Blood screen findings in a two year cohort of newly arrived refugees to Sydney

Abstract

Objectives To describe the prevalence of certain health conditions in newly arrived refugees to Sydney, and thereby help inform screening practices. Study type A clinical audit of routinely collected pathology results. Methods Demographics and pathology results from a nurse-led health assessment program for newly arrived refugees over the two years 2013 and 2014 were analysed. Prevalences of screened conditions were calculated and compared by countries of birth and other demographic features. A specific category of those from Middle Eastern countries was created for comparative analysis. Results Pathology results were analysed for 3307 persons from a total of 4768 seen by the program (69.4%). Anaemia was found in 6% of males and 7.6% of females. Vitamin D deficiency (<50 nmol/L) was detected in 77.5% of patients. Chronic hepatitis B was found in only in 1.7% overall, but in over 10% of those from Burmese and Tibetan backgrounds. Strongyloides sero-positivity was found in 4%. Among the subset tested for hepatitis C Ab, 0.5% were positive; there were zero HIV infections detected. Over 75 per cent of the study population was from Middle Eastern countries. Compared with those from other regions, this subset had less anaemia (in females), more vitamin D deficiency, less chronic hepatitis B and less strongyloides sero-positivity. Conclusions People of refugee backgrounds have differing risks of conditions based on demographics, migration history and prior screening. Post-arrival testing should be tailored to each family and individual. Results of screening should be constantly reviewed, and the approach updated based on findings. We support in particular the Canadian approach of only re-testing HIV in refugees from high prevalence (>1%) countries.