Migration and health: targeting highly prevalent infections from Sub-Saharan Africa

What is the project about?

Infections are an important part of migrant health. Detecting and treating infections could prevent potentially severe acute and chronic conditions in migrants. Migration from countries in Sub-Saharan Africa has increased over the last years. Screening programmes therefore need to address infections that are highly prevalent in this region. Despite high parasite prevalence in endemic areas, malaria, schistosomiasis and strongyloides are not included in the current screening program for migrants and evidence-based guidelines are needed. In a recent study in Sweden, we detected an unexpectedly high malaria parasite prevalence in asymptomatic migrants screened at migrant health facility with 9% prevalence overall, and up to 35% in children. Clinical observation when assessed for treatment, have detected several health issues in parasite positive individuals. These findings suggest that screening of malaria should be considered. This project aims at establishing the need for such screening program, including exploring the parasite prevalence and health effects in a larger population of migrants from Sub-Saharan Africa, as well as developing a diagnostic platform that could be used nationwide, and assessing how long after arrival screening would be valuable. Moreover, we will perform a pilot randomised trial to assess the impact ad feasibility of screening compared to standard of care without screening. Evaluation of introducing a screening program for malaria and other parasites will include feasibility, acceptability and cost-effectiveness. The project has the potential to guide screening strategies and make significant contributions to improved health in migrants from Sub-Saharan Africa.

Research questions

The purpose of this project is to improve the health of migrants focusing on parasitic infections. The aim is to investigate the burden of malaria and other parasitic diseases, and the need of adding these parasites to screening programmes for migrants from Sub-Saharan Africa.

Specific aims

1. To assess the prevalence, burden, and health impact of parasitic infections in Sub-Saharan Africa migrants
2. To investigate screening strategies, incl diagnostic method, timing as well as acceptability
3. To perform a cluster randomised trial to assess health impact och cost of malaria screening

Project participants

The project team consists of researhers from different departments at Karolinska Institutet, including specialists in infectious diseases in both children and adults, as well as experts in diagnostics, migrant health, infectious disease control and health economics.