Blood screen findings in a 2-year cohort of newly arrived refugees to Sydney, Australia

Abstract

Objectives: To describe the prevalence of certain health conditions in newly arrived refugees to Sydney, Australia, 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 during 2013 and 2014 were analysed. Prevalences of screened conditions were calculated, and compared by country of birth and other demographic features. A specific category was created for those from Middle Eastern countries, for comparative analysis.

Results: Pathology results were analysed for 3307 people from 4768 seen by the assessment 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%. Chronic hepatitis B was found in only 1.7% but in more than 10% of people from Burmese and Tibetan backgrounds. Strongyloides seropositivity was found in 4%. Among the subset tested for hepatitis C antibody, 0.5% were positive. No human immunodeficiency virus (HIV) infections were detected. More than 75% of the study population was from Middle Eastern countries. Compared with refugees from other regions, this subset had less anaemia (in females), more vitamin D deficiency, less chronic hepatitis B and less strongyloides seropositivity.

Conclusions: People from refugee backgrounds have differing risks of conditions, based on demographics, migration history and prior screening. Postarrival 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 retesting HIV in refugees from countries with a high prevalence of infection (>1%).