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Bridging Gaps in Migrant Healthcare: CUAMM’s Experience from 13,103 Visits in Southern Italy Cover

Bridging Gaps in Migrant Healthcare: CUAMM’s Experience from 13,103 Visits in Southern Italy

Annals of Global Health
Volume 91 (2025): Issue 1
By: Cesare De Virgilio Suglia,  Renato Laforgia,  Marcella Schiavone,  Anna Belfiore,  Nicole Laforgia,  Annalisa Saracino,  Giovanni Putoto and  Francesco Di Gennaro  
Open Access
|Mar 2025
Figures & tables

Figures & Tables

Figure 1

Map of the informal settlements supported by Doctors with Africa CUAMM.

Table 1

Absolute distribution and percentage of patients at the first visit by gender and location.

GENDER SETTLEMENTMALE 2,430 (95.8%)FEMALE 107 (4.2%)TOTAL 2,537 (%)
Arena (A)275 (99.6%)1 (0.4%)276 (10.9%)
Barletta (B)15 (100%)0 (0%)15 (0.6%)
Borgo Tressanti (C)50 (73.5%)18 (26.5%)68 (2.7%)
Contrada Cicerone (D)167 (99.4%)1 (0.6%)168 (6.6%)
Madonna di Ripalta (E)78 (95.1%)4 (4.9%)82 (3.2%)
Pista (F)773 (91.7%)70 (8.3%)843 (33.2%)
San Carlo d’Ascoli (G)7 (100%)0 (0%)7 (0.3%)
Sankara (H)643 (98.9%)7 (1.1%)650 (25.6%)
Terlizzi (I)63 (100%)0 (0%)63 (2.5%)
Terraneo (J)90 (93.8%)6 (6.3%)96 (3.8%)
Turi (K)223 (100%)0 (0%)223 (8.8%)
Uliveto (L)46 (100%)0 (0%)46 (1.8%)
Figure 2

Gender distribution.

Table 2

Distribution of patient nationalities by settlement.

SETTLEMENT NATIONALITYN (%)ABCDEFGHIJKL
Afghanistan14 (0.55%)0000014000000
Algeria7 (0.28%)010000000060
Bangladesh1 (0.04%)000001000000
Belgium1 (0.04%)000000010000
Benin17 (0.67%)800005040000
Bulgaria29 (1.14%)0028100000000
Burkina Faso109 (4.3%)10026282303100
Cameroon8 (0.32%)000013040000
Chad4 (0.16%)100102000000
Congo3 (0.12%)000300000000
Ivory Coast86 (3.39%)1600284200160200
Ethiopia1 (0.04%)000001000000
Gambia523 (20.61%)101000016802510210
Ghana33 (1.3%)2001021020700
Guinea‑Bissau31 (1.22%)40010160100000
Guinea‑Conakry110 (4.34%)1100131550300000
India5 (0.2%)000050000000
Italy3 (0.12%)001000000200
Liberia3 (0.12%)000012000000
Libya1 (0.04%)000000000100
Mali254 (10.01%)42001034541440510
Morocco344 (13.56%)02260021155620942
Mauritania3 (0.12%)000002010000
Mauritius1 (0.04%)000000010000
Somalia (Mogadishu)1 (0.04%)000001000000
Nigeria137 (5.4%)1000011201001400
Pakistan8 (0.32%)000008000000
Poland9 (0.35%)000010000800
Punjab (India/Pakistan)2 (0.08%)000020000000
Romania24 (0.95%)0070003001400
Senegal686 (27.04%)850015131502630340
Sierra Leone11 (0.43%)200005040000
Somalia15 (0.59%)0000015000000
Sudan3 (0.12%)000003000000
Togo3 (0.12%)000002010000
Tunisia26 (1.02%)0125000006021
Not available21 (0.83%)201008042103

[i] A = Arena; B = Barletta; C = Borgo Tressanti; D = Contrada Cicerone; E = Madonna di Ripalta; F = Pista; G = San Carlo d’Ascoli; H = Sankara; I = Terlizzi; J = Terraneo; K = Turi; L = Uliveto.

Figure 3

Countries of origins.

Table 3

Distribution by settlement of age at first visit, presence of residence permit, presence of GP, and year of first visit.

