refugee health 101 with focus on syrian refugees

January 27, 2016

Dr. Bhooma BhayanaDr. Natalie LoveseyJoanne Veldhorst, NP

REFUGEE HEALTH 101

Mission StatementChronic DiseasesInfectious DiseasesWomen’s HealthMental HealthCCIRH Preventative Care Forms

PRESENTATION OVERVIEW

MISSION STATEMENT

Transition/ welcome“altruism” the caring of “the other”Global health, our boundaries are beyond “sea to sea”Early detectionEvidence based- informed by evidence and not

xenophobiaNot an immigration medical exam

CHRONIC DISEASE IN SYRIAN NEWCOMERS

Diabetes Iron Deficiency AnemiaDental HealthVision Health

Varicella – most adolescents and young adults will be immune

CHILDREN: Catch-up childhood vaccine if absent or uncertain vaccination records. Offer varicella vaccine to children <13 yo.

ADULTS: If no records, give 1 dose of MMR and a primary series of tetanus, diphtheria and polio, with 1st dose being Tdap. Varicella serology & vaccinate if susceptible.

INFECTIOUS DISEASES

Do not offer testing for latent TB

Screen all children and adults for chronic Hep B infection and vaccinate if susceptible

Consider screening for Hepatitis C

Shoulder consider Strongyloides serology, but should not collect stool samples unless the patient has abdominal symptoms.

INFECTIOUS DISEASES RECOMMENDATIONS

Hep B sAg, sAb, cAb

Hep C serology

Varicella serology (esp women of childbearing age)

Rubella serology (women of childbearing age)

Strongyloides serology

Stool O&P only if GI symptoms

ID SUMMARY – WHAT TO ORDER

Childbearing years - Rubella and varicella serologyAnemiaConfirming or ruling out pregnancyDiscussing contraception needs Preconception considerations (folic acid)Follow up visit – gyne exam/Pap smear, STI screening,

screening for IPVAdjustment stress/social isolation

WOMEN’S HEALTH

Immunization catch-upGrowth and development (WHO growth charts)Anemia Resource: www.kidsnewtocanada.ca

PEDIATRICS

CCIRH: Remain alert for possible PTSD but do not routinely screen for history of trauma

CCIRH: Screen for depression (as usual for primary care)

MENTAL HEALTH

SAMPLE REQUISITIONS

Paper/e-Package of Resources Caring for Kids New to Canada (CPS) –

kidsnewtocanada.caSick Kids – aboutkidshealth.ca – multilingual patient

handoutsCCIRH: www.ccihrken.caOnline London Refugee Health Network List

RESOURCES