7.5-O4Italian guideline on “health checks and protection pathways for migrants on arrival and while hosted in reception centres”

Issue: The migratory phenomenon represents a big challenge for the Italian health system to be answered through a systematic approach and public health practices based on scientific evidence. Description: During 2016-17, a guideline was developed to offer evidence-based recommendations on the practice of health checks at arrival in Italy and during the reception phases. The target population are migrants and international protection seekers intercepted by the reception system. The areas taken into consideration are both infectious diseases and chronic conditions, in addition to pregnancy. Results: The guideline identifies specific health conditions (TD, malaria, STD, intestinal parasites, diabetes, anaemia) for which signs and symptoms are to be actively sought and others for which testing is also offered to asymptomatic subjects coming from endemic areas or exposed to specific risk factors (tuberculosis, HIV, HBV, HCV, syphilis, chlamydia, gonorrhea, strongyloides, schistosoma, diabetes). Mass screening is recommended for anaemia and hypertension, a pregnancy test should be considered and inclusion in the Italian cervical cancer screening and vaccination programmes is advocated. The recommendations are intended to a) promote clinical and organisational appropriateness; b) prevent waste connected with carrying out unnecessary or unnecessarily repeated assessments; c) diminish defensive practices due to unjustified alarmism. Conclusions: The main lesson learned during the guideline development was the need for continuity of care between the different stages of the reception process. Therefore, a modulated, progressive approach was chosen, covering the initial evaluation at the rescue phase, the full medical examination in the first reception stage, and the referral to national health services in the second reception phase. Main message: The diffusion and implementation of this guideline at national level would facilitate the adoption of evidence-based good practice during the reception of newly arrived migrants in Italy, to avoid uncertainty and variability of practices at regional and local level.