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