10/8/2018 https://ncsi.gov.om/Pages/NCSI.aspx Protocol Based Screening of Migrants in Oman Seif Al-Abri and Eskild Petersen Population Pyramid For 2016 Discuss the pre-departure and the post-arrival screening Discuss the results and implications of screening of migrants with emphasis Objectives on TB and malaria Discuss how to establish a cost- effective, and sustainable approach to screening migrants Do Migrants Pose a Communicable Diseases Risk to Host Countries? Eskild Petersen Seif Al-Abri Royal Hospital MoH 1
10/8/2018 GCC Pre-departure screening Health Ministers’ Council for GCC States passed a resolution of initiating a pre- If You Are a Member of the National Taskforce for departure expatriates health screening program in 1995 Screening of Migrants In Your Country: Pre-departure screening takes place in the country of origin 1. What diseases will you include in your screening? Ensure that expatriates migrating to the GCC are physically and psychologically fit 2. What methods will you use? and able to perform the job they are hired for. Ensure that the expatriates are declared free of infectious diseases that could threaten the health security and safety of the Gulf community. Pre-arrival Screening What do we do in Pre-departure Screening Oman? Approved medical centres abroad Post-arrival screening GCC database Ministry of Health Oman database Royal Oman Police database Pre-arrival Screening for GCC 2
10/8/2018 Where to Do the Medical Checkup? What to Test for? All? Where do we do the Specific categories/professions? medical check up in Whom to Test? Oman? Specific Age groups? Medical fitness centers Specific Nationalities? Licenced private centers Primary health care HIV HBV HCV What Do We Test for Syphilis in Oman? TB Malaria (selected persons only) Food Handlers: stool 3
10/8/2018 Ministerial regulations What Are The Department of environment and Requirements For A occupational health Screening System At Framework and operational plan for A National Level, medical fitness Oman? National e-surveillance system E-link between MoH, Royal Oman Police and Ministry of Manpower What Are the Requirements for a Screening System at a National Level? Will You Offer For which diseases? Vaccination to For whom? Statutory body What Are the Migrants? Regulations, Policies and procedures Specific age groups? Requirements For a Specific categories of migrants? Accountability and governance Screening System at a National Level? Specific nationalities? Surveillance; HIS/networking between all stakeholders Who should pay for it? Training 4
10/8/2018 Every 2 years for category One National EPI vaccines free to children HIV, HBV and HCV Oman: Will You Oman: Will You Offer MMR: Measles, Mumps and Rubella Conduct A Follow-up TB screening Vaccination to HBV Screening For Migrants? Every 4 years for category Two Migrants? Typhoid for food handlers TB and HIV Will You Conduct a Follow-up Screening for Migrants? For whom? Will You Conduct A For what? Follow-up Screening For Migrants? When? Will you offer treatment? 5
10/8/2018 Should we screen migrants from specific countries based on endemicity? Should We Screen Migrants to Oman for What tests should we use? microscopy, Rapid Diagnostic tests or Malaria? molecular methods (PCR, LAMP) Should we just ensure surveillance and handle outbreaks when they occur ? 43566 tested 11 countries Oman, Screening of Migrants for First time visitors Malaria, 2017 Within 4 weeks of arrival Medical fitness centers Microscopy 6
10/8/2018 Sustainability Cost esp for new technologies: IGRA Oman: What Are The and Gene-Xpert Main Challenges For Resources for screening for malaria Screening Of Migrants? Follow up of migrants with TB Vaccination IGRA and treatment of latent TB PCR or LAMP for malaria screening What Is Next? Serosurvey for migrants from measles endemic countries Integration of migrants health in national diseases elimination strategic plans Establishment of Public Private Mix Oman and GCC countries have established a systematic process for What Are the Main screening of migrants Screening probably needs to stratify Challenges for risk based on the disease prevalence In conclusion in the country of origin, e.g TB & Screening of Migrants? malaria Screening will never be 100% effective, and a well functioning surveillance program is needed 7
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