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Fulltext A Prospective Cohort Study of Obstetric Immigrants in the Maternity Hospital Kuala Lumpur. A Pilot

Noraihan Mohd. Nordin, Sharda, Priya, Zainab Shamsuddin

International Medical Journal Malaysia, 2006;5(1):1-12.
MyJurnal

Objectives: The objectives of this study were to ascertain the prevalence of Indonesians obstetrics immigrant and to assess the fetal maternal outcome. Methodology: A prospective cohort study design was used to analyse 54 consecutive Indonesians obstetrics immigrant compared to 56 Malay women. Chi square and student t test were used where appropriate, p < 0.05 was considered to be of statistical significance. Results: There was a reducing trend in the incidence admission of Indonesians from 10.5 in 1999 to 6.5 % in 2002. The maternal mortality ratio showed an increasing trend from 1999 (40.0/100000) to 2001 (162.9/100000) but decreased to 5.8/100000 in 2002. The majority was between 20-40 years old, multiparous and booked, which was similar to the Malay population. Most Malays were in occupational class 1 to 3 and the husband has secondary and tertiary education compared to the Indonesians who were in class 4 and 5 and the husband has primary and no formal education. Significantly more immigrants were housewives compared to Malays who were working women. There was no significant difference in the antenatal complications. There were no significant difference in terms of delivery and most delivered vaginally. The perinatal outcome in terms of gestation, birth weight, Apgar score and admission to neonatal ICU were similar in both populations and there was no perinatal mortality. In conclusion, the incidence admission of Indonesian immigrant was on the decreasing trend. The outcome of these patients managed in MHKL was similar to the Malay population. Further studies with enrollment of a larger number of patients should be carried out to ascertain the significance of these findings.

Matched MeSH terms: Emigrants and Immigrants
A probable case of poliomyelitis imported to Malaysia

Tay CG, Ong LC, Goh KJ, Rahmat K, Fong CY

J Clin Neurosci, 2015 Dec;22(12):1994-5.
PMID: 26254091 DOI: 10.1016/j.jocn.2015.07.001

We report a previously well 10-month-old Somalian girl who acquired asymmetric lower limb weakness in July 2013 in Mogadishu, Banadir, before arriving in Malaysia at 12 months of age. In May 2013, there was a wild poliomyelitis outbreak in that area, as reported by the World Health Organization. Laboratory investigation, including cerebrospinal fluid, was unremarkable, and electrophysiological studies showed active axonal denervation in the left lower limb. The whole spine T2-weighted MRI revealed non-enhancing hyperintensities of the bilateral anterior horn cells, predominantly on the left side at T11-12. The viral isolations from two stool specimens at her presentation to our centre, 2 months after the onset of illness and 2 weeks apart, were negative. Despite lacking the acute virological evidence of poliomyelitis, in view of the girl's clinical, electrophysiological and classical spinal neuroradiological features, together with her temporal relationship with a World Health Organization reported wild poliomyelitis outbreak, we believe these findings are consistent with a diagnosis of imported poliomyelitis. A review at 30 months of age showed persistent left lower limb monoplegia with little recovery. Our patient reiterates the importance of maintaining awareness of wild polio importation, and keeping abreast of the latest news of global poliomyelitis outbreaks when treating patients with flaccid paralysis, even if they arrive from non-endemic poliomyelitis areas.

Matched MeSH terms: Emigrants and Immigrants*
Fulltext A review of malaria research in Malaysia

William T, Menon J

Med J Malaysia, 2014 Aug;69 Suppl A:82-7.
PMID: 25417955 MyJurnal

One hundred and thirteen articles related to Malaria were found in a search through a database dedicated to indexing all original data relevant to medicine published in Malaysia between the years 2000-2013. Thirty eight articles were selected and reviewed on the basis of clinical relevance and future research implications. The epidemiology of malaria has undergone a significant change over the last decade with P. knowlesi, formerly a relatively unknown simian parasite rapidly becoming the most predominant malaria species to infect humans in Malaysia. The epidemiology, clinical features, diagnostic methods and treatment for P. knowlesi infection are described in these studies. In Malaysia, imported malaria from foreigners also poses a challenge. In view of these changes, new strategies on malaria control need to be devised and implemented, and treatment regimens need to be redefined to help Malaysia achieve the goal of malaria elimination by the year 2020.

