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Canadian Journal of Public Health

, Volume 99, Issue 6, pp 499–504 | Cite as

Pathologies courantes chez les demandeurs d’asile à Montréal

Prévalence et facteurs de risque associés
  • Marie-Jo Ouimet
  • Marie Munoz
  • Lavanya Narasiah
  • Vanessa Rambure
  • José A. Correa
Article

Résumé

Contexte

: Le Canada a reçu 22 873 demandeurs d’asile en 2006. Le dépistage de maladies spécifiques semble indiqué dans cette population. Cette étude vise à évaluer la prévalence de pathologies dépistées au service de santé du PRAIDA à Montréal et à identifier des associations avec certains facteurs de risque.

Méthode

: Une étude rétrospective de dossiers de patients ayant été dépistés entre 2000 et 2004 a été réalisée. Des informations démographiques et cliniques ont été compilées, permettant le calcul de prévalences, ainsi que des analyses de régression logistique multiples.

Résultats

: Parmi les 289 dossiers relevés, 56,7 % proviennent d’hommes et 43,3 % de femmes; la moyenne d’âge est de 34 ans; 53 % sont Asiatiques et 38 % Africains. 59,4 % des sujets ont reçu un diagnostic psychiatrique (principalement dépression et syndrome de stress post-traumatique). Le bilan paraclinique a montré les résultats suivants: 20,3 % anémie, 9 % éosinophilie, 29,7 % HBcAc+, 5 % HBsAg+, 1,5 % hépatite C (ARN+), 2,5 % VIH+, 45,9 % TCT+; 10,5 % des selles présentent un germe pathogène, 17,3 % des sérologies sont positives pour strongyloïdose et 3,9 % pour schistosomiase. Les associations significatives sont: anémie et sexe féminin; origine africaine et taux d’HBcAc et de TCT+; âge et taux d’HBcAc et d’hépatite C; longue durée de séjour au Canada et éosinophilie et strongyloïdose; courte durée de séjour et HBcAc; origine asiatique et trouble psychiatrique.

Conclusion

: Cette étude suggère que les prévalences des pathologies dépistées au PRAIDA sont élevées et justifient d’en maintenir le dépistage dans cette population jusqu’à ce que des recommandations soient émises.

Mots clés

demandeurs de statut de réfugié demandeurs d’asile prévalence dépistage réfugiés immigrants 

Abstract

Background

: Canada received 22,873 asylum seekers in 2006. The screening of specific health problems in this population seems warranted. This study aims to estimate the prevalence of pathologies that were screened at the PRAIDA health service in Montreal, and to identify associations with certain risk factors.

Methods

: A retrospective study was conducted on the files of patients who were screened between 2000 and 2004. Demographic and clinical information was compiled for computation of prevalence as well as multiple logistic regression analysis.

Results

: Of the 289 files reviewed, 56.7% are for male and 43.3% for female patients, with a mean age of 34 years; 53% are Asians and 38% Africans. 59.4% of subjects received a psychiatric diagnosis (mainly depression and post-traumatic stress disorder). The paraclinical work-up showed: 20.3% anaemia, 9% eosinophilia, 29.7% HBcAb+, 5% HBsAg+, 1.5% hepatitis C (RNA+), 2.5% HIV+ and 45.9% TST+. 10.5% of stool samples contained a pathogen, and serologies for strongyloidiasis and schistosomiasis were positive in 17.3% and 3.9% of samples respectively. Significant associations included female gender with anaemia, African origin with rates of HBcAb and TST+, age with HBcAb and hepatitis C positivity, longer length of stay in Canada with eosinophilia and strongyloidiasis, shorter length of stay with HBcAb, and Asian origin with psychiatric disorders.

Conclusions

: This study suggests that the prevalence of screened pathologies as part of the PRAIDA health service work-up are high in this population and therefore warrant continuation of their screening until guidelines are constituted.

