Xavier Balanzó

Enfermedades importadas en inmigrantes africanos: estudio de 1.321 pacientes

Fundamento Los inmigrantes pueden ser portadores de enfermedades propias de sus paises deorigen, denominadas enfermedades importadas (EIM). Estas pueden clasificarse en tropicales(ET) o cosmopolitas (EC). Los objetivos de este estudio son caracterizar las EIM por inmigrantesafricanos y valorar su posible repercusion en la salud publica en Espana. Pacientes y metodo Estudio observacional retrospectivo, realizado entre 1984 y 1994 a inmigrantesafricanos que consultaron a la Unidad de Medicina de la Inmigracion y Tropical delHospital de Mataro desde enero de 1984 a diciembre de 1994. Se excluyeron las EIM cronicasno infecciosas. En relacion con la repercusion en la salud publica del pais receptor se definierontres categorias: a) EIM sin riesgo actual; b) EIM con riesgo potencial y c) EIM de riesgo. Resultados Se estudio a 1.321 inmigrantes africanos. El 8,6% era de origen magrebi y el 87%del Africa subsahariana. De las ET destacaron las helmintiasis, y de las EC, la tuberculosis, lasenfermedades de transmision sexual y las parasitosis. Las EIM sin riesgo de transmision representaronel 26,7% (2,4% EC y 24,3% ET); las EIM con riesgo potencial, el 35,2% (33,6% ECy 1,6% ET) y las EIM con riesgo, el 38% (EC en la totalidad). Conclusiones Las enfermedades de distribucion cosmopolita y asociadas a las situaciones deprecariedad economica y marginacion social suponen un mayor riesgo de transmision a la poblaciondel pais receptor. Las politicas globales de ayuda a la insercion socioeconomica de lapoblacion inmigrante y la colaboracion sanitaria internacional deberian repercutir positivamenteen la salud de la poblacion general.

Resistance to the migration of microorganisms of a needle-free disinfectable connector

The aim of this study was to assess the efficacy of a disinfectable needle-free connector in reducing the pass of micro-organisms to the lumen of the catheter. A prospective, controlled, experimental trial was performed in which a laboratory model simulated the insertion of a peripheral venous catheter. Catheters inserted in sterile conditions in a hemoculture bottle were closed with the disinfectable needle-free connector (study group) or with a cap (control group). After 9 days of contamination and manipulation of the connector and cap external surfaces, 100% of bottles in the control group were contaminated whereas 60% remained sterile in the study group. The disinfectable needle-free connector showed more resistance to the pass of microorganisms than the conventional cap according to our experimental model.

Epidemiologic and biogeographic analysis of 542 VFR traveling children in Catalonia (Spain). A rising new population with specific needs.

BACKGROUND Imported diseases recorded in the European Union (EU) increasingly involve traveling immigrants returning from visits to their relatives and friends (VFR). Children of these immigrant families can represent a population of extreme vulnerability. METHODS A randomized cross-sectional study of 698 traveling children under the age of 15 was performed. VFR traveling children and non-VFR (or tourist) children groups were compared. RESULTS A total of 698 individuals were analyzed: 354 males (50.7%) and 344 females (49.3%), with a median age (interquartile range) of 4 (2-9) years. Of these, 578 (82.8%) had been born in the EU with 542 (77.7%) being considered as VFR, whereas 156 (22.3%) were considered tourists. VFR children were younger (4.7 vs 8.2 yr; p < 0.001), they had more frequently been born in the EU (62.8% vs 20.1%; p < 0.01) and were more frequently lodged in private homes (76.6% vs 3.2%: p < 0.001) and rural areas (23.2% vs 1.6%; p < 0.001). Furthermore, VFR remained abroad longer (51.6 vs 16.6 d; p < 0.001), the visit/travel time interval was shorter (21.8 vs 32.2 d; p < 0.001) than tourists, and consultation was within 10 days prior to the departure (26.4% vs 2.7%; p < 0.001). The risk factor most differentiating VFR children from tourists was accommodation in a rural setting [odds ratio(OR) = 5.26;95%CI = 2.704-10.262;p < 0.001]. CONCLUSIONS VFR traveling children showed a greater risk of exposure to infectious diseases compared with tourists. Immigrant families may represent a target group to prioritize international preventive activities.