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Communicable diseases 127 migrants among newly infected HIV cases were reported from Norway (39.5%), Iceland (36.4%), Cyprus (35.3%), Sweden (35.3%), Malta (34.5%) and Ireland (32.2%) (EuroHIV 2007). The majority of HIV infections diagnosed in migrants seemed to have been acquired within their countries of origin (Hamers et al. 2004). In addition to national surveillance statistics, studies from different European countries can be used to illustrate the possible impact of migration on HIV/ AIDS in Europe. For example, one Greek study found that around 12% of all HIV cases reported in 1989–2003 occurred among migrants. Most originated from sub-Saharan Africa (32.4%) and central and eastern Europe (almost 20%) (Nikolopoulos et al. 2005). A large Spanish survey, in which 8861 people with and without migration background were tested for HIV, also showed a high proportion of HIV infections among migrants (34.7%). Over half of these infections were among female sex workers originating from Latin America. The HIV prevalence in non-migrant subjects differed significantly from that in migrants from sub-Saharan Africa (1.8% vs 8.4%; P
128 Migration and health in the European Union deaths in migrants can, at least in part, be attributed to the high frequency of late diagnosis (e.g. diagnosis with an AIDS-defining illness). This reflects the presence of many different barriers, such as access to testing and care, fear of disease and death, fear of discrimination in the community and (mainly unfounded) fear of deportation (Fakoya et al. 2008). Childhood diseases Many communicable diseases occurring during childhood, such as measles, mumps, rubella and polio, are preventable by immunization and their incidence is now low in most developed countries. However, other common childhood diseases, such as gastroenteritis and acute respiratory infections, are not notifiable and, even if they are, migration status is rarely recorded. In addition, data on vaccination coverage of children generally do not include information on migration background. One of the few studies on this topic analysed routine surveillance data of 32 European countries on measles for 2006–07 (Muscat et al. 2009). Within this period, 12,132 measles cases were reported, 85% of them from Germany, Italy, Romania, Switzerland and the United Kingdom. Where data were available, the study analysed whether measles cases were of indigenous origin or imported from another country, finding substantial differences across countries. In total, 210 cases were imported in 2006 and 2007. In Bulgaria, Croatia, Cyprus, Finland, Hungary, Iceland, Portugal, Slovakia and Slovenia, all reported measles cases seemed to be imported (Muscat et al. 2009). A recent study from Italy suggested that at least one of the two measles outbreaks which took place in 2006 and 2007 seemed to be due to imported cases from Romania (Curtale et al. 2010). According to one German study, children of parents with non-German nationality had a lower immunization rate for measles, mumps and rubella (MMR) (Markuzzi et al. 1997). Studies in Greenland and Belgium also identified migration as a risk factor for low immunization coverage (Hansen et al. 2003; Vandermeulen et al. 2008). Another German study explored whether there was an association between immunization coverage of pre-school children and their acculturation, i.e. the process of cultural adaption to their new host country. While the study did not find any difference in immunization status for the MMR vaccine, lower acculturation was associated with incomplete immunization with the multi-dose vaccine against HBV, but the “native” population was more likely to forego vaccination altogether (Mikolajczyk et al. 2008). The practice of screening migrants for infectious diseases Discussions of migration and communicable disease often revolve around the practice of screening migrants at entry. However, the value of screening incoming migrants for infectious diseases is highly contested and there is no consistent policy across Europe. There are countries that have established
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European Observatory on Health Syst
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The European Observatory on Health
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Open University Press McGraw-Hill E
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European Observatory on Health Syst
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viii Contents five Migrants’ acce
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List of tables and figures Tables 2
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About the authors Róza Ádány is
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About the authors xv Anthony M. Mes
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Acknowledgements This book is the r
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xx Abbreviations EU10 the 10 countr
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chapter one Migration and health in
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Introduction 5 time of residence in
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Introduction 7 co-financed by the E
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Introduction 9 of health services f
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Introduction 11 modified. Among the
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Introduction 13 Vasileva, K. (2010)
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chapter two Trends in Europe’s in
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Trends in Europe’s international
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Figure 2.1 Foreign citizens as a pe
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Table 2.1 Three largest groups of f
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(b) Central and eastern Europe 1995
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Table 2.3 Asylum applications in se
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chapter three Asylum, residency and
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Asylum, residency and citizenship p
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chapter four The right to health of
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The right to health of migrants in
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chapter five Migrants’ access to
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Migrants’ access to health servic
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178 Migration and health in the Eur
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Section VI Policy response
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chapter thirteen Differences in lan
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Differences in language, religious
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chapter fourteen Good practice in e
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Good practice in emergency care: vi
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“Cultural” factors Good practic
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chapter fifteen Good practice in he
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Good practice in health service pro
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Sustainability of changes Good prac
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Section VII Conclusions
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Migration and Health in the Europea
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English - World Health Organization Regional Office for Europe

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