AGE IN YEARSTOTAL (%)ABCDEFGHIJKL
0–1842 (1.66%)108064031919
19–29783 (30.86%)88783113288124241103618
30–451,327 (52.31%)169634118314543345143810312
46–65317 (12.50%)12214183272251635712
Over 6519 (0.75%)002006141140
Not available49 (1.93%)6021019050385
Median29.729.528.935.632.640.226.945.028.926.039.836.725.5
Average (SD)31.8 (10.4)30.7 (6.8)31.1 (8.3)35.6 (14.3)34.00 (7.8)39.2 (13.9)28.9 (8.4)49.5 (21.2)30.9 (8.7)29.7 (9.8)39.1 (14.8)39.5 (13.4)29.1 (12.6)
RESIDENCE PERMITTOTAL (%)ABCDEFGHIJKL
Absent2,083 (82.10%)191156071698387452596221046
Present454 (17.90%)8508971350198434130
GENERAL PRATICTIONERTOTAL (%)ABCDEFGHIJKL
Absent2,352 (92.71%)2581566160827337614638922144
Present185 (7.29%)1802801100360722
YEAR OF FIRST VISITTOTAL (%)ABCDEFGHIJKL
201797 (3.82%)160000330480000
2018574 (22.63%)41000040801250000
2019447 (17.62%)2600003340870000
2020465 (18.33%)1110062068019003400
2021243 (9.58%)4300740007704900
2022338 (13.32%)17150195301600121610
2023373 (14.70%)22068132906636316246

[i] A = Arena; B = Barletta; C = Borgo Tressanti; D = Contrada Cicerone; E = Madonna di Ripalta; F = Pista; G = San Carlo d’Ascoli; H = Sankara; I = Terlizzi; J = Terraneo; K = Turi; L = Uliveto.

Table 4

Distribution by location of clinical characteristics recorded at the first visit.

PATHOLOGYTOTAL (%)ABCDEFGHIJKL
Diabetes
Absent2,514 (99.09%)2731566167828407644629322144
Present23 (0.91%)302103061322
High blood pressure
Absent2,448 (96.49%)2691565158798315620638321545
Present89 (3.51%)7031031223001381
“Fatigue” pathologies
Absent2,036 (80.25%)2291556134646245531528420636
Present501 (19.75%)470123418219211911121710
Asthma or chronic bronchitis
Absent2,507 (98.82%)2731567168828367636639622044
Present30 (1.18%)3010070140032
Tubercolosis
Absent2,515 (99.13%)2741568168828377637639622246
Present22 (0.87%)2000060130010
HIV
Absent2,531 (99.76%)2731568167818437649639622346
Present6 (0.24%)300110010000
HBV
Absent2,528 (99.65%)2731568168828417646639622346
Present9 (0.35%)300002040000
HCV
Absent2,534 (99.88%)2751568168828437648639622346
Present3 (0.12%)100000020000

[i] A = Arena; B = Barletta; C = Borgo Tressanti; D = Contrada Cicerone; E = Madonna di Ripalta; F = Pista; G = San Carlo d’Ascoli; H = Sankara; I = Terlizzi; J = Terraneo; K = Turi; L = Uliveto.

Table 5

Distribution of the number of visits by settlement.

MALES N (%) 12,809 (97.8%)FEMALE N (%) 294 (2.2%)TOTAL N (%) 13,103 (100%)AVERAGE NUMBER OF VISITS PER PATIENT 5.16
Arena2,647 (99.9%)3 (0.1%)2,650 (20.2%)9.6
Barletta40 (100%)0 (0%)40 (0.3%)2.67
Borgo Tressanti127 (66.1%)65 (33.9%)192 (1.5%)2.82
Contrada Cicerone1,062 (99.7%)3 (0.3%)1,065 (8.1%)6.34
Madonna di Ripalta410 (94%)26 (6%)436 (3.3%)5.32
Pista1,517 (91.1%)148 (8.9%)1,665 (12.7%)1.98
San Carlo d’Ascoli51 (100%)0 (0%)51 (0.4%)7.29
Sankara5,281 (99.4%)34 (0.6%)5,315 (40.6%)8.18
Terlizzi160 (100%)0 (0%)160 (1.2%)2.54
Terraneo785 (98.1%)15 (1.9%)800 (6.1%)8.33
Turi653 (100%)0 (0%)653 (5%)2.93
Uliveto76 (100%)0 (0%)76 (0.6%)1.65
Figure 4

Pareto chart of total number of visits per patient.