Matched MeSH terms: Emigrants and Immigrants
Fulltext Acquisition of HIV by African-born residents of Victoria, Australia: insights from molecular epidemiology

Lemoh C, Ryan CE, Sekawi Z, Hearps AC, Aleksic E, Chibo D, et al.

PLoS One, 2013;8(12):e84008.
PMID: 24391866 DOI: 10.1371/journal.pone.0084008

African-born Australians are a recognised "priority population" in Australia's Sixth National HIV/AIDS Strategy. We compared exposure location and route for African-born people living with HIV (PLHIV) in Victoria, Australia, with HIV-1 pol subtype from drug resistance assays and geographical origin suggested by phylogenetic analysis of env gene. Twenty adult HIV positive African-born Victorian residents were recruited via treating doctors. HIV exposure details were obtained from interviews and case notes. Viral RNA was extracted from participant stored plasma or whole blood. The env V3 region was sequenced and compared to globally representative reference HIV-1 sequences in the Los Alamos National Library HIV Database. Twelve participants reported exposure via heterosexual sex and two via iatrogenic blood exposures; four were men having sex with men (MSM); two were exposed via unknown routes. Eight participants reported exposure in their countries of birth, seven in Australia, three in other countries and two in unknown locations. Genotype results (pol) were available for ten participants. HIV env amplification was successful in eighteen cases. HIV-1 subtype was identified in all participants: eight both pol and env; ten env alone and two pol alone. Twelve were subtype C, four subtype B, three subtype A and one subtype CRF02_AG. Reported exposure location was consistent with the phylogenetic clustering of env sequences. African Australians are members of multiple transnational social and sexual networks influencing their exposure to HIV. Phylogenetic analysis may complement traditional surveillance to discern patterns of HIV exposure, providing focus for HIV prevention programs in mobile populations.

Matched MeSH terms: Emigrants and Immigrants/statistics & numerical data*
Awareness of cervical cancer and its associated socio-demographic factors among Yemeni immigrant women in Malaysia

Azzani M, Ba-Alawi E, Atroosh WM, Yadav H

BMC Womens Health, 2023 Jan 16;23(1):19.
PMID: 36647066 DOI: 10.1186/s12905-023-02172-y

BACKGROUND: Studies have revealed that a higher proportion of women affected by cervical cancer are from some minority groups of immigrant women. Hence, this study was conducted to assess Yemeni immigrant women's awareness of cervical cancer and its associated socio-demographic factors.
METHODS: A cross-sectional study was conducted among 370 Yemeni women in Selangor and Kuala Lumpur, Malaysia. Data on the awareness of symptoms/signs, risk factors, and screening programme were collected using Cervical Cancer Awareness Measurement (Cervical CAM) questionnaire.
RESULTS: More than 74% of the study participants were unable to recall any warning symptoms/signs, and 73% were unable to recall any risk factors. The factors associated with the awareness of symptoms and risk factors were age (95% CI 4.22-5.22, p = 0.039), marital status (95% CI 4.05-7.87, p = 0.021), employment (95% CI 3.89-5.77, p = 0.046) and the number of children (95% CI 5.33-6.54, p = 0.041).
CONCLUSION: The findings underline the need for public awareness campaigns to improve public awareness of cancer symptoms and risk factors among underserved communities.

Matched MeSH terms: Emigrants and Immigrants*
Fulltext Breaking down the barriers: Understanding migrant workers' access to healthcare in Malaysia

Loganathan T, Rui D, Ng CW, Pocock NS

PLoS One, 2019;14(7):e0218669.
PMID: 31269052 DOI: 10.1371/journal.pone.0218669

BACKGROUND: Malaysia is widely credited to have achieved universal health coverage for citizens. However, the accessibility of healthcare services to migrant workers is questionable. Recently, medical fees for foreigners at public facilities were substantially increased. Mandatory health insurance only covers public hospital admissions and excludes undocumented migrants. This study explores barriers to healthcare access faced by documented and undocumented migrant workers in Malaysia.
METHODS: We use qualitative data from 17 in-depth interviews conducted with key informants from civil society organisations, trade unions, academia, medical professionals, as well as migrant workers and their representatives. We interviewed doctors working in public hospitals and private clinics frequented by migrants. Data were analysed using thematic analysis.
RESULTS: We found that healthcare services in Malaysia are often inaccessible to migrant workers. Complex access barriers were identified, many beyond the control of the health sector. Major themes include affordability and financial constraints, the need for legal documents like valid passports and work permits, language barriers, discrimination and xenophobia, physical inaccessibility and employer-related barriers. Our study suggests that government mandated insurance for migrant workers is insufficient in view of the recent increase in medical fees. The perceived close working relationship between the ministries of health and immigration effectively excludes undocumented migrants from access to public healthcare facilities. Language barriers may affect the quality of care received by migrant workers, by inadvertently resulting in medical errors, while preventing them from giving truly informed consent.
CONCLUSIONS: We propose instituting migrant-friendly health services at public facilities. We also suggest implementing a comprehensive health insurance to enable healthcare access and financial risk protection for all migrant workers. Non-health sector solutions include the formation of a multi-stakeholder migration management body towards a comprehensive national policy on labour migration which includes health.

