Health assessment of immigrants and refugees

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
Develeopmental 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

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

Further Reading