Table 6

Distribution of pathologies by settlement.

DIAGNOSIS N (%)A 1,217 (17.9%)B 18 (0.3%)C 129 (1.9%)D 461 (6.8%)E 218 (3.2%)F 1,170 (17.2%)G 26 (0.4%)H 2,710 (40%)I 96 (1.4%)J 331 (4.9%)K 350 (5.2%)L 57 (0.8%)TOTAL 6,783 (100%)
Fatigue disorders (tiredness and osteoarticular disorders)297 (24.4%)5 (27.8%)36 (27.9%)125 (27.1%)82 (37.6%)334 (28.6%)11 (42.3%)775 (28.6%)23 (23.9%)66 (20.0%)86 (24.6%)16 (28.1%)1,856 (27.3%)
Gastrointestinal disorders180 (14.8%)1 (5.6%)11 (8.5%)81 (17.6%)23 (10.6%)225 (19.2%)0 (0%)412 (15.2%)4 (4.2%)14 (4.2%)47 (13.4%)2 (3.5%)1,000 (14.7%)
Airways pathologies158 (13%)2 (11.1%)21 (16.3%)52 (11.3%)19 (8.7%)207 (17.7%)1 (3.8%)421 (15.5%)19 (19.8%)21 (6.3%)37 (10.6%)9 (15.8%)967 (14.3%)
Dermatological174 (14.3%)4 (22.2%)8 (6.2%)90 (19.5%)22 (10.1%)120 (10.3%)1 (3.8%)279 (10.3%)25 (26%)41 (12.4%)46 (13.1%)13 (22.8%)823 (12.1%)
Cardiovascular70 (5.8%)2 (11.1%)15 (11.6%)44 (9.5%)37 (17%)31 (2.6%)10 (38.5%)201 (7.4%)0 (0%)119 (36%)24 (6.9%)2 (3.5%)555 (8.2%)
Dental problems109 (9%)1 (5.6%)7 (5.4%)26 (5.6%)5 (2.3%)103 (8.8%)0 (0%)186 (6.9%)8 (8.3%)9 (2.7%)32 (9.1%)4 (7%)490 (7.2%)
Traumas91 (7.5%)1 (5.6%)2 (1.6%)9 (2%)5 (2.3%)40 (3.4%)2 (7.7%)134 (4.9%)5 (5.2%)12 (3.6%)17 (4.9%)6 (10.5%)324 (4.8%)
Ophthalmological56 (4.6%)1 (5.6%)4 (3.1%)21 (4.6%)10 (4.6%)35 (3%)1 (3.8%)100 (3.7%)4 (4.2%)25 (7.6%)34 (9.7%)2 (3.5%)293 (4.3%)
Urinary tract31 (2.5%)0 (0%)2 (1.6%)3 (0.7%)5 (2.3%)31 (2.6%)0 (0%)31 (1.1%)0 (0%)4 (1.2%)10 (2.9%)0 (0%)117 (1.7%)
ENT pathologies20 (1.6%)1 (5.6%)2 (1.6%)4 (0.9%)5 (2.3%)5 (0.4%)0 (0%)42 (1.5%)1 (1%)0 (0%)6 (1.7%)0 (0%)86 (1.3%)
Diabetes and endocrinological disorders4 (0.3%)0 (0%)14 (10.9%)4 (0.9%)1 (0.5%)4 (0.3%)0 (0%)23 (0.8%)3 (3,1%)18 (5.4%)5 (1.4%)2 (3.5%)78 (1.2%)
Neuropsychiatric disorders16 (1%)0 (0%)5 (3.9%)1 (0.2%)1 (0.5%)5 (0.5%)0 (0%)31 (1.1%)3 (3.1%)2 (0.6%)5 (1.4%)1 (1.8%)70 (1.1%)
TB6 (0.5%)0 (0%)0 (0%)0 (0%)0 (0%)6 (0.5%)0 (0%)26 (1%)0 (0%)0 (0%)1 (0.3%)0 (0%)39 (0.6%)
Rheumatological2 (0.2%)0 (0%)0 (0%)0 (0%)0 (0%)1 (0.1%)0 (0%)35 (1.3%)0 (0%)0 (0%)0 (0%)0 (0%)38 (0.6%)
Obstetric‑gynecological0 (0%)0 (0%)1 (0.8%)0 (0%)0 (0%)23 (2%)0 (0%)0 (0%)0 (0%)0 (0%)0 (0%)0 (0%)24 (0.4%)
HIV3 (0.2%)0 (0%)0 (0%)1 (0.2%)3 (1.4%)0 (0%)0 (0%)2 (0.1%)0 (0%)0 (0%)0 (0%)0 (0%)9 (0.1%)
Oncological0 (0%)0 (0%)1 (0.8%)0 (0%)0 (0%)0 (0%)0 (0%)5 (0.2%)1 (1%)0 (0%)0 (0%)0 (0%)7 (0.1%)
Hematological0 (0%)0 (0%)0 (0%)0 (0%)0 (0%)0 (0%)0 (0%)7 (0.3%)0 (0%)0 (0%)0 (0%)0 (0%)7 (0.1%)