Matched MeSH terms: Emigrants and Immigrants/statistics & numerical data
Cardiovascular responses to stress in Singapore and India

Kaur D, Bishop GD

Int J Psychophysiol, 2013 Feb;87(2):130-40.
PMID: 23206971 DOI: 10.1016/j.ijpsycho.2012.11.011

Epidemiological studies have shown significant ethnic differences in coronary heart disease death rates with South Asians showing significantly greater coronary heart disease mortality than other groups.

Matched MeSH terms: Emigrants and Immigrants
Fulltext Characteristics of young colorectal cancer in Brunei Darussalam: an epidemiologic study of 29 years (1986-2014)

Koh KS, Telisinghe PU, Bickle I, Abdullah MS, Chong CF, Chong VH

Asian Pac J Cancer Prev, 2015;16(8):3279-83.
PMID: 25921132

BACKGROUND: Colorectal cancer (CRC) is the most common gastrointestinal cancer and the incidence is increasing. CRC is more common with increasing age, but a proportion occurs in young adults, termed young CRC. This study assessed the incidence and the demographic of young CRC in Brunei Darussalam.

MATERIALS AND METHODS: All histologically proven CRC between 1986 and 2014 registered with the Department of Pathology cancer registry were reviewed and data extracted for analyses. Young CRC was defined as cancer in patients aged less than 45 years. The various population groups were categorized into locals (Malays, Chinese and Indigenous) and expatriates.

RESULTS: Over the study period, there were 1,126 histologically proven CRC (mean age 59.1 ± 14.7 years, Male 58.0%, Locals 91.8% and 8.2% expatriates). Young CRC accounted for 15.1% with the proportion declining over the years, from 29% (1986-1990) to 13.2% (2011-2014). The proportion of young CRC was highest among the indigenous (30.8%), followed by the expatriates (29.3%), Malays (14.3%) and lowest among the Chinese (10.8%). The mean age of young CRC was 35.9 ± 6.2; lowest among the indigenous (33.5 ± 6.7), expatriate (34.9 ± 6.0) groupd and the Malays (35.6 ± 6.5) compared to the Chinese (38.6 ± 4.6), a similar trend being observed in the non-young CRC groups. There were no difference between the genders and tumor locations (rectum or colon) between the young and the non-young CRC cases. Female young CRC was significantly younger than male (p<0.05) without any significant variation between the various population groups (p>0.05).

CONCLUSIONS: Our study showed that the young CRC accounted for 15.1% of all CRC with declining trend observed over recent years. Young CRC was more common among indigenous, expatriates and Malays and least common among the Chinese. There were no differences in the gender and tumor locations.

Matched MeSH terms: Emigrants and Immigrants/statistics & numerical data*
Comparison of features and outcomes of perforated peptic ulcer between Malaysians and foreigners

Kugan V, Mahadevan DT, Kandasami P

Med J Malaysia, 2016 02;71(1):12-6.
PMID: 27130737

BACKGROUND: Perforated peptic ulcers (PPU) present as serious surgical emergencies that carry high mortality and morbidity. Foreigners with PPU are also managed in our hospital setting. Their inclusion significantly alters the trend and pattern of PPU seen in Malaysia.
AIM: To compare per-operative and post-operative features and outcomes of perforated peptic ulcers between Malaysians and foreigners.
MATERIAL AND METHODS: This was an analytical crosssectional study. All patients who underwent repair of perforated peptic ulcer disease during a 6-year period were included. 50 consecutive patients' records with perforated peptic ulcer were analysed. Data were collected from operation theatre database and hospital medical records. Chi square and t test were performed using SPSS statistical software.
RESULTS: Total of 50 patients, of which 30 were Malaysians and 20 were foreigners. The mean age of Malaysian patients was 58.3 ± 15.2 years whereas the mean age for foreign patients was 30.3 ± 6.7 years, with foreign patients being significantly younger than local patients. Foreigners had significantly smaller ulcers with only 5% of them having ulcers more than 1cm while 36.7% of Malaysian patients had ulcers more than 1cm. Post-operative complications are significantly higher in Malaysian patients (p<0.05) with 40% of Malaysian patients and 10% of foreign patients developing post-operative complications.
CONCLUSION: Foreign patients are younger with significantly smaller perforated ulcers and better post-operative outcomes.

