CAT/OP/ITA/1/Add.1 78. In July 2016, additional material useful for the management of suspected cases of highly transmissible diseases, including products for decontamination, has been made available in the eastern and western Sicily (Catania, Trapani). 79. As regards the prevention of Tuberculosis (TB), the project, called "Diagnosis at the docks” developed by USMAF of Catania, in collaboration with Garibaldi Hospital in Catania, is particularly noteworthy. It is well known that many migrants are from highly endemic areas affected by TB. Plus, we carefully consider the very poor conditions of their journeys, which often last many weeks or months and set the conditions for the spread of latent infections. - Since late summer 2015, the project "Diagnosis at the docks", through a molecular biology technique called "GeneXpert", allows to make the diagnosis of TB in two hours (when the migrant shows suspicious signs and symptoms, such as fever, general malaise, persistent coughing, significant weight loss, and is still at the docks for identification procedures). 80. Thanks to the above Project, by screening and rapid diagnosis we have identified and initiated the pharmacological treatment in about 20 cases of active TB 6. 81. There are other aspects worthy of consideration, with regard to health conditions of migrants, as identified in the course of controls put in place both on board of ships and upon arrival, which are not so much related to infectious diseases but are the result of poor conditions, which these people have been exposed to before and during the journey: in addition to dehydration, fever syndromes not coupled with other symptoms, and conjunctivitis, we frequently detect trauma, burns, injuries from firearms and poisoning by exposure to toxic fumes in the cargo hold. 82. On a more general note, the geographical origin and the demographic profile of migrants is changing. In 2014 and 2015, the average age has risen; and women and children (including unaccompanied) migrants have become more frequent than in the past. Overall, in the period 2013-2015, the distribution by gender and age was, as follows: men 74.54%; 14,28 women; minors 10.39%; and the proportion was, as follows: men 75.56% in 2015 only; women, 17.73%; minors, 7.66%. The health-care controls upon arrival show serious health conditions, including heart disease, diabetes, poliomyelitis (in the form of paralysis of limbs) or other neurological disorders, traumatic and psychiatric outcomes related to torture and violence suffered either in the country of origin or in the migration route, as well as precarious physicological conditions, and other medical situations, such as pregnancy. 83. Guidelines on “Assistance to refugees, victims of torture, rape and/or other serious forms of psychological, physical or sexual violence”. In recent years, Italy has been characterized by an increasing number of forced migrants, so as to become the third European Union country, after Germany and Sweden, for number of asylum applications (as of 31 December 2015, there were 103.792). Forced migrants, asylum-seekers and those entitled to international and humanitarian protection, are - in the context of the migrant population -, a group at high risk of developing psychopathological syndromes due to the frequent incidence of stressful or traumatic experiences, which can seriously impact on their physical and mental health, as well as on their family members’ and the society at 6 The Ministry of Health actively participated, including with its medical staff, in the Mare Nostrum Operation. This action started in June 2014, following an MoU with the Minitsry of Defense allowing the anticipation of medical checks during the transfer to the port. About 20 physicans from the Ministry of Health have been deployed to the Navy vessels up to December 2014. Triton operation replaced Mare Nostrum’s. Needless this support keeps going. 15