Canadian Family Physician
Volume 61, Issue 7, 2015, Pages e303-e309 and e331-e337

Health status of newly arrived refugees in Toronto, Ont: Part 1: Infectious diseases [État de santé des nouveaux réfugiés à Toronto, en Ontario: Partie 1: maladies infectieuses] (Review)

Redditt V.J.* , Janakiram P. , Graziano D. , Rashid M.
  • a Department of Family and Community Medicine (DFCM), University of TorontoON, Canada
  • b Department of Family and Community Medicine (DFCM), University of TorontoON, Canada
  • c Crossroads Clinic Through the Women's College Hospital Institute for Health System Solutions, Virtual Care Program, Canada
  • d Department of Family and Community Medicine (DFCM), University of TorontoON, Canada

Abstract

Objective: To determine the prevalence of selected infectious diseases among newly arrived refugee patients and whether there is variation by key demographic factors. Design: Retrospective chart review. Setting: Primary care clinic for refugee patients in Toronto, Ont. Participants: A total of 1063 refugee patients rostered at the clinic from December 2011 to June 2014. Main outcome measures: Demographic information (age, sex, and region of birth); prevalence of HIV, hepatitis B, hepatitis C, Strongyloides, Schistosoma, intestinal parasites, gonorrhea, chlamydia, and syphilis infections; and varicella immune status. Results: The median age of patients was 29 years and 56% were female. Refugees were born in 87 different countries. Approximately 33% of patients were from Africa, 28% were from Europe, 14% were from the Eastern Mediterranean Region, 14% were from Asia, and 8% were from the Americas (excluding 4% born in Canada or the United States). The overall rate of HIV infection was 2%. The prevalence of hepatitis B infection was 4%, with a higher rate among refugees from Asia (12%, P < .001). Hepatitis B immunity was 39%, with higher rates among Asian refugees (64%, P < .001) and children younger than 5 years (68%, P < .001). The rate of hepatitis C infection was less than 1%. Strongyloides infection was found in 3% of tested patients, with higher rates among refugees from Africa (6%, P = .003). Schistosoma infection was identified in 15% of patients from Africa. Intestinal parasites were identified in 16% of patients who submitted stool samples. Approximately 8% of patients were varicella nonimmune, with higher rates in patients from the Americas (21%, P < .001). Conclusion: This study highlights the importance of screening for infectious diseases among refugee patients to provide timely preventive and curative care. Our data also point to possible policy and clinical implications, such as targeted screening approaches and improved access to vaccinations and therapeutics.

Author Keywords

[No Keywords available]

Index Keywords

medical record review Nigeria parasitosis primary medical care refugee Human immunodeficiency virus infection mass screening Europe human Communicable Diseases Refugees Asia middle aged statistics and numerical data chickenpox health status Aged Hungary Young Adult gonorrhea Humans classification Adolescent Infant, Newborn Canada male preschool child female Infant Child, Preschool newborn Review Africa North Korea Ambulatory Care Facilities refugee camp outpatient department Syphilis Retrospective Studies Southern Europe Ontario strongyloides infection major clinical study adult intestine parasite infection schistosomiasis chronic hepatitis B outcome assessment nematodiasis infection retrospective study chlamydiasis hepatitis C Child

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84938066438&partnerID=40&md5=d51dae50627ad90d63d27368a1b52646

ISSN: 0008350X
Cited by: 25
Original Language: English; French