Journal of Paediatrics and Child Health
Volume 55, Issue 1, 2019, Pages 95-103

‘I think we've had a health screen’: New offshore screening, new refugee health guidelines, new Syrian and Iraqi cohorts: Recommendations, reality, results and review (Article) (Open Access)

Heenan R.C. , Volkman T. , Stokes S. , Tosif S. , Graham H. , Smith A. , Tran D. , Paxton G.*
  • a Immigrant Health Service, Department of General Medicine, Royal Children's Hospital, Melbourne, VIC, Australia
  • b Immigrant Health Service, Department of General Medicine, Royal Children's Hospital, Melbourne, VIC, Australia, Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia, Infection and Immunity, Murdoch Childrens Research Institute, Melbourne, VIC, Australia
  • c Immigrant Health Service, Department of General Medicine, Royal Children's Hospital, Melbourne, VIC, Australia
  • d Immigrant Health Service, Department of General Medicine, Royal Children's Hospital, Melbourne, VIC, Australia, Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia, Infection and Immunity, Murdoch Childrens Research Institute, Melbourne, VIC, Australia
  • e Immigrant Health Service, Department of General Medicine, Royal Children's Hospital, Melbourne, VIC, Australia, Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia, Infection and Immunity, Murdoch Childrens Research Institute, Melbourne, VIC, Australia
  • f Immigrant Health Service, Department of General Medicine, Royal Children's Hospital, Melbourne, VIC, Australia
  • g Immigrant Health Service, Department of General Medicine, Royal Children's Hospital, Melbourne, VIC, Australia, Department of Paediatrics, Northern Hospital, Melbourne, VIC, Australia
  • h Immigrant Health Service, Department of General Medicine, Royal Children's Hospital, Melbourne, VIC, Australia, Infection and Immunity, Murdoch Childrens Research Institute, Melbourne, VIC, Australia

Abstract

Aim: To examine refugee health assessments in Syrian and Iraqi children in the context of changes to offshore immigration screening, updated Australian refugee health guidelines and the primary care refugee health model in Victoria. Methods: This is a retrospective audit of Syrian and Iraqi children aged 0–17 years attending a specialist immigrant health service from January 2015 to September 2017. Results: We saw 128 children (7 months–16 years, 64.8% male). Prior to arrival, 58.9% of children had experienced trauma, and 67.9% had missed at least 1 year of school. Almost all children (93.3%) were linked with a regular general practitioner in Australia, and 23.6% children were linked with a refugee health nurse; offshore health records were infrequently available. Of school-aged children, 25% were not enrolled in school 3 months after arrival. Only 2 of 113 (1.8%) children had completed a recommended refugee health assessment, and 55.1% had commenced appropriate catch-up vaccination in primary care. After screening completion, the most prevalent conditions were low vitamin D (63.6%); growth/nutrition (24.2%), neurological/metabolic (16.4%), learning/behaviour (15.6%) and mental health (12.5%) concerns; latent tuberculosis infection (11.8%); and developmental delay (10.2%). Sixteen children required surgery after arrival, and six children had life-threatening medical conditions on arrival – only one had an offshore critical alert; care for the other five children resulted in 133 unanticipated hospital admission days. Conclusions: There are substantial challenges with the current primary care screening model in Victoria. Disability, developmental and mental health concerns were prominent in this cohort, and many children had delays in education access, compounding prior disadvantage. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians)

Author Keywords

Iraq Syria Refugee Health assessment

Index Keywords

educational status primary medical care refugee nurse Iraqi mass screening Australia offshore immigration screening mental health human metabolic disorder neurologic disease nutritional disorder priority journal general practitioner Adolescent growth disorder male developmental delay latent tuberculosis female Infant medical record learning disorder prevalence child health vitamin D deficiency Article behavior disorder Syrian age child hospitalization cohort analysis psychotrauma retrospective study life threat vaccination practice guideline Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85053062815&doi=10.1111%2fjpc.14142&partnerID=40&md5=ade9a61dc0c6ab6232aad02bb8d52259
DOI: 10.1111/jpc.14142
ISSN: 10344810
Original Language: English