Letter to the editors | Volume 40, Article 97, 13 Oct 2021 | 10.11604/pamj.2021.40.97.28116

Forced migration as a risk factor for COVID-19 infection in Africa: insight from Agadez, Niger

Aboubacar Abdou Batoure, Oumarou Batoure, Blanche-Philomene Melanga Anya, Didier Tambwe, Bienvenu Baruani, Ishag El Khalef, Joseph Nsiari-Muzeyi Biey, Patrick Katoto, Charles Shey Wiysonge

Corresponding author: Charles Shey Wiysonge, Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa

Received: 28 Jan 2021 - Accepted: 03 Oct 2021 - Published: 13 Oct 2021

Domain: Community health,Global health,International health

Keywords: SARS-COV-2, humanitarian crisis, migrants, mobility

©Aboubacar Abdou Batoure et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article: Aboubacar Abdou Batoure et al. Forced migration as a risk factor for COVID-19 infection in Africa: insight from Agadez, Niger. Pan African Medical Journal. 2021;40:97. [doi: 10.11604/pamj.2021.40.97.28116]

Available online at: https://www.panafrican-med-journal.com/content/article/40/97/full

Home | Volume 40 | Article number 97

Letter to the editors

Forced migration as a risk factor for COVID-19 infection in Africa: insight from Agadez, Niger

Forced migration as a risk factor for COVID-19 infection in Africa: insight from Agadez, Niger

Aboubacar Abdou Batoure1, Oumarou Batoure1, Blanche-Philomene Melanga Anya1, Didier Tambwe1, Bienvenu Baruani1, Ishag El Khalef1, Joseph Nsiari-Muzeyi Biey2, Patrick Katoto3,4,5, Charles Shey Wiysonge5,6,7,&

 

1World Health Organization, Niamey, Niger 2World Health Organization, Ouagadougou, Burkina Faso, 3Centre for Infectious Diseases, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa, 4Centre for Tropical Diseases and Global Health, Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of Congo, 5Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa, 6Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa, 7School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa

 

 

&Corresponding author
Charles Shey Wiysonge, Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa

 

 

To the editors of the Pan African Medical Journal    Down

Notwithstanding the mobility limitations accompanying the COVID-19 pandemic restriction, migrants continue to embark on clandestine journeys, escaping conflict and hardship in search of a more stable life. Although many deaths attributable to COVID-19 infection among migrants´ workers have been underreported, it has been estimated that over 2,500 migrants have died during migration in 2020, as measures to contain the pandemic such as lockdowns and travel restrictions, have increased the risks and uncertainties associated with these journeys. Numerous fatalities among migrant workers associated with COVID-19 infection and related measures were not included in this figure. [1]. The Agadez Region in Niger is experiencing the consequences of destabilization in the Sahel by armed groups while being the gateway to Europe for most Africans. Given its size (half of the country land), Agadez is a major challenge for epidemiological surveillance. As migration is a contributing factor to the spread of COVID-19 disease [2], we hypothesized that forcibly displaced persons are at increased risk for COVID-19 infection in Agadez. In a retrospective study of the health data of the national health information system (supplemented as needed by consultation registers), we reviewed all COVID-19 positive migrant patient records admitted from 1stMay to 8th December 2020. Of note, medical checks were performed at seven entrance gates on all incoming passengers by trained health workers. A team of 58 officers with different backgrounds under the direction of the referring physician managed confirmed cases.

 

For holistic approach, two psychologists recruited by WHO provided psycho-social support to COVID-19 patients and relatives. We used deidentified data and ensure principles of ethics are respected during data cleaning process and analysis. Graphpad prism V.8 was used for graphing results and for descriptive analysis of proportions. We found that between 1st May 2020 date of notification of the first case of the region to 8th December 2020, Agadez recorded 174 confirmed cases (age median/range: 29.3/ 6-75 years) of COVID-19 out of 1,258 samples taken (846 routine screenings). Of the 174, 93 (53.5%) were migrants (91 or 97.8% males) (Figure 1). Geographically, of the 93 positive migrant cases, 91 cases were recorded in common Agadez and two in Assamaka. A successfully contact-tracing and testing was reported as 27/336 people contacts for the 93 positive migrants had also tested positive for COVID-19 infection. Among the 93 positive migrants, more than half were unemployed. Positive cases among migrants were all asymptomatic and, all successfully recovered from COVID-19 infection and benefited with psychologic support. Depression was common among migrants infected for SARS-CoV-2 in and related with the forced return from Algeria and confirmed COVID-19-infection.

