Infectious and non-communicable health conditions among East African immigrants at arrival and post integration in Switzerland

Background and Rationale
East African immigrants comprise one of the most important groups among newly arriving immigrants in Switzerland. At arrival they may suffer from previously undiagnosed parasitic or viral infections as well as from mental health conditions. After arrival and eventual adaptation to a Western lifestyle, immigrants may be vulnerable to non-communicable health conditions, such as impaired glucose metabolism or dyslipidaemia and present impaired mental health and compromised resilience. Health conditions of this immigrant group at arrival and post-integration have, however, never been studied systematically in Switzerland. This study aims at assessing health status of East African immigrants at their arrival in Switzerland as well as two years after arrival.

Objectives
Phase 1 (cross-sectional survey):
To assess the following health conditions among East African immigrants at arrival in Switzerland: 
1.    Infectious disorders:
- Parasitic infections (malaria, schistosoma, strongyloides and other stool-helminths)
- Viral infections (hepatitis B and C, HIV)
- Treponema pallidum infection (syphilis)

2.    Non-infectious health conditions:
- Serum vitamin D level
- Cardio-vascular risk-factors (lipid-profile, glucose-metabolism, blood-pressure, BMI, physical activity  and smoking)
- Mental health status (depression, anxiety, post-traumatic stress disorder and alcohol use disorder).
- Resilience

Phase 2 (cohort-study):
To assess the changes in the following health conditions after two years of follow-up:
- Vitamin D level
- Cardio-vascular risk-factors (lipid-profile, glucose-metabolism, blood-pressure, and smoking, BMI, physical inactivity)
Mental health status (depression, anxiety, post-traumatic stress disorder and alcohol use disorder).

Project assessments and procedures
Eligible individuals will be invited for phase 1 to the Swiss Tropical and Public Health Institute (Swiss TPH). Phase 1 includes assessment of socio-demographic variables, clinical interview and clinical examination followed by standardized screening for mental health conditions including resilience and collection of blood, urine and stool-samples.
Laboratory results will be reviewed and in case of any pathologic finding during the screening, the participant will be contacted to organize further medical management and follow-up. Two years after the 

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