Health Concerns and Issues for Sub-Saharan African Immigrants

This article discusses the health concerns and issues faced by Sub-Saharan African immigrants, including infectious diseases like HIV, tuberculosis, and malaria. It explores the pharmacological treatment regimens for these health issues, the impact of traditional beliefs on health, and culturally sensitive strategies for promoting health and wellness.

Running head: HEALTH CARE
Health care
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Health concerns and issues for the population:
Immigrants coming from Sub-Saharan Africa have been found to be disproportionately
affected by infectious diseases like tuberculosis infection, helminths infection, Human
immunodeficiency virus infection and malaria. A study evaluating the prevalence of infectious
disease in the cohort group of Sub-Saharan Africans revealed that diagnoses of HIV, chronic
hepatitis B and tuberculosis is more common in Sub-Saharan Africans immigrants (Delcor et al.
2016). According to the report by Monge-Maillo et al. (2015), the burden of new HIV infection
varies by region. About 77% new cases of HIV infection was found in Latin America and 84%
new cases in Asia. A study done by Delcor et al. (2016) to investigate about prevalence of
disease in target population in Spain revealed diagnosis of at least one infectious disease in
72.8% of the population which can contribute to other chronic health issues. Hence, the burden
of infectious disease is particularly challenging for the target immigrant group. This is mainly
seen because of incidence of infectious disease in the country of origin, exposure to infection
during migration.
Current pharmacological treatment regimens for the health issues:
The main health concerns for Sub-Saharan Africans included high burden of infectious
diseases like HIV, tuberculosis and malaria infection. According to pharmacological treatment
regimens, the main drug for treatment of HIV includes antiretroviral therapy (ART). It is
recommended for everyone who has HIV and it works to reduce the risk of transmission. This
pharmacological regimen is also effective in reducing the viral load (Cohen et al., 2016). Patient
should understand the goal of the therapy and have the willingness to initiate the therapy
(Günthard et al., 2016). In addition, for people diagnosed with tuberculosis, specific drugs are

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taken for 6 to 9 months to to cure the disease. The first line of anti-tuberculosis drugs includes
rifampin, pyrazinamide and isoniazid. The pharmacological regimen for TB also differs for drug
susceptible TB and drug resistant TB. The second line of drugs is used for drug resistant TB
(Center for Disease Control and Prevention 2018).
Impact of traditional beliefs associated with the health issues:
The Sub-Saharan African immigrants are at risk of infectious diseases because of their
traditional beliefs and practices. For example, early marriage and the need to migrate to new
regions influences the size of HIV and AIDs epidemics and the scale of the disease in vulnerable
population. Zhang et al. (2017) revealed that HIV rate is disproportionately high among migrants
because of unsafe sexual practices, partners and contexts. Migration is one factor that has
increased health care stressors for the immigrant population as it increases marginalization,
exposure to insecure legal standard and lack of social support in the destination country. Hence,
all these stressors associated with the process of migration increases the risk of engaging in risky
behaviours such as using illicit drugs and having unsafe sex. In addition, late HIV test is
common among African immigrants because of the use of traditional language, low education
and inability to comprehend the message of health care providers. Research study by Ojikutu et
al. (2014) reveal that language discordance and fear of deportation are some barriers faced by
immigrants that prevents them from accessing health care service. HIV related stigma and low
HIV knowledge also increases risk of unsafe sexual practices among sub-Saharan Africans.
Hayward et al. (2018) argues that inequity in socioeconomic conditions and conditions
associated with migration lead to differences in TB prevalence for migrants.

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Impact of cultural values and traditional practices on acceptance and use of prescribed
pharmacological treatments:
Cultural norms and values determine health seeking behaviour and adherence to
treatment for many Africans. The immigrants of Sub-Saharan Africa follow diverse ligions that
emphasize on moral behaviour and teachings. Hence, many immigrants rely on spiritual and
religious resources to improve their health instead of following medical regimen. Hence, spiritual
beliefs of immigrants can act as a barrier in the acceptance of pharmacological treatments for
HIV and tuberculosis (Arrey et al., 2016). Bezabhe et al. (2014) defines that adherence to ART
therapy in immigrants of Sub-Saharan Africa is influenced by socio-cultural factors like religious
rituals, stigma and discrimination. Perceived stigma and certain religious norms prohibit the
group from taking and collecting medications on time. These people have the fear that they will
be differentiated, if people get to know they take ART pills. Hence, these barriers lead to poor
acceptance and use of pharmacological treatment for HIV.
Evidence-based, culturally sensitive strategies for correct use of the pharmacology
treatments:
To ensure adherence to the recommended pharmacological regimen for infectious disease
like HIV and tuberculosis among African immigrants, it is necessary to implement unique
strategies to increase the cultural relevance of medication regimen. This means implementing
interventions for the target group that attends to cultural values such as spirituality, communality,
and commitment to family (Conn et al., 2017). Hence, the immigrant population group from
Sub-Saharan Africa can be educated that ART does not interfere with spiritual aspects of health
and well-being. Similar form of educational intervention is also needed for the group to ensure

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adherence to other pharmacologic drugs for malaria and tuberculosis. Evidence based strategy
also suggest the need for implementing multi-faceted interventions like information exchange,
skill building, counselling and active communication to ensure that immigrants groups are
informed about the benefits of treatment and risk of not adhering to the same. This type of
cultural sensitive strategy is also likely to reduce stigma and improve adherence to treatment like
ART and other drugs for different infectious disease (Bezabhe et al., 2014).
Culturally sensitive strategies the nursing staff can employ with the population to promote
health and wellness
To reduce the burden of infectious disease in sub-Saharan Africans, the nursing staffs can
employ the strategy of developing cultural competence to understand the impact of cultural
values on health behaviour of the group. This will help to provide culturally sensitive care and
ensure that any drug or pharmacological regimen does not interfere with cultural values of sub-
Saharan Africans. They can adapt personalized strategies to address stigma and empower
patients in seeking appropriate health support and enhancing patient’s engagement in their
treatment (Chen et al., 2016).

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References:
Arrey, A. E., Bilsen, J., Lacor, P., & Deschepper, R. (2016). Spirituality/religiosity: A cultural
and psychological resource among Sub-Saharan African migrant women with HIV/AIDS
in Belgium. PloS one, 11(7), e0159488.
Bezabhe, W. M., Chalmers, L., Bereznicki, L. R., Peterson, G. M., Bimirew, M. A., & Kassie, D.
M. (2014). Barriers and facilitators of adherence to antiretroviral drug therapy and
retention in care among adult HIV-positive patients: a qualitative study from
Ethiopia. PloS one, 9(5), e97353.
Center for Disease Control and Prevention (2018). Tuberculosis. Retrieved from:
https://www.cdc.gov/tb/topic/treatment/tbdisease.htm
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meta-analysis of outcomes. Preventive medicine, 69, 239-247.

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