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