[i] A = Arena; B = Barletta; C = Borgo Tressanti; D = Contrada Cicerone; E = Madonna di Ripalta; F = Pista; G = San Carlo d’Ascoli; H = Sankara; I = Terlizzi; J = Terraneo; K = Turi; L = Uliveto; ENT = ears, nose, and throat.

Table 7

Therapies administered.

THERAPIES N (%)A 1,217 (17.9%)B 18 (0.3%)C 129 (1.9%)D 461 (6.8%)E 218 (3.2%)F 1,170 (17.2%)G 26 (0.4%)H 2,710 (40%)I 96 (1.4%)J 331 (4.9%)K 350 (5.2%)L 57 (0.8%)TOTAL 6,783 (100%)
NSAIDs, painkillers and cortisone394 (30.9%)5 (27.8%)29 (22.5%)132 (28.7%)66 (30.3%)478 (40.9%)10 (38.4%)951 (35.1%)33 (34.3%)70 (21.1%)97 (27.7%)7 (12.3%)2272 (33.6%)
Topicals (creams and eye drops)159 (13.1%)2 (11.1%)7 (5.4%)70 (15.2%)34 (15.6%)122 (10.4%)0 (0%)296 (10.9%)17 (17.7%)42 (12.7%)21 (6%)12 (21.1%)782 (11.5%)
Adjuvants, supplements, and probiotics122 (10%)3 (16.7%)13 (10.1%)62 (13.4%)30 (13.8%)103 (8.8%)2 (7.7%)300 (11.1%)7 (7.3%)30 (9.1%)47 (13.4%)7 (12.3%)726 (10.7%)
Gastrointestinal99 (8.1%)1 (5.6%)6 (4.7%)44 (9.5%)12 (5.6%)137 (11.7%)0 (0%)229 (8.4%)3 (3.1%)6 (1.8%)30 (8.5%)1 (1.8%)568 (8.3%)
Antibiotics, antifungals, and antiparasitics102 (8.4%)0 (0%)13 (10.1%)25 (5.4%)5 (2.3%)136 (11.6%)1 (3.8%)189 (7.0%)18 (18.8%)10 (3.0%)22 (6.3%)8 (14.0%)529 (7.9%)
Cardiovascular (antihypertensives, diuretics, and anticoagulants)56 (4.5%)0 (0%)10 (7.8%)28 (6.1%)27 (12.5%)30 (2.6%)10 (38.5%)161 (5.9%)0 (0%)102 (30.8%)18 (5.2%)1 (1.8%)443 (6.5%)
Respiratory tract treatments75 (6.1%)2 (11.1%)11 (8.6%)15 (3.2%)1 (0.5%)80 (6.8%)1 (3.8%)193 (7.1%)5 (5.2%)13 (3.9%)28 (8.0%)4 (7.1%)428 (6.3%)
Medication38 (3.1%)0 (0%)1 (0.8%)14 (3%)1 (0.5%)14 (1.2%)2 (7.7%)61 (2.3%)1 (1%)8 (2.4%)13 (3.7%)5 (8.8%)158 (2.3%)
Antidiabetics1 (0.1%)0 (0%)12 (9.4%)1 (0.2%)1 (0.5%)2 (0.2%)0 (0%)17 (0.7%)2 (2.0%)15 (4.5%)3 (0.9%)2 (3.6%)56 (1.0%)
Neurological0 (0%)0 (0%)1 (0.8%)1 (0.2%)0 (0%)3 (0.3%)0 (0%)3 (0.1%)1 (1%)0 (0%)2 (0.6%)0 (0%)11 (0.2%)
Health orientation and hospital care3 (0.3%)0 (0%)0 (0%)1 (0.2%)0 (0%)1 (0.1%)0 (0%)11 (0.4%)0 (0%)1 (0.3%)1 (0.3%)0 (0%)18 (0.2%)
Not available168 (13.8%)5 (27.8%)26 (20.2%)68 (14.8%)41 (18.8%)64 (5.5%)0 (0%)299 (11%)9 (9.4%)34 (10.3%)68 (19.4%)10 (17.5%)792 (11.7%)

