Health assessment of immigrants and refugees
From IDWiki
| Test | Notes |
|---|---|
| Routine Screening | |
| CBC | anemia, iron deficiency, and eosinophilia |
| Hepatitis B serology (HBsAg) | |
| Strongyloides serology | |
| HIV serology | ≥15 years old or unaccompanied minor |
| TST or IGRA for LTBI | if planning to treat; for most ≤35 years |
| Varicella serology | immunize if not immune |
| Visual acuity | |
| Glaucoma assessment | |
| Dental review | |
| Hearing review | |
| Social and emotional wellbeing and mental health | to diagnose mental health conditions and trauma |
| Developmental delay | children and adolescents |
| Risk-Based Screening | |
| Rubella IgG | women of childbearing age; vaccinate if non-immune |
| Ferritin | all women and children, men if risk factors for iron deficiency |
| Vitamin D, Ca, PO4, ALP | risk factors for vitamin D deficiency or rickets |
| Vitamin B12 | if recent arrival <6 months, food insecurity, or vegan diet |
| Gonorrhea and chlamydia urine NAAT | if risk factors for STIs |
| Syphilis serology (RPR) | if risk factors for STIs, or unaccompanied minor |
| Helicobacter pylori stool antigen or breath test | if gastritis, peptic ulcer disease, dyspepsia, or family history of gastric cancer |
| Stool microscopy for ova and parasites | if no predeparture albendazole, or persistent eosinophilia |
| Country-Based Screening | |
| Schistosoma serology | Burma, Congo, Egypt, Eritrea, India, Iraq, Somalia, Sudan, Syria; but recommended against in Canadian guidelines |
| Malaria thick-and-thin smears | Bangladesh, Bhutan, Burma, Congo, Eritrea, India, Pakistan, Somalia, Sri Lanka, Sudan |
| Hepatitis C serology | Congo, Egypt, Iraq, Pakistan |
Further Reading
- The Australasian Society for Infectious Diseases and Refugee Health Network of Australia recommendations for health assessment for people from refugee-like backgrounds: an abridged outline. Med J Aust. 2017;207(7):310-315. doi: 10.5694/mja16.00826
- Australian guidelines; easy-to-implement
- Evidence-based clinical guidelines for immigrants and refugees. CMAJ. 2011;183(12):E824-E925. doi: 10.1503/cmaj.090313
- Canadian guidelines; possibly more rigorous, but also older and not as clearly laid out