Matched MeSH terms: Emigrants and Immigrants*
Depression Among Immigrant Nigerians in Canada

Aluh DO, Aigbogun O, Anyachebelu OC

J Immigr Minor Health, 2023 Apr;25(2):315-323.
PMID: 36271302 DOI: 10.1007/s10903-022-01404-x

Immigrant status, especially a few years post arrival, is a major risk factor for depression in populations that have been adequately studied. While information on depression among Asian migrants, including those from India, China and Philippines, in Canada have been reported in previous studies, there is inadequate information about depression among Nigerian immigrants who make up the largest percentage of African migrants and black population residing in Canada. A cross-sectional study was conducted among 187 Nigerian immigrants in Canada. Participants completed the Patient Health Questionnaire (PHQ-9). Descriptive and multivariate logistic regression analyses were carried out using IBM SPPS. About half (51.7%, n = 91) of the participants screened positive to the PHQ-9. Being female, unmarried, not being at all satisfied with the decision to migrate, and having stayed for more than 10 years in Canada significantly increased the risk of screening positive to depression. More than half of the participants screened positive for depression, suggesting an important mental health concern and the potential need for intervention. This population differed from other immigrant populations from previous studies because the absence of social support, satisfaction with employment status, and perceived discrimination did not significantly predict a positive screen for depression in this study.

Matched MeSH terms: Emigrants and Immigrants*
Domestic Violence in Cross-Border Marriages: A Systematic Review

Md Said MHB, Emmanuel Kaka G

Trauma Violence Abuse, 2023 Jul;24(3):1483-1502.
PMID: 35232287 DOI: 10.1177/15248380221074321

Cross-border marriages have been found to be associated with domestic violence due to the migration experiences of the couples concerned and the stress experienced before, during, and after migration, despite local and international legislation on domestic violence. A systematic review using the PRISMA Statement was conducted to examine the relationship between domestic violence and cross-border marriages among cross-border wives from Asian countries. Six databases-Taylor & Francis Online, Wiley Online, Scopus, Web of Science, Sage Journals, and Springer Online library, were used in the research which found 179 articles for eligibility and 58 articles were finally used in the review. To be included, studies must have addressed domestic violence and cross-border marriage among Asians, report qualitative, quantitative, or mixed methods, addressed the RQs, been published in polished English between 2010 and 2020 and published in a reputable journal with high impact factor. The systematic review found that immigration status, citizenship, culture, language barrier, diversity/intersectionality, age, and economic dependence are the risk factors for domestic violence, which leads effects such as divorce or separation, racism, loneliness, loss of identity & inheritance, stigma, abandonment, and discrimination. Yet these cross-border wives resorted to NGOs, social & religious groups, and traditional beliefs as coping strategies. The review suggests that legislations on domestic violence should be amended to include a definition of the rights of immigrant women, and the plight of cross-border wives, which should be protected. It is also imperative to propose favorable laws and policies regarding immigration status and citizenship for these cross-border couples.

Matched MeSH terms: Emigrants and Immigrants*
Fulltext Education for non-citizen children in Malaysia during the COVID-19 pandemic: A qualitative study

Loganathan T, Chan ZX, Hassan F, Kunpeuk W, Suphanchaimat R, Yi H, et al.

