Hennepin County anticipates a significant increase in the arrival of refugees/immigrants from Sub-Saharan East Africa. HCMC, the flagship acute care and teaching hospital of the Hennepin Healthcare System in downtown Minneapolis, is in a unique position to compile and assess incident and longitudinal data with regards to various health issues in this immigrating population. Significant metabolic and infection related healthcare trends have been recognized by examination of medical data obtained via federally mandated immigration health screening and anecdotally via provision of routine health care to the immigrant Somali population at the HCMC. These metabolic issues include: diabetes, metabolic syndrome, obesity, vitamin D deficiency, and osteoporosis. Infection related issues that have been recognized include reactivation of tuberculosis, with interesting preference for extrapulmonary involvement, when compared to indigenous populations.
Clinical observation of Somali immigrants suggests development of metabolic and infection related problems following immigration to the United States. Metabolic abnormalities including diabetes, obesity, vitamin D deficiency, osteopenia, and osteoporosis have been observed. In addition to these metabolic abnormalities, Minnesota Department of Health surveillance data demonstrate rates of reactivation of pulmonary and extrapulmonary tuberculosis that exceed indigenous norms. Mechanisms and risks underlying these population trends have not been described.
Further, there are no data demonstrating progression after acclimation to the new lifestyle and diet in the United States, specifically Minnesota. This pilot project is undertaken to gather anthropometric and biochemical characteristics of Somali immigrants who are completing immigration screening through HCMC and the Health Assessment Program clinics. Future projects, dependent on this initial data, aim to identify risk factors associated with development of these metabolic and infectious diseases. This grant request is made to partially support the determination of biomarker concentrations from plasma collected in a minimum of 100, newly immigrating, Somali volunteers. Laboratory data of interest are outlined in the body of the grant application. After collection and analysis of this pilot data we plan to apply for future NIH (or other) funding to further characterize disease progression in this population.
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