 

The deadliest immigration path in the world remains the central Mediterranean-some 580 people perished on this route between March and October 2020. Hereby, we provide an earlier insight of COVID-19 infection among migrants in Agadez Region, Niger. We found that migrants are more likely of being young [1,2] and at increased risk for SARS-COV-2 infection [2]. In addition to language as barrier to quality of care access in the emergence room [3], mental health has been of concern among migrants worldwide [4-6]. The continuous arrival of migrant in this region makes hard contact tracing of positive cases. Moreover, considering the substantial positivity rate observed, the current over-whelmed site (Assamaka-Alit) might not be able of providing necessary infection and prevention controls measures such as observing physical distance. It is therefore a call for stakeholders involved in the region and for the African Union leadership to address the crisis and to consider migrants in the COVID-19 vaccination program.

 

Further, we found that migrants were more likely at working in informal sector as many of them could not fully describe their living job. Consequently, migrant involved in this precarious employment were less likely to be considered as essential workers but they work daily and cannot qualify for sick leave or for social security if any [7]. Effort is needed to address socio-economic challenges that face migrants in COVID-19 era. As such, communication in Agadez is more oriented towards migration management; above all, the peaceful cohabitation between migrants and indigenous peoples, in particular the management of the rumor that COVID-19 is being spread by migration. Despite being informative, the generalizability of our findings is limited by the fact that the reported high rate of positive cases among migrants in Agadez could be linked to the routine COVID-19 testing among migrants compared to residents due to lack of routine testing performed at the community level. For efficient border migration management in COVID-19 era; collaboration agreements and contingency plans for public health activities between countries and stakeholders are essential at common ports of entry, notably between Niger, Algeria and Libya. While a holistic approach is urgently needed to improve migrants´ health and social-economic conditions during COVID-19 pandemic, effort is needed to eradicate forcibly migration in Africa.

 

 

Ethical approval and consent to participate: this study used routine program data retrospectively collected with no individual data identifiers revealed or used. The study was approved by the Niger, Ministry of Public Health, and the Niger National COVID-19 Multisectoral Response Committee.

 

Competing interests    Down

The authors declare no competing interests.

 

 

Authors´ contributions Up    Down

All authors read and agreed to the final version of this manuscript and substantially contributed to its conception, implementation and content.

 

 

Acknowledgements Up    Down

The effective management of all confirmed cases registered in the region, thanks to certain structures (CHR; Hospitals Somar, Cominak, CSI Koukoki) and some premises (Villas SOKNI) the site of the salty cure (Ingall) had been identified, redeveloped, equipped, and upgraded to serve as a site of care.

 

 

Figure Up    Down

Figure 1: chronology of COVID-19 and characteristic of migrants infected with COVID-19 infection in Agadez Region in Niger from 01/05/2020 to 08/12/2020

 

 

References Up    Down

  1. Migration Data Portal. Migration data relevant for the COVID-19 pandemic. 2017 Sep 7.

  2. Indseth T, Grøsland M, Arnesen T, Skyrud K, Kløvstad H, Lamprini V et al. COVID-19 among immigrants in Norway, notified infections, related hospitalizations and associated mortality: a register-based study. Scand J Public Health. 2021 Feb;49(1):48-56. PubMed | Google Scholar

  3. Cox A, Iedema R, Li S, Sabbe M, Salaets H, Dauby N. Adding barriers to barriers during the COVID-19 pandemic: a call for interdisciplinary research on communication with migrant patients in the emergency department. Eur J Emerg Med. 2021 Jan 1;28(1):5-6. PubMed | Google Scholar

  4. Aragona M, Tumiati MC, Ferrari F, Viale S, Nicolella G, Barbato A et al. Psychopathological effects of the Coronavirus (Sars-CoV-2) imposed lockdown on vulnerable patients in treatment in a mental health outpatient department for migrants and individuals in poor socioeconomic conditions. Int J Soc Psychiatry. 2021 Jan 13;20764020988572. PubMed | Google Scholar

  5. Mukumbang FC. Are asylum seekers, refugees and foreign migrants considered in the COVID-19 vaccine discourse? BMJ Glob Health. 2020 Nov;5(11):004085. PubMed | Google Scholar

  6. Greenaway C, Hargreaves S, Barkati S, Coyle CM, Gobbi F, Veizis A et al. COVID-19: exposing and addressing health disparities among ethnic minorities and migrants. J Travel Med. 2020 Nov 9;27(7):taaa113. PubMed | Google Scholar

  7. Reid A, Rhonda-Perez E, Schenker MB. Migrant workers, essential work, and COVID-19. Am J Ind Med. 2021 Feb;64(2):73-77. PubMed | Google Scholar

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Letter to the editors

Forced migration as a risk factor for COVID-19 infection in Africa: insight from Agadez, Niger

Letter to the editors

Forced migration as a risk factor for COVID-19 infection in Africa: insight from Agadez, Niger

Letter to the editors

Forced migration as a risk factor for COVID-19 infection in Africa: insight from Agadez, Niger