TROPICAL DISEASES IN AN ITALIAN OUTPATIENT CLINIC

Morrone A., Franco G., Valenzano MC., Fazio R., Terranova M., Padovese V., Calcaterra R., Latini O.

21° WORLD CONGRESS OF DERMATOLOGY
Buenos Aires, 30 September – 5 October 2007

Background
Immigration has become an important factor in health and global social development. The World Health Organization (WHO) uses the term “Human Mobile Population” to collectively define immigrants, refugees, asylum seekers, migrant workers, tourists, travellers and anyone who for whatever reason lives temporarily or permanently outside the country of origin.
Materials and methods
To develop trend’s estimates of tropical diseases observed between 1995 and 2007 in the Department of Preventive Medicine of Migration, Tourism and Tropical Dermatology at San Gallicano Institute in Rome.
We analysed the immigrants’ number per year, the provenience and the clinical diagnosis reported in the Department between 1995 and 2004. We focalised our attention on the tropical diseases’ diagnosis.
Results
Between 1995 and 2006 we examined 91,536 immigrants, 4,868 (45,7%) women and 49,678 (54,3%) man. The proveniences’ profile changed with a decreased number of immigrants coming from tropical areas (in 1995 it was estimated 36%, whereas in 2006 it was 23%) and an increase from East Europe. We identified some cases of tropical diseases (mycetoma, sporotrichosis, lobomycosis, paracoccidioidomycosis, blastomycosis, cryptococcosis, filariasis, myasis, loiasis), which were very probably contracted in a tropical area and then imported to Italy. The tropical diseases in the immigrant population increased from 6% in 1995 to 27% in 2006.
Conclusions
In 2006, the Human Mobile Population was estimated at around 1,2 billion worldwide. This extraordinary phenomenon has drastically changed the incidence and prevalence of many pathologies, foremost of which rank infectious diseases (tuberculosis, malaria, leprosy) sexually transmitted diseases and tropical diseases.
In our experience, we have stressed that when the immigrant arrives in Italy he is fundamentally healthy and he develops diseases related to the condition in which he lives in the host country (“poverty related diseases”). This is partially true. The increase of certain tropical diseases, which is not related to an increase of immigrants’ flow from endemic areas, may be due to the higher influx of immigrant women, older people and children who are already ill when they arrive in Italy. As migration increases, more and more dermatological diseases with tropical or unusual features will be present in immigrants from endemic areas or in individuals returning from such areas. It is therefore vital that dermatologists receive appropriate training in recognizing these new diseases so that they can be caught a an early stage and followed up adequately.
References
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