BMC Public Health
Volume 16, Issue 1, 2016

Undocumented migrant women in Denmark have inadequate access to pregnancy screening and have a higher prevalence Hepatitis B virus infection compared to documented migrants in Denmark: A prevalence study (Article) (Open Access)

Wendland A.* , Ehmsen B.K. , Lenskjold V. , Astrup B.S. , Mohr M. , Williams C.J. , Cowan S.A.
  • a Statens Serum Institut, Artillerivej 5, København S, 2300, Denmark, European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
  • b Danish Research Centre for Migration, Ethnicity and Health (MESU), Oster Farimagsgade 5, Postboks, København K, 20991014, Denmark
  • c Røde Kors Sundhedsklinikken, Blegdamsvej 27, København Ø, 2100, Denmark
  • d ProVest Clinic, Fredericia, Denmark
  • e Reden International, Colbjørnsensgade 12 st.tv, København V, 1652, Denmark
  • f European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden, Public Health Wales, Temple of Peace and Health, Cathays Park, Cardiff, CF10 3AP, United Kingdom
  • g Statens Serum Institut, Artillerivej 5, København S, 2300, Denmark

Abstract

Background: Pregnant residents of Denmark are tested by their GP for current infections with Hepatitis B virus (HBV), HIV and syphilis through the Danish pregnancy screening programme to identify infections and initiate interventions to prevent mother-to-child transmission. Documented migrants (DM) have access to this screening but undocumented migrants (UM) do not, instead relying on ad-hoc care from clinics run by non-governmental organisations. We aimed to assess screening frequency in UM and to compare prevalence of infection in UM with DM. Methods: We obtained individual-level information on HBV, HIV and syphilis testing frequency and results for pregnant women attending three clinics specialising in care for UM between August 2011 and August 2014. We obtained aggregate data on the prevalence of the three infections for documented migrants from the Danish pregnancy screening programme and birth register between January 2011 and January 2014. Planned abortions were excluded from the study. We described demographic features of pregnant UM and estimated the screening frequency for HIV, HBV and syphilis. We compared prevalence of current infections in UM and DM by calculating standardised prevalence ratios (SPR). Results: The three UM clinics registered 219 pregnancies qualifying for screening. Overall 43, 58 and 60 % of pregnant UM had a test result recorded for HBV, Syphilis and HIV respectively, compared to >99 % in the general Danish population including DM. The prevalence of HBV was higher in UM than in DM (SPR: 2.4; 95 % CI: 1.1-5.3). The SPR of 2 (95 % CI: 0.5-8.0) for HIV was not statistically significant, potentially due to small sample size of UM. None of the pregnant UM tested positive for Syphilis. Conclusions: Pregnant UM have a poorer chance of being tested for HIV, HBV and syphilis, despite having a higher prevalence of HBV than DM. We recommend giving systematic access to routine pregnancy screening to all UM to prevent mother-to-child transmission and to address the observed health care inequity. © 2016 Wendland et al.

Author Keywords

Pregnancy screening Undocumented migrants Hepatitis B HIV Syphilis

Index Keywords

HIV Infections mass screening Pregnancy Complications, Infectious human middle aged Denmark statistics and numerical data Cross-Sectional Studies Young Adult cross-sectional study Humans Adolescent female pregnancy Syphilis prevalence prevention and control Retrospective Studies adult Infectious Disease Transmission, Vertical migration vertical transmission Transients and Migrants retrospective study hepatitis B
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85007603371&doi=10.1186%2fs12889-016-3096-8&partnerID=40&md5=3c49b687cd8ef44b29d3e6f0c0d3474a
DOI: 10.1186/s12889-016-3096-8
ISSN: 14712458
Cited by: 7
Original Language: English