Keywords

Refugee claimants asylum seekers prevalence screening refugees immigrants 

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Références

  1. 1.
    Commission de l’Immigration et du Statut de Réfugié. Document interne; 2006.Google Scholar
  2. 2.
    Silove D, Steel Z, Watters C. Policies of deterrence and the mental health of asylum seekers. JAMA 2000;284:604–11.CrossRefPubMedGoogle Scholar
  3. 3.
    Hobbs M, Moor C, Wansbrough T, Calder L. The health status of asylum seekers screened by Auckland Public Health in 1999 and 2000. N Z Med J 2002;115:U152.PubMedGoogle Scholar
  4. 4.
    Silove D, Sinnerbrink I, Field A, Manicavasagar V, Steel Z. Anxiety, depression and PTSD in asylum-seekers: Associations with pre-migration trauma and post-migration stressors. Br J Psychiatry 1997;170:351–57.CrossRefPubMedGoogle Scholar
  5. 5.
    Gerritsen AA, Bramsen I, Deville W, van Willigen LH, Hovens JE, van der Ploeg HM. Physical and mental health of Afghan, Iranian and Somali asylum seekers and refugees living in the Netherlands. Soc Psychiatry Psychiatr Epidemiol 2006;41(1):18–26.CrossRefPubMedGoogle Scholar
  6. 6.
    Judson FN, Lince DM, Anders BJ, Tapy JM, Le Van D, Cohn DL, Kicera TJ. Health status of Southeast Asian refugees. West J Med 1984;141(2):183–88.PubMedCentralPubMedGoogle Scholar
  7. 7.
    Clark RC, Mytton J. Estimating infectious disease in UK asylum seekers and refugees: A systematic review of prevalence studies. J Public Health (Oxf) 2007;8:1–9.Google Scholar
  8. 8.
    Loutan L, Bierens de Haan D, Subilia L. [The health of asylum seekers: From communicable disease screening to post-traumatic disorders]. Bull Soc Pathol Exot 1997;90:233–37.PubMedGoogle Scholar
  9. 9.
    Zencovich M, Kennedy K, MacPherson DW, Gushulak BD. Immigration medical screening and HIV infection in Canada. Int J STD AIDS 2006;17(12):813–16.CrossRefPubMedGoogle Scholar
  10. 10.
    Lévesque JF, Dongier P, Brassard P, Allard R. Acceptance of screening and completion of treatment for latent tuberculosis infection among refugee claimants in Canada. Int J Tuberc Lung Dis 2004;8:711–17.PubMedGoogle Scholar
  11. 11.
    Godue CB, Goggin P, Gyorkos TW. [Tuberculin reactors among refugee status claimants newly arrived in Canada.] CMAJ 1988;139(1):41–44.PubMedCentralPubMedGoogle Scholar
  12. 12.
    Persson A, Rombo L. Intestinal parasites in refugees and asylum seekers entering the Stockholm area, 1987-88: Evaluation of routine stool screening. Scand J Infect Dis 1994;26:199–207.CrossRefPubMedGoogle Scholar
  13. 13.
    Benzeguir AK, Capraru T, Aust-Kettis A, Bjorkman A. High frequency of gastrointestinal parasites in refugees and asylum seekers upon arrival in Sweden. Scand J Infect Dis 1999;31:79–82.CrossRefPubMedGoogle Scholar
  14. 14.
    Godue CB, Gyorkos TW. Intestinal parasites in refugee claimants: A case study for selective screening? Can J Public Health 1990;81(3):191–95.PubMedGoogle Scholar
  15. 15.
    Van Burg JL, Verver S, Borgdorff MW. The epidemiology of tuberculosis among asylum seekers in The Netherlands: Implications for screening. Int J Tuberc Lung Dis 2003;7:139–44.PubMedGoogle Scholar
  16. 16.
    Monney M, Zellweger JP. Active and passive screening for tuberculosis in Vaud Canton, Switzerland. Swiss Med Wkly 2005;135(31-32):469–74.PubMedGoogle Scholar
  17. 17.
    Callister ME, Barringer J, Thanabalasingam ST, Gair R, Davidson RN. Pulmonary tuberculosis among political asylum seekers screened at Heathrow Airport, London, 1995–9. Thorax 2002;57(2):152–56.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Johnsen NL, Steen TW, Meyer H, Heldal E, Skarpaas IJ, June GB. Cohort analysis of asylum seekers in Oslo, Norway, 1987–1995: Effectiveness of screening at entry and TB incidence in subsequent years. Int J Tuberc Lung Dis 2005;9(1):37–42.PubMedGoogle Scholar
  19. 19.
    Van den Brande P, Uydebrouck M, Vermeire P, Demedts M. Tuberculosis in asylum seekers in Belgium. VRGT (Flemish Lung and Tuberculosis Association). Eur Respir J 1997;10:610–14.PubMedGoogle Scholar
