Prevalence and incidence rate of cardiovascular disease in a cohort of vulnerable migrants followed by an outpatient clinic: time trend from 1997 to 2012

in a cohort of vulnerable migrant followed by an ‘‘open access’’ outpatient clinic in Rome. Methods All migrants who entered Italy and had their first medical examination between January 1997 and December 2012(N = 30.275) represented the study population. Patients with at least one diagnosis of CVD (ICD-9-CM 390-439) were considered as cases. The prevalence of CVD was computed dividing the number of patients (np) with CVD that accessed the clinic by the overall np visiting the clinic. Since the study population is greatly dynamic, with a great np flowing in and out of it, we computed a further prevalence measure, called ‘‘underlying’’ prevalence, taking into account, both in the numerator and in the denominator, patients who returned at least one time by 2012. CVD incidence was computed by dividing the np who received their first diagnosis at the clinic by the person year (PY) of patient without CVD. All the measures were computed for each year. The results are presented only for the period 2000-2009 in order to obtain more stable estimates. Results The np with CVD were 1568 (5.2%). About 40% were Eastern European citizens, 54% were female, 69% were Extra-EU undocumented migrants. The mean age at arrival in Italy was 32,0(SD11,6) and 43,0(SD11,9), for the total population and for patients with CVD respectively. Both prevalence measures increase during the study period with a greater increase of ‘‘underlying’’ prevalence. The prevalence went from 3.4% to 7.0%, while the ‘‘underlying’’ prevalence went from 3.2% to 9.1%, respectively in 2000 and in 2009. The incidence rate was not stable ranged from 2.6 per 100 PY in 2000 to 5.1 per 100 PY in 2002. Conclusion Our findings support the need to implement surveillance systems and to consider proactive prevention and therapeutic interventions focused on this target to prevent complications and to reduce future cost for the health care system. Key message This study contributes to the research about assessment of health care need of vulnerable population in order to provide services focused on their real need.