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Peer-reviewedCC BY 4.0European Journal of Pediatrics

Systematic STI screening in unaccompanied migrant minors: a 6-year experience with urine-based NAAT

  • Sonia Milkova-Ivanova1,2
  • Isabel Mellado-Sola1,2
  • Blanca Bravo-Queipo-de-Llano1,3
  • Paula Rodríguez-Molino1,3
  • Carlos Grasa1,3
  • Milagros García-López-Hortelano1,3
  • Inmaculada Quiles-Melero4
  • Mario David Ruiz-Bastián4
  • Alfredo Maldonado-Barrueco4
  • Cristina Calvo1,3
  • Talía Sainz1,3
4 affiliations
  1. 1Pediatric, Infectious and Tropical Diseases Department, La Paz University Hospital, La Paz Research Institute (IdiPAZ), Paseo de La Castellana 261, 28046 Madrid, Spain
  2. 2Autonomous University of Madrid (UAM), Madrid, Spain
  3. 3Networked Biomedical Research Centre for Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain
  4. 4Clinical Microbiology Department, La Paz University Hospital, La Paz Research Institute (IdiPAZ), Madrid, Spain
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Abstract

Systematic screening for sexually transmitted infections (STI), beyond serology, is not standard in arrival protocols for unaccompanied migrant minors (UMM). In 2020, our center incorporated urine-based nucleic acid amplification tests (NAAT)-based screening into the existing serology-based protocol (HIV, syphilis, hepatitis B/C), and we describe the additional diagnoses of STI identified through NAAT. We conducted a retrospective observational descriptive study (2020–2025) of 226 UMM (99.6% male) in Madrid undergoing serological screening for HIV, syphilis, hepatitis B and C, with additional urine-based multiplex PCR (NAAT) screening for STI. Urine-based NAAT, performed in 163/226 participants (72.1%), identified six positive cases (3.7%, 95% CI 1.4–7.8%) of C. trachomatis, M. genitalium, or Ureaplasma spp. Of these, four patients (2.5%, 95% CI 0.7–6.2%) had actionable infections that were treated. Serology identified no HIV (0/218) or hepatitis C cases (0/212), one syphilis case (0.5%, 95% CI 0.0–2.6%, 1/209), and three chronic hepatitis B cases (1.4%, 95% CI 0.3–3.9%, 3/221). None of the cases had symptoms recorded.

Conclusion: Urine NAAT identified six infections (four actionable) not detectable by serology. However, three of eight patients with actionable infections were lost to follow-up, highlighting that the benefit of systematic screening depends on strengthening linkage-to-care alongside testing. What is Known:

• Serological screening (HIV, syphilis, hepatitis B/C) is standard in arrival health assessments for unaccompanied migrant minors, but systematic STI screening beyond serology is not routinely protocoled.

• Systematic screening is especially valuable in this population, as follow-up is often limited by care fragmentation and transfers between reception centers.

What is New:

• Urine-based NAAT screening identified additional STI in patients with no symptoms recorded, that were not detectable by serology alone.

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Cite

BibTeXRIS
BibTeX
@article{milkovaivanova2026systematic,
  title = {{Systematic STI screening in unaccompanied migrant minors: a 6-year experience with urine-based NAAT}},
  author = {Sonia Milkova-Ivanova and Isabel Mellado-Sola and Blanca Bravo-Queipo-de-Llano and Paula Rodríguez-Molino and Carlos Grasa and Milagros García-López-Hortelano and Inmaculada Quiles-Melero and Mario David Ruiz-Bastián and Alfredo Maldonado-Barrueco and Cristina Calvo and Talía Sainz},
  journal = {European Journal of Pediatrics},
  year = {2026},
  month = oct,
  doi = {10.1007/s00431-026-07549-3},
  url = {https://doi.org/10.1007/s00431-026-07549-3},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Systematic STI screening in unaccompanied migrant minors: a 6-year experience with urine-based NAAT
AU  - Sonia Milkova-Ivanova
AU  - Isabel Mellado-Sola
AU  - Blanca Bravo-Queipo-de-Llano
AU  - Paula Rodríguez-Molino
AU  - Carlos Grasa
AU  - Milagros García-López-Hortelano
AU  - Inmaculada Quiles-Melero
AU  - Mario David Ruiz-Bastián
AU  - Alfredo Maldonado-Barrueco
AU  - Cristina Calvo
AU  - Talía Sainz
PY  - 2026
DA  - 2026/10/26
JO  - European Journal of Pediatrics
DO  - 10.1007/s00431-026-07549-3
UR  - https://doi.org/10.1007/s00431-026-07549-3
AB  - Systematic screening for sexually transmitted infections (STI), beyond serology, is not standard in arrival protocols for unaccompanied migrant minors (UMM). In 2020, our center incorporated urine-based nucleic acid amplification tests (NAAT)-based screening into the existing serology-based protocol (HIV, syphilis, hepatitis B/C), and we describe the additional diagnoses of STI identified through NAAT. We conducted a retrospective observational descriptive study (2020–2025) of 226 UMM (99.6% male) in Madrid undergoing serological screening for HIV, syphilis, hepatitis B and C, with additional urine-based multiplex PCR (NAAT) screening for STI. Urine-based NAAT, performed in 163/226 participants (72.1%), identified six positive cases (3.7%, 95% CI 1.4–7.8%) of C. trachomatis, M. genitalium, or Ureaplasma spp. Of these, four patients (2.5%, 95% CI 0.7–6.2%) had actionable infections that were treated. Serology identified no HIV (0/218) or hepatitis C cases (0/212), one syphilis case (0.5%, 95% CI 0.0–2.6%, 1/209), and three chronic hepatitis B cases (1.4%, 95% CI 0.3–3.9%, 3/221). None of the cases had symptoms recorded.  Conclusion: Urine NAAT identified six infections (four actionable) not detectable by serology. However, three of eight patients with actionable infections were lost to follow-up, highlighting that the benefit of systematic screening depends on strengthening linkage-to-care alongside testing. What is Known:  • Serological screening (HIV, syphilis, hepatitis B/C) is standard in arrival health assessments for unaccompanied migrant minors, but systematic STI screening beyond serology is not routinely protocoled.  • Systematic screening is especially valuable in this population, as follow-up is often limited by care fragmentation and transfers between reception centers.  What is New:  • Urine-based NAAT screening identified additional STI in patients with no symptoms recorded, that were not detectable by serology alone.
SN  - 0340-6199
SN  - 1432-1076
ER  -