Health status of pediatric refugees in Buffalo, NY
S. B. Meropol
Department of Pediatrics, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, USA.
OBJECTIVE: To characterize the health status of recent pediatric refugees.
RESEARCH DESIGN: Medical records of 107 pediatric refugees who underwent
screening during a recent 24-month period were reviewed. SETTING: A county
hospital pediatric clinic in a metropolitan area with a population of
1,189,000. The majority of pediatric refugees who come to the Buffalo, NY,
area receive a health screening in this clinic. RESULTS: Most of the
children were from Vietnam (67%), the Soviet Republics (19%), or Africa
(14%). The median age was 8 years 2 months (range, 1 to 18 years). Only 39%
of the children had evidence of adequate immunizations for age (39 of the
children from Vietnam, two children from Africa, and one from the Soviet
Republics). In 30%, physical examinations exposed conditions that required
follow-up or referral to a medical or surgical specialist. Forty-two
percent of the children required dental referral. Seven children were
anemic; three had microcytic anemia. Of 81 children who underwent screening
for hepatitis B, six (7%) were carriers, 35 (43%) were positive for
hepatitis B surface antibody, and only four (5%) related a history of
hepatitis exposure. Stool specimens were examined for ova and parasites in
87 children; 19 had pathogenic parasites with multiple organisms in two.
Thirteen (24%) of 55 children who were tested from Vietnam, five (36%) of
14 children who were tested from Africa, and one (5%) of 18 children who
were tested from the Soviet Republics had pathogenic parasites. Parasites
included Ascaris lumbricoides (n = 8), Necator americanus or Ancylostoma
duodenale (n = 5), Giardia lamblia (n = 3), Trichuris trichiura (n = 2),
Dientamoeba fragilis (n = 2), and Entamoeba histolytica (n = 1). Skin
testing for tuberculosis with purified protein derivative (tuberculin) was
completed in 83 children, and 17 (20%) had reactive tests (21% [12/58] from
Vietnam, 11% [1/9] from Africa, and 25% [4/16] from the Soviet Republics).
CONCLUSIONS: Refugee children who come to the United States frequently have
conditions that put them at risk of future morbidity and may require
utilization of substantial health care resources. Some of these conditions
represent public health concerns.
