Wednesday, 4 December 2024

Yam Alkaissy, Nuria Serre-Delcor, Marta Arsuaga Vicente, Israel Molina, Francesca F. Norman...Alfonso Muriel, Jose A. Pérez-Molina. Trends in imported infections among migrants and travellers to Spain: a decade of analysis through the +Redivi network (2012-2022)

J Travel Med. 2024

"Our study showed that accurate data are essential for understanding the dynamics of imported infectious diseases, emphasizing how demographic shifts, migration trends, and healthcare policies affect disease profiles.". - José A. Pérez-Molina-

Summary:

Background: High-speed global travel, increased trade, world population growth, migration, urbanization and climate change have favoured the emergence and spread of pathogens. We aimed to analyse the evolution of imported infections in Spain during 2012-2022 and the potential impact of some of the abovementioned factors on differential morbidity patterns.

Methods: In this retrospective study (January 2012 to December 2022), we analysed data collected by the +Redivi network across 25 health centres. The network's standardised database records new cases of imported infections, including patient demographics, travel history, pre-travel advice and diagnostic information. To assess outcome rates over time and potential interactions, we constructed penalized weighted models to reduce the bias related to a low event rate and used weighted logistic regression for morbidity outcomes.

Results: We recorded 25 632 episodes, comprising 13 913 migrants, 4047 visiting friends and relatives (VFR) immigrants, 392 VFR travellers and 7280 travellers. Most immigrants came from South America (48.3%), Sub-Saharan Africa (28.5%), North Africa (6.6%), South Central Asia (5.4%) and Central America/Caribbean (5.3%). The most common regions visited by travellers were Sub-Saharan Africa (33.5%), South America (24.5%), Central America/Caribbean (13.5%), Southeast Asia (12%) and South Central Asia (10%). The proportion of diagnoses of malaria, strongyloidiasis and unspecified self-limiting febrile syndrome < 3 weeks remained unchanged during the study period. An increased frequency of diagnosis was reported for schistosomiasis, blastocystosis, giardiasis, dengue, diarrhoea, new cases of HIV, latent and pulmonary tuberculosis, whereas a decrease was reported for syphilis, chikungunya fever, Chagas disease and eosinophilia. We detected interactions between time and sex or type of participant across the different diagnoses.

Conclusions: Our study underscores the importance of epidemiological data in understanding infectious diseases dynamics among travellers and migrants, emphasizing how demographic shifts, migration trends and healthcare policies affect disease profiles. Comprehensive data play an essential role in enhancing public health policies and travel advice.

Why do you highlight this publication?

Global trends, such as travel, trade, population growth, migration, urbanization, and climate change, have contributed to pathogen spread. This study analysed imported infections in Spain from 2012-2022 and assessed the impact of these factors on disease patterns, emphasizing the importance of comprehensive data for improving public health policies and travel guidance.