[i] A = Arena; B = Barletta; C = Borgo Tressanti; D = Contrada Cicerone; E = Madonna di Ripalta; F = Pista; G = San Carlo d’Ascoli; H = Sankara; I = Terlizzi; J = Terraneo; K = Turi; L = Uliveto; NSAIDs = nonsteroidal anti‑inflammatory drugs.

Table 8

Simple logistic regression (unadjusted OR) and multiple logistic regression (adjusted OR) on the probability of returning to the visit with respect to the reference settlement Casa Sankara.

UNADJUSTED ORSADJUSTED OR
OR95% CIP‑VALUEOR95% CIP‑VALUE
Settlements
Sankara (H)ref.––ref.––
Arena (A)1.221.12–1.34<0.0011.161.06–1.280.002
Barletta (B)1.270.68–2.380.4511.921.01–3.650.045
Borgo Tressanti (C)0.510.37–0.690.0180.700.49–1.010.055
Contrada Cicerone (D)1.361.19–1.56<0.0011.341.18–1.54<0.001
Madonna di Ripalta (E)1.040.86–1.260.6921.641.29–2.090.001
Pista (F)0.450.39–0.50<0.0010.400.36–0.46<0.001
San Carlo d’Ascoli (G)1.000.58–1.740.9990.960.50–1.820.897
Terlizzi (I)0.690.50–0.960.0251.020.71–1.450.932
Terraneo (J)1.471.27–1.71<0.0011.391.18–1.640.001
Turi (K)0.900.77–1.060.2081.411.14–1.760.002
Uliveto (L)0.350.21–0.58<0.0010.520.29–0.930.027
Gender
Maleref.––ref.––
Female0.710.56–0.900.0051.100.83–1.440.514
Age range at first visit (years)
0–18ref.––ref.––
19–290.860.60–1.230.4011.000.67–1.500.987
30–450.810.57–1.170.2640.930.62–1.390.729
46–640.840.58–1.210.3450.870.58–1.300.492
65+0.610.34–1.080.0870.920.50–1.710.804
Country of origin
Other nationsref.––ref.––
Romania2.881.80–4.6<0.0013.091.79–5.34<0.001
Year of first visit
<2022ref.––ref.––
2022–20230.760.70–0.83<0.0010.600.52–0.70<0.001
Diagnosis of TB
Noref.––ref.––
Yes0.630.49–0.81<0.0010.630.49–0.81<0.001

[i] CI = confidence interval; OR = odds ratio

DOI: https://doi.org/10.5334/aogh.4666 | Journal eISSN: 2214-9996
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Language: English
Submitted on: Jan 6, 2025
Accepted on: Mar 2, 2025
Published on: Mar 28, 2025
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year
Keywords:
Migrant health,
healthcare access,
social determinant,
vulnerability,
mobile clinics,
labor exploitation,
social inclusion,
Doctors with Africa CUAMM,
health disparities,
primary health care,
infectious disease,
health policy

© 2025 Cesare De Virgilio Suglia, Renato Laforgia, Marcella Schiavone, Anna Belfiore, Nicole Laforgia, Annalisa Saracino, Giovanni Putoto, Francesco Di Gennaro, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

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