Are immigrants living in France more reluctant to receive vaccines than native-born French citizens? findings from the national health Barometer study

BackgroundFrance is one of the world's most vaccine hesitant countries and vaccine hesitancy (VH) is considered one of the world's leading threats to global health. However, little is known about VH in immigrant populations in France. Using data from the 2016 Health Barometer, we examined VH among newcomers, more established immigrants, and the native-born population in France.MethodsData was collected from French speaking individuals aged from 15 to 75 years old, residing in France. Individuals were selected through randomly generated landline and mobile phone numbers. Vaccine hesitancy was assessed through four questions and a “time spent in France” variable was created, using the year of arrival in France. Associations were studied using logistic regression.ResultsA sample of 15,216 participants residing in France included 1,524 foreign-born immigrants and 13,692 native-born individuals, with a mean age of 46-years. Most participants (75.7%) reported being favorable to vaccination regardless of country of origin but immigrants were less hesitant toward vaccinations than the host population. Foreign-born immigrants from North Africa had the most favorable views whereas those from sub-Saharan Africa held most unfavorable views on vaccination. With time spent in France, the opinions towards vaccination became more negative (aOR = 0.57, 95 %CI [0.40–0.79], p = 0.001) and the risk of vaccine refusal (aOR = 2.34, 95 %CI [1.45 – 3.78] p = 0.001) and reluctant acceptance of vaccines increased (aOR = 1.89 95 %CI [1.20 – 2.99], p = 0.006).Foreign-born individuals with the longest residency in France had more negative opinions than native-born individuals, regardless of region of origin.ConclusionImmigrants were less hesitant toward vaccinations than the host population, but vaccine hesitancy increased with time spent in France. The provision of appropriate information and awareness to facilitate critical thinking towards antivaccine theories is necessary for immigrants in France.     

Immunisation of migrants in EU/EEA countries: Policies and practices

In recent years various EU/EEA countries have experienced an influx of migrants from low and middle-income countries. In 2018, the “Vaccine European New Integrated Collaboration Effort (VENICE)” survey group conducted a survey among 30 EU/EEA countries to investigate immunisation policies and practices targeting irregular migrants, refugees and asylum seekers (later called “migrants” in this report). Twenty-nine countries participated in the survey. Twenty-eight countries reported having national policies targeting children/adolescent and adult migrants, however vaccinations offered to adult migrants are limited to specific conditions in seven countries. All the vaccinations included in the National Immunisation Programme (NIP) are offered to children/adolescents in 27/28 countries and to adults in 13/28 countries. In the 15 countries offering only certain vaccinations to adults, priority is given to diphtheria-tetanus, measles-mumps-rubella and polio vaccinations. Information about the vaccines given to child/adolescent migrants is recorded in 22 countries and to adult migrants in 19 countries with a large variation in recording methods found across countries. Individual and aggregated data are reportedly not shared with other centres/institutions in 13 and 15 countries, respectively. Twenty countries reported not collecting data on vaccination uptake among migrants; only three countries have these data at the national level. Procedures to guarantee migrants’ access to vaccinations at the community level are available in 13 countries. In conclusion, although diversified, strategies for migrant vaccination are in place in all countries except for one, and the strategies are generally in line with international recommendations. Efforts are needed to strengthen partnerships and implement initiatives across countries of origin, transit and destination to develop and better share documentation in order to guarantee a completion of vaccination series and to avoid unnecessary re-vaccination. Development of migrant-friendly strategies to facilitate migrants' access to vaccination and collection of vaccination uptake data among migrants is needed to meet existing gaps.     

Utility of the Tétanos Quick Stick® in the vaccine catch-up of adult migrants without proof of prior vaccination

BackgroundUnknowing immunity status make migrants vaccine catch-up difficult. The interest of using a rapid tetanus immunotest as the Tétanos Quick Stick® (TQS®) to assess immunity status against tetanus has been evaluated in emergency rooms and it is now commonly used. The study aim was to evaluate TQS® as a tool for migrants’ vaccine catch-up.MethodsFrom December 2018 to February 2019, a prospective study was performed and included consecutively migrants who attented to the primary medicine outconsultation of a health care centre in Paris. Migrants above 18, without any records of tetanus immunization were included and a TQS® was performed during a medical consultation. Adapted vaccine catch-up was then proposed. Immunity against tetanus among migrants, factors associated with positive TQS® and costs savings were evaluated.ResultsTQS® test was positive for 32% of the 310 included patients. In the univariable analysis, factors associated to the presence of a positive TQS® test were a female gender (OR = 1.69 CI95% [1.02–2.80]) and an urban living in the country of origin (OR = 1.79 CI95% [1.07–3.02]). In the multivariable analysis, these factors were not significantly associated to a positive TQS®. Anamnesis was not correlated to the immunity status: only 26% of the migrants who reported vaccinations in childhood, adolescence and adulthood had a positive TQS® test. The use of TQS® test allowed savings of 6,522 US$ as compared to the immediate catch-up strategy for the 310 patients.ConclusionThe TQS® test is an acceptable, simple, rapid and cost saving test that could find a place in the migrants’ vaccine catch-up.     

