Hepatitis E, Schistosomiasis and Echinococcosis–Prevalence in a Cohort of Pregnant Migrants in Germany and Their Influence on Fetal Growth Restriction

Background: Infections, as well as adverse birth outcomes, may be more frequent in migrant women. Schistosomiasis, echinococcosis, and hepatitis E virus (HEV) seropositivity are associated with the adverse pregnancy outcomes of fetal growth restriction and premature delivery. Methods: A cohort study of 82 pregnant women with a history of migration and corresponding delivery of newborns in Germany was conducted. Results: Overall, 9% of sera tested positive for anti-HEV IgG. None of the patients tested positive for anti-HEV IgM, schistosomiasis, or echinococcus serology. Birth weights were below the 10th percentile for gestational age in 8.5% of the neonates. No association between HEV serology and fetal growth restriction (FGR) frequency was found. Conclusions: In comparison to German baseline data, no increased risk for HEV exposure or serological signs of exposure against schistosomiasis or echinococcosis could be observed in pregnant migrants. An influence of the anti-HEV serology status on fetal growth restriction could not be found.

The impact of the caregiver mobility on child HIV care in the Manhiça District, Southern Mozambique: A clinical based study

Introduction Manhiça District, in Southern Mozambique harbors high HIV prevalence and a long history of migration. To optimize HIV care, we sought to assess how caregiver’s mobility impacts children living with HIV (CLHIV)´s continuation in HIV care and to explore the strategies used by caregivers to maintain their CLHIV on antiretroviral treatment (ART). Methods A clinic-based cross-sectional survey conducted at the Manhiça District Hospital between December-2017 and February-2018. We enrolled CLHIV with a self-identified migrant caregiver (moved outside of Manhiça District ≤12 months prior to survey) and non-migrant caregiver, matched by the child age and sex. Survey data were linked to CLHIV clinical records from the HIV care and treatment program. Results Among the 975 CLHIV screened, 285 (29.2%) were excluded due to absence of an adult at the appointment. A total of 232 CLHIV-caregiver pairs were included. Of the 41 (35%) CLHIV migrating with their caregivers, 38 (92.6%) had access to ART at the destination because either the caregivers travelled with it 24 (63%) or it was sent by a family member 14 (36%). Among the 76 (65%) CLHIV who did not migrate with their caregivers, for the purpose of pharmacy visits, 39% were cared by their grandfather/grandmother, 28% by an aunt/uncle and 16% by an adult brother/sister. CLHIV of migrant caregivers had a non-statistically significant increase in the number of previous reported sickness episodes (OR = 1.38, 95%CI: 0.79–2.42; p = 0.257), ART interruptions (OR = 1.73; 95%CI: 0.82–3.63; p = 0.142) and lost-to-follow-up episodes (OR = 1.53; 95%CI: 0.80–2.94; p = 0.193). Conclusions Nearly one third of the children attend their HIV care appointments unaccompanied by an adult. The caregiver mobility was not found to significantly affect child’s retention on ART. Migrant caregivers adopted strategies such as the transportation of ART to the mobility destination to avoid impact of mobility on the child’s HIV care. However this may have implications on ART stability and effectiveness that should be investigated in rural areas.

“We Are Suffering Here”

Liberia is a state built on a history of migration. From the transatlantic slave trade to its contemporary generation of transnational citizens, images of elsewhere have always informed this West African country’s local and national discussions of integration and exclusion. This paper shows how historical imaginations and representations of ‘here’ and ‘there’, of ‘suffering’ and ‘escape’, inform contemporary discourses of belonging in Liberia. I argue that the imagination of civilisation – kwii – and distinction plays an important role in the ways distance and mobility are perceived and articulated, both from a physical point of view and a moral-social point of view, at transnational and local levels. Rather than being merely tied to a national elite, the imagination of mobility is, I demonstrate, linked to an ethos of suffering articulated at all levels of society, informed by the experience of structural violence and crises over time.

The History of Migration from Turkey to Western Europe: A Multi-theoretical Analysis of the Routes to Germany and the United Kingdom

Since the existing research on migration from Turkey to Western Europe does not employ multiple theoretical perspectives, this article, based on two field studies, focuses on the changing phases and forms of this human mobility by utilising a number of relevant international migration theories. The article examines the uncovered socio-economic, demographic, and political aspects of migration from Turkey to Germany and the United Kingdom and unpacks how the parameters and motives for these two routes have changed from a comparative historical perspective. In this way, it deepens the discussion on the factors and circumstances leading to migration and demonstrates that while individual, household, and historical-structural distinctions and conflicts initiate human mobility, it is perpetuated by ongoing differences, a culture of migration, networks, and ethnic economies.

