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Pathologies courantes chez les demandeurs d’asile à Montréal

Prévalence et facteurs de risque associés

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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.

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.

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Authors and Affiliations

  1. Service de santé du PRAIDA, Centre de Recherche et Formation, Centre de santé et de services sociaux de la Montagne, Centre affilié universitaire, Université McGill, 5700 ch. de la Côte-des Neiges, Montréal, QC, H3T 2A8, Canada

    Marie-Jo Ouimet MD, MSc, DTM, Marie Munoz MD1 & Lavanya Narasiah MD, MSc

  2. Faculté de médecine, Université de Nancy, Nancy, France

    Vanessa Rambure MD

  3. Département de Mathématiques et Statistiques, Université McGill, Canada

    José A. Correa PhD

Authors
  1. Marie-Jo Ouimet MD, MSc, DTM
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  2. Marie Munoz MD1
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  3. Lavanya Narasiah MD, MSc
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  4. Vanessa Rambure MD
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  5. José A. Correa PhD
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Additional information

Remerciements: Nous souhaitons souligner notre gratitude à tous les membres de l’équipe du PRAIDA pour son support et sa précieuse aide technique. Nous remercions Dr Morency Duchastel et Dr Gilles de Margerie d’avoir initié le projet du bilan de dépistage. Nous remercions aussi Dr Christina Greenaway, Dr Brian Ward et Dr Dick Maclean pour leurs conseils concernant les maladies infectieuses et tropicales ainsi que Dr Jean-Frédéric Lévesque et Dr Pierre Dongier pour leurs commentaires. Nous soulignons également la participation de Dr Nadine Sicard aux analyses préliminaires.

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Ouimet, MJ., Munoz, M., Narasiah, L. et al. Pathologies courantes chez les demandeurs d’asile à Montréal. Can J Public Health 99, 499–504 (2008). https://doi.org/10.1007/BF03403785

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