Percepción de los derechos de salud para la población migrante en Chile: análisis desde Twitter

ObjectiveTo describe the different perceptions about health rights for migrant population in Chile published on Twitter, concerning the first liver transplant carried out in Chile to a foreign national woman from Haiti, in September 2018.MethodQualitative study, case analysis. The case corresponded to the first emergency liver transplant in a migrant woman in Chile. Opinions expressed on Twitter regarding this case were collected between September 29 and November 17 (n = 339). Thematic analysis was performed using NVivo12 software, with codes defined conforming to the objective.ResultsAccording to the perceptions raised on Twitter, the right to access health services of the migrant population in Chile should be limited, and priority should be given to nationals. These opinions coexist with viewing health as a human right. There are also feelings of racism and discrimination towards this group.ConclusionsIn Chile, there are different perceptions of what should grant rights of access to migrant health services. This situation can generate a worsening of stigmatization and vulnerability faced by migrants and a barrier to the policy's implementation, further exacerbating the presence of health inequities.     

重点学校和民工子弟学校9～10岁学生近视状态及相关因素分析

目的：研究重点学校和民工子弟学校9～10岁学生近视状态和近视相关因素。方法选取苏州市重点小学（n=156）和民工子弟小学（n=178）部分4年级学生，给予1%环戊通药水，5 min滴1次，共3次后等待45 min，进行检影验光，确定验光结果。针对父母双方是否有近视、有无不良的用眼习惯、每天和每周户外活动时间、多媒体教学使用情况、电脑及电子产品使用情况、家长的认知和重视程度六方面设计调查问卷，由受试者和家长共同填写。结果（1）重点学校156例（312眼）近视者比例为25.6%，近视眼比例为22.4%，近视平均屈光度为（-2.07±1.04）D；民工子弟学校178例（356眼）近视者比例为16.3%，近视眼比例为15.7%，近视平均屈光度（-1.71±1.29）D。（2）重点学校和民工子弟学校近视发生人群比例相比，χ2=4.433，差异有统计学意义（P＜0.05），近视眼只数发生比例，χ2=4.885，差异有统计学意义（P＜0.05）。2所学校近视眼屈光度对比差异，无统计学意义。（3）78.2%近视学生有父母一方或双方近视、较多的多媒体课程和电子产品使用、不良的用眼习惯、课外活动时间较少等。结论减少多媒体教学时间和电子产品使用、增加课外活动时间、家长和学校重视学生的用眼习惯和近视情况，可以减少近视眼的发生。     

Consequences of criminalisation: the Dutch khat market before and after the ban

Abstract

Aims: To evaluate the consequences of criminalising khat, with a focus on the changes in law enforcement and the use, availability, price and quality of khat in the Netherlands. Methods: Mixed methods, including law enforcement data, expert interviews, focus group interviews with members of the Somali community, and a survey among 168 current (last month) khat users. Findings: Soon after the law changed (early in 2013), and khat had become an illicit drug, much of the khat imported from Africa was confiscated at Schiphol International Airport and users found it more difficult to obtain fresh khat leaves. About two years after the ban had been implemented, the price of fresh khat at user level had increased tenfold on average, and much of it was of poorer quality (e.g. sold in dried or powdered form). Conclusion: Criminalisation of khat in the Netherlands had substantial consequences for the khat market, predominantly because the ban was actively enforced at a crucial stage in the distribution chain (transcontinental import by air) and there was a lack of alternative transportation routes that could supply users with fresh khat. It is highly likely that the total number of Somali khat users in the Netherlands dropped, but that the proportion of dependent and poor, “problem users” increased.     

Risk factors for preterm premature rupture of membranes in Chinese women from urban cities

Objective

To investigate the prevalence of preterm premature rupture of membranes (PPROM) in urban areas in China and examine the associated risk factors.

Methods

A population-based, prospective study was undertaken in 14 cities in China between January 1, 2011, and January 31, 2012. Women were recruited at their first prenatal-care visit, when maternal characteristics were recorded. Risk factors were analyzed by one-way analysis of variance.

Results

Of 112 439 women included in analyses, 3077 (2.7%) had PPROM. Univariate analysis showed an increased risk of PPROM before 28 weeks of pregnancy in migrant women (odds ratio [OR] 2.25; 95% confidence interval [CI] 1.53–3.30; P < 0.001), in those with a history of recurrent induced abortions (OR 2.75; 95% CI 1.66–4.56; P < 0.001), and in those with a history of preterm birth (OR 3.90; 95% CI 0.77–19.61; P < 0.001). The associations were maintained in multivariate analysis (P < 0.001).

Conclusion

Migration as a result of urbanization, high rates of induced abortion, and preterm birth are potential risk factors for PPROM in Chinese women.     

合肥市庐阳区娱乐场所女性流动人群HIV检测服务利用及影响因素分析

目的了解合肥市庐阳区娱乐场所青年女性流动人群HIV咨询检测服务利用现状,探讨该人群寻求HIV检测服务的影响因素。方法通过横断面调查,采取随机抽样的方法,抽取合肥市庐阳区22家娱乐场所为调查现场,招募符合要求的调查对象。调查内容包括社会人口学特征、艾滋病性病知识、艾滋病咨询检测服务的知晓和利用情况、近一年患性病及生殖道感染状况、流产、近6个月性行为及性伴状况。结果共调查娱乐场所流动女性180人,33.9%的调查对象知道可在正规医院或疾控中心咨询艾滋病,47.2%的调查对象知道在疾控中心免费检测艾滋病;16.1%调查对象报告既往做过HIV咨询,31.7%报告既往做过HIV抗体检测;多因素Logistic分析结果显示,年龄在26~29岁,婚姻状态为已婚或同居,知道可在正规医院或疾控中心咨询艾滋病,近6个月与男朋友有性行为,有较高的艾滋病性病知识会促进其进行HIV抗体检测。结论合肥市庐阳区娱乐场所青年女性流动人群对艾滋病咨询检测服务的知晓和利用情况均有待加强,需要继续加强针对该人群的艾滋病防治知识的宣传教育,扩大艾滋病咨询检测服务的覆盖面。