PLoS One, 2021;16(12):e0259546.
PMID: 34855770 DOI: 10.1371/journal.pone.0259546

The COVID-19 pandemic disrupted schooling for children worldwide. Most vulnerable are non-citizen children without access to public education. This study aims to explore challenges faced in achieving education access for children of refugee and asylum-seekers, migrant workers, stateless and undocumented persons in Malaysia during the pandemic. In-depth interviews of 33 stakeholders were conducted from June 2020 to March 2021. Data were thematically analysed. Our findings suggest that lockdowns disproportionately impacted non-citizen households as employment, food and housing insecurity were compounded by xenophobia, exacerbating pre-existing inequities. School closures disrupted school meals and deprived children of social interaction needed for mental wellbeing. Many non-citizen children were unable to participate in online learning due to the scarcity of digital devices, and poor internet connectivity, parental support, and home learning environments. Teachers were forced to adapt to online learning and adopt alternative arrangements to ensure continuity of learning and prevent school dropouts. The lack of government oversight over learning centres meant that measures taken were not uniform. The COVID-19 pandemic presents an opportunity for the design of more inclusive national educational policies, by recognising and supporting informal learning centres, to ensure that no child is left behind.

Matched MeSH terms: Emigrants and Immigrants/education*
Epidemiological findings on Hepatitis C infection in a tertiary level hospital in mid-northern Anatolia in Turkey: A four-year analysis

Taskin MH, Gunal O, Arslan S, Kaya B, Kilic SS, Akkoyunlu GK, et al.

Trop Biomed, 2020 Mar 01;37(1):227-236.
PMID: 33612734

The hepatitis C virus (HCV) is a blood-borne pathogen that causes acute or chronic infection of the liver, sometimes leading to serious liver damage and fatality. The objective of this study was to evaluate HCV prevalence in patients attending the Regional Training and Research Hospital for Medical Examination and Surgery in Samsun Province of Turkey between 2014 and 2017. Blood specimens taken from 152 596 patients were screened for HCV infection by using the anti-HCV assay. Seropositive samples were subjected to polymerase chain reaction (PCR) testing in order to determine whether the HCV infection was active. Genotyping was then performed. Overall, HCV seropositivity and active HCV infection were 2.76% and 2.05%, respectively. Foreign nationals accounted for 5.61% of the seropositive samples and 1.37% of active HCV infective samples. We further report that 2017 was the year with the highest seroprevalence which was 3.64%. HCV genotype 1 was the most common genotype detected in residents of Samsun Province at 89.86%, followed by Genotype 3 at 4.54%. This study provides important information on the levels of HCV infection in the Samsun region of Turkey. The data indicate that there was a rising trend of HCV infection between 2014 and 2017.

Matched MeSH terms: Emigrants and Immigrants
Fulltext Epidemiological screening of lymphatic filariasis among immigrants using dipstick colloidal dye immunoassay

Wan Omar A, Sulaiman O, Yusof S, Ismail G, Fatmah MS, Rahmah N, et al.

Malays J Med Sci, 2001 Jul;8(2):19-24.
PMID: 22893756

We have recently reported that a dipstick colloidal dye immunoassay (DIA) that detect parasite antigens in human serum is sensitive and specific for the diagnosis of active infection of lymphatic filariasis. Rabbit polyclonal antibodies (RbBmCAg) labelled with a commercial dye, palanil navy blue was used to detect filarial antigenemia among Indonesian and Bangladeshi immigrant workers (N= 630) at oil palm estates at Hulu Trengganu District, Peninsular Malaysia. Microfilaremia with Brugia malayi were detected in 51 (8.10 %) individuals, of which 42 (6.67 %) were among the Indonesians and 9 (1.98 %) among the Bangladeshis. Microfilaremia with Wuchereria bancrofti were detected in 33 (5.24 %) individuals of which 15 (2.38 %) were among the Indonesians and 18 (2.86 %) among the Bangladeshis workers. The DIA detected 96 (15.24 %) antigenemic cases which comprise of all the microfilaremic cases and 15 (2.38 %) amicrofilaremic cases. The amicrofilaremic cases with filarial antigenemia consisted of 9 (1. 43 %) Indonesians and 6 (0.95%) Bangladeshis. We have used 6 ul of the RbBmCAg and diluted (1:10) patients' sera per dipstick which make the DIA reagent conservative. The DIA is a rapid test and can be read in approximate 2 hours.. Additionally, coloured dots developed in the DIA can be qualitatively assessed visually for intensity. The DIA does not require sophisticated equipment or radioactivity, and therefore suitable for field application.

Matched MeSH terms: Emigrants and Immigrants
Epidemiology and control of chikungunya fever in Singapore

Ho K, Ang LW, Tan BH, Tang CS, Ooi PL, James L, et al.