The migration ban policy cycle: a comparative analysis of restrictions on the emigration of women domestic workers

Policies banning women domestic workers from migrating overseas have long been imposed by labour-sending states in the Indo-Pacific region. This article presents the complexities surrounding such bans by developing an overarching model of a migration ban policy cycle, which provides a theoretical framework for understanding the circumstances under which migration bans arise and play out. It examines the history of migration bans for four prominent labour-sending states – Indonesia, Nepal, the Philippines and Sri Lanka - to assess the causes, outcomes and extent of regional convergence of these policies. In doing so, we uncover two prominent policy narratives. The first involves labour diplomacy, where countries employ bans to negotiate superior working conditions and rights for migrant workers. The second concerns paternalist states as ‘protector’, where states are primarily motivated to reaffirm traditional gender norms. We conclude that migration bans have been most effective, both in curbing departures and achieving desired outcomes, when they are primarily motivated by labour issues and not gender politics. Nevertheless, even when used as a form of diplomatic negotiation, migration bans heighten the vulnerability of domestic workers to exploitation by pushing them into irregular pathways fraught with risk.

Human Mobility Towards Turkey: A Retrospective Endeavor to Understand

Last decade, Turkey experienced the most extensive migration raids in its history. The transition of Turkey from a migrant-sending country to a transit and target country is one of the most referenced periodization practices in the literature. However, Anatolia has a history of migration with very different experiences by its location. Human mobility is inherent to the structure of this geography, even though its quality and quantity have changed and transformed in the historical process. Therefore, it is important to understand that Turkey, which is home to the most significant number of forced migrants in the twenty-first century, is historically a country of migration. Hence, in this article that attempts to understand human mobility towards Turkey, we have focused on Turkey's changing position on the international migration scheme after summarizing the migration flows before and during the republic period to capture the holistic perspective. Based on the current research, reports, and statistical data, this article seeks a better understanding of the possibility and sustainability of social cohesion and integration in Turkey, in a global world characterized by uncertainties, risks, and pursuits.

Characteristics of children with leprosy: Factors associated with delay in disease diagnosis

Objectives: The objectives of the study were to characterize the clinical profile of childhood leprosy presenting at tertiary leprosy care hospitals in the states of Bihar, West Bengal and Uttar Pradesh in India, and to determine the possible risk factors associated with disabilities at presentation. Methods: Subjects were children with newly diagnosed leprosy registered for treatment at tertiary Leprosy Mission Hospitals in Muzaffarpur (Bihar), Purulia (West Bengal) and Faizabad (Uttar Pradesh), India, between June and December 2019. Demographic and leprosy characteristics were collected at the time of diagnosis. Parents/guardians were interviewed on reasons for delay in presenting at the hospital. Associations between various factors and delay in diagnosis were assessed. Results: Among the 84 children, the mean (SD) age was 10 (3) years with a range of 4–14 years. There were more boys (58%) and most children were currently in school (93%), resident in rural areas (90%) and belonged to a lower socioeconomic status (68%). More children were diagnosed with multibacillary leprosy (69%), one-third of them being skin smear positive for Mycobacterium leprae. On presentation, 17% had deformity (5% grade 1 deformity and 12% grade 2), 29% had nerve involvement and skin lesions were spread across the body in half of the children. Mean (SD) duration of delay was 10.5 (9.8) months. Delayed presentation was more in boys (43% vs. 17%; P = 0.01), those without a history of migration for work compared to those who had a history of migration (40% vs. 9%; P = 0.008) and in those children who were from a poor economic status compared with those that came from a better economic status (44% vs. 7%; P = 0.001) Limitations: Because our study was conducted at tertiary care hospitals, the findings are not representative of the situation in the field. Furthermore, a comparison group of newly diagnosed adult leprosy patients with disability could have been included in the study. Conclusion: Childhood leprosy continues to occur in endemic pockets in India and a substantial number present with skin smear positivity and deformity. Guardians of these children cite many reasons for the delay in presentation.