1278. Health Screening of Refugees in Providence, RI
Session: Poster Abstract Session: Travel/Tropical Medicine and Parasitology
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
  • 1278_SylviaLaCourse_NatashaRybak(2).pdf (344.3 kB)
  • Background: Since the Refugee Act of 1980, more than 4300 refugees have resettled in Rhode Island.  Refugees are at increased risk of many infections and their vaccination status is frequently unknown.  Since October 2008, our clinic has worked with the International Institute of Rhode Island to coordinate the medical care of newly resettled refugees at a monthly Refugee Clinic.  The disease burden, limited insurance coverage and immunization requirements for naturalization increase the importance of timely identification and treatment of conditions and completion of vaccinations.

    Methods: Retrospective chart review of all refugee patients with initial intake exams at the Medicine/Pediatrics Primary Care Clinic in Providence, RI, from October 2008 to October 2010.

    Results: A total of 77 patients were seen from Africa, the Middle East, and Southeast Asia, with the largest percentage from Bhutan (28%).  Median age was 31 (range 4 months - 87 years), with 55% between the ages of 20-39.  Latent TB infection was diagnosed in 64% of patients.  Two patients had active Hepatitis B infection with detectable viral loads.  40% of patients had stool positive for parasites, approximately 2/3 of which were potentially pathogenic.  Immunity to measles, mumps and rubella was found in 95% of patients tested, while, immunity to varicella was found in 84% of refugees.  Hepatitis B immunity was lacking in 70% of refugees and 12% were non-immune despite core antibody positivity reflecting previous exposure.

    Conclusion: A structured refugee clinic aids in the identification of treatable infections as well as lack of immunity to vaccine-preventable diseases. Documentation of vaccination or immunity is necessary to access education, employment, and naturalization.  Our results demonstrate that although Hepatitis B is endemic in many of the countries of origin, immunity was low. Despite high rates of immunity to measles, mumps, rubella and varicella, not all refugees were immune and could serve as source patients for or susceptibles to future epidemics.  Given recent outbreaks of vaccine preventable diseases both domestically and internationally it is crucial that refugees and other high risk populations are screened appropriately and receive timely immunization.


    Subject Category: J. Clinical practice issues

    Natasha Rybak, MD1, Carol Lewis, MD2, Jerome Larkin, MD3 and Sylvia LaCourse, MD1, (1)Medicine/Pediatrics, The Warren Alpert Medical School of Brown University, Providence, RI, (2)Dept of Pediatrics, Hasbro Children's Hospital, Providence, RI, (3)Infectious Disease, Rhode Island Hospital, Providence, RI

    Disclosures:

    N. Rybak, None

    C. Lewis, None

    J. Larkin, None

    S. LaCourse, None

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