J Infect, 2011 Apr;62(4):263-70.
PMID: 21315108 DOI: 10.1016/j.jinf.2011.02.001

OBJECTIVES: We conducted an epidemiological review of the chikungunya fever situation in Singapore and described the measures taken to prevent the chikungunya virus from becoming entrenched in the tropical city-state.
METHODS: All laboratory-confirmed cases and outbreak investigation reports maintained by the Communicable Diseases Division, Ministry of Health, and Aedes mosquito surveillance data obtained by the National Environment Agency during the period 2006 and 2009 were reviewed and analysed.
RESULTS: Sporadic cases were imported into Singapore until the first local transmission occurred in an urban area where Aedes aegypti was the predominant vector. Subsequent introduction of a mutant viral strain (A226V) in early 2008 resulted in the rapid spread to suburban and rural areas where Aedes albopictus was the primary vector. 1072 cases including 812 (75.7%) indigenous cases were reported. The main sources of importation were India and Malaysia. Foreign contract workers were identified as high-risk for indigenous infections.
CONCLUSIONS: The disease was successfully brought under control through aggressive vector control measures directed at A. albopictus. Although the incidence has sharply declined since January 2009, a high degree of vigilance is maintained to prevent a recurrence of epidemic transmission which can occur even with a well-established nationwide mosquito control programme.

Matched MeSH terms: Emigrants and Immigrants/statistics & numerical data
Fulltext Falciparum Malaria Outbreak in Sabah Linked to an Immigrant Rubber Tapper

Jeffree SM, Ahmed K, Safian N, Hassan R, Mihat O, Lukman KA, et al.

Am J Trop Med Hyg, 2018 Jan;98(1):45-50.
PMID: 29141714 DOI: 10.4269/ajtmh.17-0081

Sabah is a Malaysian state situated in the northern part of Borneo, and it is endemic for malaria. The incidence of malaria is the lowest (0.05/1,000 population) in Penampang districts of Sabah. In June 26, 2012, two Plasmodium falciparum malaria cases were notified to public health department from a village in Penampang. Immediate investigation was initiated to identify the risk factors and to institute control measures. We performed active case finding by asking household members of all houses in the village regarding malaria symptoms and by examining blood smears. Environmental investigation was performed by collecting samples to detect mosquito breeding sites and to identify malaria transmitting vector mosquitoes. A case-control study with a ratio of 1:4 (11 cases and 44 controls) was conducted using self-administered questionnaire. The microscopic examination of blood smear for malarial parasite and entomology sampling was carried out. The malarial attack rate was 2.3%, 6/11 smears have gametocyte, and the case fatality rate was 9.1%. One case was a migrant rubber tapper from Indonesia which happened to be the first case with gametocyte positive. Overall, the incidence of malaria was higher (6/11) among rubber tappers. The odds of cases for those living nearby stagnant water were 7.3 [95% confidence interval: 1.2-43.5] times higher. In conclusion, an outbreak of P. falciparum malaria was introduced into a malaria-free village by a migrant rubber tapper, by whom the imported parasite was introduced to the community via vector Anopheles balabacensis. Living near stagnant water bodies was the risk factor in this outbreak.

Matched MeSH terms: Emigrants and Immigrants*
Fulltext First report of sylvatic DENV-2-associated dengue hemorrhagic fever in West Africa

Franco L, Palacios G, Martinez JA, Vázquez A, Savji N, De Ory F, et al.

PLoS Negl Trop Dis, 2011 Aug;5(8):e1251.
PMID: 21829739 DOI: 10.1371/journal.pntd.0001251

Dengue virus (DENV) circulates in human and sylvatic cycles. Sylvatic strains are both ecologically and evolutionarily distinct from endemic viruses. Although sylvatic dengue cycles occur in West African countries and Malaysia, only a few cases of mild human disease caused by sylvatic strains and one single case of dengue hemorrhagic fever in Malaysia have been reported. Here we report a case of dengue hemorrhagic fever (DHF) with thrombocytopenia (13000/µl), a raised hematocrit (32% above baseline) and mucosal bleeding in a 27-year-old male returning to Spain in November 2009 after visiting his home country Guinea Bissau. Sylvatic DENV-2 West African lineage was isolated from blood and sera. This is the first case of DHF associated with sylvatic DENV-2 in Africa and the second case worldwide of DHF caused by a sylvatic strain.

Matched MeSH terms: Emigrants and Immigrants
Genital tuberculosis: a new challenge in an old disease

Nissapatorn V

South. Med. J., 2008 Dec;101(12):1201.
PMID: 19005453 DOI: 10.1097/SMJ.0b013e318185a090
Matched MeSH terms: Emigrants and Immigrants*
Global migration and factors influencing retention of Asian internationally educated nurses: a systematic review

Ung DSK, Goh YS, Poon RYS, Lin YP, Seah B, Lopez V, et al.