  20. 20.
    Fazel M, Wheeler J, Danesh J. Prevalence of serious mental disorder in 7000 refugees resettled in western countries: A systematic review. Lancet 2005;365(9467):1309–14.CrossRefGoogle Scholar
  21. 21.
    Katsumata T, Kohno S, Yamashita K, Takeno Y, Matsunaga K, Oka R, et al. Health problems among Vietnamese refugees resettled in Japan. Southeast Asian J Trop Med Public Health 1993;24(4):647–53.PubMedGoogle Scholar
  22. 22.
    Erickson RV, Hoang GN. Health problems among Indochinese refugees. Am J Public Health 1980;70(9):1003–6.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Catanzaro A, Moser RJ. Health status of refugees from Vietnam, Laos and Cambodia. JAMA 1982;247:1303–8.CrossRefPubMedGoogle Scholar
  24. 24.
    Sutherland JE, Avant RF, Franz WB 3rd, Monzon CM, Stark NM. Indochinese refugee health assessment and treatment. J Fam Pract 1983;16(1):61–67.PubMedGoogle Scholar
  25. 25.
    Craft J, Coleman D, Coulter H, Horwitz R, Barry M. Hematologic abnormalities in Southeast Asian refugees. JAMA 1983;249:3204–6.CrossRefPubMedGoogle Scholar
  26. 26.
    Gordon AM Jr. Nutritional status of Cuban refugees: A field study on the health and nutriture of refugees processed at Opa Locka, Florida. Am J Clin Nutr 1982;35(3):582–90.CrossRefPubMedGoogle Scholar
  27. 27.
    Hill LL, Hovell M, Benenson AS. Prevention of hepatitis B transmission in Indo-Chinese refugees with active and passive immunization. Am J Prev Med 1991;7(1):29–32.CrossRefPubMedGoogle Scholar
  28. 28.
    Roussos A, Goritsas C, Pappas T, Spanaki M, Papadaki P, Ferti A. Prevalence of hepatitis B and C markers among refugees in Athens. World J Gastroenterol 2003;9:993–95.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Lifson AR, Thai D, O’Fallon A, Mills WA, Hang K. Prevalence of tuberculosis, hepatitis B virus, and intestinal parasitic infections among refugees to Minnesota. Public Health Rep 2002;117:69–77.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Geltman PL, Cochran J, Hedgecock C. Intestinal parasites among African refugees resettled in Massachusetts and the impact of an overseas pre-departure treatment program. Am J Trop Med Hyg 2003;69(6):657–62.CrossRefPubMedGoogle Scholar
  31. 31.
    Miller JM, Boyd HA, Ostrowski SR, Cookson ST, Parise ME, Gonzaga PS, et al. Malaria, intestinal parasites, and schistosomiasis among Barawan Somali refugees resettling to the United States: A strategy to reduce morbidity and decrease the risk of imported infections. Am J Trop Med Hyg 2000;62(1):115–21.CrossRefPubMedGoogle Scholar
  32. 32.
    Molina CD, Molina MM, Molina JM. Intestinal parasites in southeast Asian refugees two years after immigration. West J Med 1988;149:422–25.PubMedCentralPubMedGoogle Scholar
  33. 33.
    Buchwald D, Lam M, Hooton TM. Prevalence of intestinal parasites and association with symptoms in Southeast Asian refugees. J Clin Pharm Ther 1995;20:271–75.CrossRefPubMedGoogle Scholar
  34. 34.
    Garg PK, Perry S, Dorn M, Hardcastle L, Parsonnet J. Risk of intestinal helminth and protozoan infection in a refugee population. Am J Trop Med Hyg 2005;73(2):386–91.CrossRefPubMedGoogle Scholar
  35. 35.
    Lamour P, Bouree P, Hennequin C, Lombrail P, Squinazi F, Roussel C, Brodin M. [Blind treatment or treatment oriented to intestinal parasitoses in a Parisian health center for refugees]. Santé 1994;4(1):21–26.PubMedGoogle Scholar
  36. 36.
    Vernes A, Abdellatifi M, Dei-Cas E, Poirriez J, Abdelmalek RY, Leroux N, et coll. [Parasitic infestation and haemoglobinopathies in a population of 1170 refugees from South East Asia]. Nouv Presse Méd 1982;11(36):2687–91.PubMedGoogle Scholar
  37. 37.
    Gyorkos TW, MacLean JD, Viens P, Chheang C, Kokoskin-Nelson E. Intestinal parasite infection in the Kampuchean refugee population 6 years after resettlement in Canada. J Infect Dis 1992;166(2):413–17.CrossRefPubMedGoogle Scholar
  38. 38.
