Health status of pediatric refugees in Buffalo, NY

Abstract

Objective: To characterize the health status of recent pediatric refugees.

Research design: Medical records of 107 pediatric refugees who underwent screening during a recent 24-month period were reviewed.

Setting: A county hospital pediatric clinic in a metropolitan area with a population of 1,189,000. The majority of pediatric refugees who come to the Buffalo, NY, area receive a health screening in this clinic.

Results: Most of the children were from Vietnam (67%), the Soviet Republics (19%), or Africa (14%). The median age was 8 years 2 months (range, 1 to 18 years). Only 39% of the children had evidence of adequate immunizations for age (39 of the children from Vietnam, two children from Africa, and one from the Soviet Republics). In 30%, physical examinations exposed conditions that required follow-up or referral to a medical or surgical specialist. Forty-two percent of the children required dental referral. Seven children were anemic; three had microcytic anemia. Of 81 children who underwent screening for hepatitis B, six (7%) were carriers, 35 (43%) were positive for hepatitis B surface antibody, and only four (5%) related a history of hepatitis exposure. Stool specimens were examined for ova and parasites in 87 children; 19 had pathogenic parasites with multiple organisms in two. Thirteen (24%) of 55 children who were tested from Vietnam, five (36%) of 14 children who were tested from Africa, and one (5%) of 18 children who were tested from the Soviet Republics had pathogenic parasites. Parasites included Ascaris lumbricoides (n = 8), Necator americanus or Ancylostoma duodenale (n = 5), Giardia lamblia (n = 3), Trichuris trichiura (n = 2), Dientamoeba fragilis (n = 2), and Entamoeba histolytica (n = 1). Skin testing for tuberculosis with purified protein derivative (tuberculin) was completed in 83 children, and 17 (20%) had reactive tests (21% [12/58] from Vietnam, 11% [1/9] from Africa, and 25% [4/16] from the Soviet Republics).

Conclusions: Refugee children who come to the United States frequently have conditions that put them at risk of future morbidity and may require utilization of substantial health care resources. Some of these conditions represent public health concerns.