Hum Resour Health, 2024 Mar 01;22(1):17.
PMID: 38429767 DOI: 10.1186/s12960-024-00900-5

BACKGROUND: Given nurses' increasing international mobility, Asian internationally educated nurses (IENs) represent a critical human resource highly sought after within the global healthcare workforce. Developed countries have grown excessively reliant on them, leading to heightened competition among these countries. Hence, this review aims to uncover factors underlying the retention of Asian IENs in host countries to facilitate the development of more effective staff retention strategies.
METHODS: A mixed-methods systematic review was conducted using the Joanna Briggs Institute methodology for mixed-method systematic review. A search was undertaken across the following electronic databases for studies published in English during 2013-2022: CINAHL, Embase, PubMed, Scopus, Web of Science and PsycINFO. Two of the researchers critically appraised included articles independently using the Joanna Briggs Critical Appraisal Tools and Mixed Methods Appraisal Tool (version 2018). A data-based convergent integrated approach was adopted for data synthesis.
RESULTS: Of the 27 included articles (19 qualitative and eight quantitative), five each were conducted in Asia (Japan, Taiwan, Singapore and Malaysia), Australia and Europe (Italy, Norway and the United Kingdom); four each in the United States and the Middle East (Saudi Arabia and Kuwait); two in Canada; and one each in New Zealand and South Africa. Five themes emerged from the data synthesis: (1) desire for better career prospects, (2) occupational downward mobility, (3) inequality in career advancement, (4) acculturation and (5) support system.
CONCLUSION: This systematic review investigated the factors influencing AMN retention and identified several promising retention strategies: granting them permanent residency, ensuring transparency in credentialing assessment, providing equal opportunities for career advancement, instituting induction programmes for newly employed Asian IENs, enabling families to be with them and building workplace social support. Retention strategies that embrace the Asian IENs' perspectives and experiences are envisioned to ensure a sustainable nursing workforce.

Matched MeSH terms: Emigrants and Immigrants*
Fulltext Health profiles of foreigners attending primary care clinics in Malaysia

Ab Rahman N, Sivasampu S, Mohamad Noh K, Khoo EM

BMC Health Serv Res, 2016 06 14;16:197.
PMID: 27301972 DOI: 10.1186/s12913-016-1444-0

BACKGROUND: The world population has become more globalised with increasing number of people residing in another country for work or other reasons. Little is known about the health profiles of foreign population in Malaysia. The aim of this study was to provide a detailed description of the health problems presented by foreigners attending primary care clinics in Malaysia.

METHODS: Data were derived from the 2012 National Medical Care Survey (NMCS), a cross sectional survey of primary care encounters from public and private primary care clinics sampled from five regions in Malaysia. Patients with foreign nationality were identified and analysed for demographic profiles, reasons for encounter (RFEs), diagnosis, and provision of care.

RESULTS: Foreigners accounted for 7.7 % (10,830) of all patient encounters from NMCS. Most encounters were from private clinics (90.2 %). Median age was 28 years (IQR: 24.0, 34.8) and 69.9 % were male. Most visits to the primary care clinics were for symptom-based complaints (69.5 %), followed by procedures (23.0 %) and follow-up visit (7.4 %). The commonest diagnosis in public clinics was antenatal care (21.8 %), followed by high risk pregnancies (7.5 %) and upper respiratory tract infection (URTI) (6.8 %). Private clinics had more cases for general medical examination (13.5 %), URTI (13.1 %) and fever (3.9 %). Medications were prescribed to 76.5 % of these encounters.

CONCLUSIONS: More foreigners were seeking primary medical care from private clinics and the encounters were for general medical examinations and acute minor ailments. Those who sought care from public clinics were for obstetric problems and chronic diseases. Medications were prescribed to two-thirds of the encounters while other interventions: laboratory investigations, medical procedures and follow-up appointment had lower rates in private clinics. Foreigners are generally of young working group and are expected to have mandatory medical checks. The preponderance of obstetrics seen in public clinics suggests a need for improved access to maternal care and pregnancy related care. This has implication on policy and health care provision and access for foreigners and future studies are needed to look into strategies to solve these problems.

Matched MeSH terms: Emigrants and Immigrants*

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