    Gyorkos TW, Frappier-Davignon L, MacLean JD, Viens P. Effect of screening and treatment on imported intestinal parasite infections: Results from a randomized, controlled trial. Am J Epidemiol 1989;129(4):753–61.CrossRefPubMedGoogle Scholar
  39. 39.
    Pottie K, Janakiram P, Topp P, McCarthy A. Prevalence of selected preventable and treatable diseases among government-assisted refugees. Can Fam Phys 2007;53:1928–34.Google Scholar
  40. 40.
    Citoyenneté et Immigration Canada. Programme Fédéral de Santé Interimaire: Manuel pour les professionnels de la santé; 2001.Google Scholar
  41. 41.
    Hosmer DW, Lemeshow S. Applied Logistic Regression, 2nd ed. New York: Wiley, 2000.CrossRefGoogle Scholar
  42. 42.
    Blackwell D, Holden K, Tregoning D. An interim report of health needs assessment of asylum seekers in Sunderland and North Tyneside. Public Health 2002;116:221–26.CrossRefPubMedGoogle Scholar
  43. 43.
    Gilbody S, Sheldon T, House A. Screening and case-finding instruments for depression: A meta-analysis. CMAJ 2008;178:997–1003.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Ramos JM, Pastor C, Masía MM, Cascales E, Royo G, Gutiérrez-Rodero F. [Health in the immigrant population: Prevalence of latent tuberculosis, hepatitis B, hepatitis C, human immunodeficiency virus and syphilis infection]. Enferm Infecc Microbiol Clin 2003;21(10):540–42.CrossRefPubMedGoogle Scholar
  45. 45.
    Gay NJ, Hesketh LM, Osborne KP, Farrington CP, Morgan-Capner P, Miller E. The prevalence of hepatitis B infection in adults in England and Wales. Epidemiol Infect 1999;122(1):133–38.CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    El-Hamad I, Casalini C, Matteelli A, Casari S, Bugiani M, Caputo M, et coll. Screening for tuberculosis and latent tuberculosis infection among undocumented immigrants at an unspecialised health service unit. Int J Tuberc Lung Dis 2001;5(8):712–16.PubMedGoogle Scholar
  47. 47.
    Bran C, Gómez i Prat J, Caylá JA, García de Olalla P. [Factors associated with latent tuberculous infection in immigrants less than 35 years old]. Enferm Infecc Microbiol Clin 2006;24(5):322–25.CrossRefPubMedGoogle Scholar
  48. 48.
    OMS. [En ligne] 2007 [visité le 26 octobre]. Disponible au https://doi.org/www.who.int/vaccine_research/diseases/viral_cancers/en/index2.htmlGoogle Scholar
  49. 49.
    Laban CJ, Gernaat HB, Komproe IH, Schreuders BA, De Jong JT. Impact of a long asylum procedure on the prevalence of psychiatric disorders in Iraqi asylum seekers in The Netherlands. J Nerv Ment Dis 2004;192:843–51.CrossRefPubMedGoogle Scholar
  50. 50.
    Momartin S, Steel Z, Coello M, Aroche J, Silove DM, Brooks R. A comparison of the mental health of refugees with temporary versus permanent protection visas. Med J Australia 2006;185(7):357–61.PubMedGoogle Scholar
  51. 51.
    Silove D, Steel Z, McGorry P, Mohan P. Trauma exposure, postmigration stressors, and symptoms of anxiety, depression and post-traumatic stress in Tamil asylum-seekers: Comparison with refugees and immigrants. Acta Psychiatr Scand 1998;97(3):175–81.CrossRefGoogle Scholar
  52. 52.
    CCSIR. [En ligne] 2008 [visité le 14 avril]. Disponible au https://doi.org/www.intermed.med.uottawa.ca/research/immrefhealth/eng/index.htmlGoogle Scholar
  53. 53.
    Gushulak BD, Williams LS. National immigration health policy: Existing policy, changing needs, and future directions. Can J Public Health 2004;95(3):I27–I29.PubMedGoogle Scholar

Copyright information

© The Canadian Public Health Association 2008

Authors and Affiliations

  • Marie-Jo Ouimet
    • 1
  • Marie Munoz
    • 1
  • Lavanya Narasiah
    • 1
  • Vanessa Rambure
    • 2
  • José A. Correa
    • 3
  1. 1.Service de santé du PRAIDA, Centre de Recherche et Formation, Centre de santé et de services sociaux de la Montagne, Centre affilié universitaireUniversité McGillMontréalCanada
  2. 2.Faculté de médecineUniversité de NancyNancyFrance
  3. 3.Département de Mathématiques et StatistiquesUniversité McGillCanada

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