Hitherto there has been no epidemiologic basis for the extent of initial medical examination (IME) of children of refugees. In Switzerland little data is published on the incidence of diseases among refugees; in particular information on their children is scarce. We report the results of IME in these children in the Canton of Zurich from 1 July 1990 to 30 June 1991. The Federal Refugees Office assigned 1487 children to the Canton of Zurich. 920 children (61.9%) were registered, 259 (17.4%) at Zurich Children's Hospital and 661 with local physicians (44.5%). The current IME included a tuberculin skin test only, with additional hepatitis B screening of children from high risk countries. At the Zurich Children's Hospital the IME was extended: every child was examined clinically and a history was taken. The findings in the children examined at the Zurich Children's Hospital were as follows: 171 (66%) were healthy. 5 children (2%) had tuberculosis, 2 (0.8%) vitamin D deficiency rickets, 5 (2%) had iron deficiency anemia, 9 had hepatitis B (all recovered), 25 (9.7%) had various skin diseases and in 51 a variety of diseases of differing clinical significance were diagnosed. The local physicians found a similar incidence of tuberculosis, vitamin D deficiency rickets, iron deficiency anemia and skin diseases. It is concluded that (1) contrary to current directives on the IME, all children should undergo a clinical examination and have a history taken, in view of the high prevalence of various diseases, (2) screening for tuberculosis among the children of refugees is crucial, and (3) the vaccination programme according to the Swiss schedule should be extended to hepatitis B in all children from high risk countries, while BCG vaccination should be performed as soon as possible in all children with a negative tuberculin skin test and with no BCG vaccination mark.

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refugee medical examination human skin disease Refugees priority journal morbidity BCG vaccine Skin Diseases screening rickets anemia male iron deficiency female tuberculosis Infant Child, Preschool Anemia, Hypochromic vitamin D deficiency Article Hepatitis B Vaccines major clinical study English Abstract vaccination hepatitis B Physical Examination Switzerland Child