prevalence of viral hepatitis B and C in asylum seekers and refugees who participated in screening across three cities in Northern Italy. The analysis highlights significant pitfalls in linkage and retention in care, as well as factors associated with continuing or discontinuing the healthcare pathways, controlling for WHO Region of origin, gender, age and study site. Hospital records provided demographic and clinical data. Screening for HBV, HCV, and HIV was conducted, followed by clinical management and vaccination where appropriate. Multinomial logistic regression identified distinct care pathways. Of 1,514 participants, 80.2 % underwent screening, with 87.3 % testing negative for all infections. For those with chronic infections, 20.8 % missed their first infectious disease consultation, and only 39.3 % were retained in care after one year. Among the 591 individuals (55.8 % of the total) eligible for HBV vaccination, 10.0 % (59 out of 591) actually received the vaccine. Seven distinct care pathways were identified, where significant differences were observed based on the region of origin and the specific study site, highlighting the impact of local healthcare infrastructure and support systems. This study highlights the critical need for innovative, intersectoral and community-based approaches that are responsive to migrants' needs and perspectives. Key recommendations include enhancing linkage to care, improving followup strategies, and establishing a robust national and European network to ensure continuity of care and to integrate public health efforts across the entire care pathway and deliver fair and equitable healthcare..http://www.sciencedirect.com/science/article/pii/S2666623525000066Chronic viral infectionViral HepatitisMigrationPublic HealthCascade of careMigrants' health |
| spellingShingle | Beatrice Formenti Roberto Benoni Jacopo Testa Giulia Bertoli Giacomo Stroffolini Maria Grazia Pizzi Barbara Menzaghi Niccolò Ronzoni Paola Magro Issa El Hamad Carla Scolari Angiola Spinetti Serena Zaltron Francesco Castelli Valentina Marchese Alberto Matteelli Navigating healthcare pathways: Cascade of prevention and care for chronic viral hepatitis in asylum seekers and refugees. A multicenter analysis in Northern Italy Journal of Migration and Health Chronic viral infection Viral Hepatitis Migration Public Health Cascade of care Migrants' health |
| title | Navigating healthcare pathways: Cascade of prevention and care for chronic viral hepatitis in asylum seekers and refugees. A multicenter analysis in Northern Italy |
| title_full | Navigating healthcare pathways: Cascade of prevention and care for chronic viral hepatitis in asylum seekers and refugees. A multicenter analysis in Northern Italy |
| title_fullStr | Navigating healthcare pathways: Cascade of prevention and care for chronic viral hepatitis in asylum seekers and refugees. A multicenter analysis in Northern Italy |
| title_full_unstemmed | Navigating healthcare pathways: Cascade of prevention and care for chronic viral hepatitis in asylum seekers and refugees. A multicenter analysis in Northern Italy |
| title_short | Navigating healthcare pathways: Cascade of prevention and care for chronic viral hepatitis in asylum seekers and refugees. A multicenter analysis in Northern Italy |
| title_sort | navigating healthcare pathways cascade of prevention and care for chronic viral hepatitis in asylum seekers and refugees a multicenter analysis in northern italy |
| topic | Chronic viral infection Viral Hepatitis Migration Public Health Cascade of care Migrants' health |
| url | http://www.sciencedirect.com/science/article/pii/S2666623525000066 |
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