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The Australasian Society for Infectious Diseases and Refugee Health Network of Australia recommendations for health assessment for people from refugee-like backgrounds: an abridged outline

Nadia J Chaves, Georgia A Paxton, Beverley-Ann Biggs, Aesen Thambiran, Joanne Gardiner, Jan Williams, Mitchell M Smith and Joshua S Davis
Med J Aust 2017; 206 (7): 310-315. || doi: 10.5694/mja16.00826

Summary

Introduction: In 2009, the Australasian Society of Infectious Diseases published guidelines on the post-arrival health assessment of recently arrived refugees. Since then, the number of refugees and asylum seekers reaching Australia has increased substantially (17 555 refugees in 2015–16) and the countries of origin have changed. These groups are likely to have had poor access to health care pre-arrival and, consequently, are at risk of a range of chronic and infectious diseases. We established an advisory group that included infectious diseases physicians, general practitioners, public health specialists, paediatricians and refugee health nurses to update the 2009 guidelines.

Main recommendations: All people from refugee-like backgrounds, including children, should be offered a tailored comprehensive health assessment and management plan, ideally within 1 month of arrival in Australia. This can be offered at any time if initial contact with a GP or clinic is delayed. Recommended screening depends on history, examination and previous investigations, and is tailored based on age, gender, countries of origin and transit and risk profile. The full version of the guidelines is available at http://www.asid.net.au/documents/item/1225.

Changes in management as a result of this guideline: These guidelines apply to all people from refugee-like backgrounds, including asylum seekers. They provide more information about non-communicable diseases and consider Asia and the Middle East as regions of origin as well as Africa. Key changes include an emphasis on person-centred care; risk-based rather than universal screening for hepatitis C virus, malaria, schistosomiasis and sexually transmissible infections; updated immunisation guidelines; and new recommendations for other problems, such as nutritional deficiencies, women’s health and mental health.

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  • Nadia J Chaves1,2
  • Georgia A Paxton3
  • Beverley-Ann Biggs4
  • Aesen Thambiran5
  • Joanne Gardiner6
  • Jan Williams7
  • Mitchell M Smith8
  • Joshua S Davis9,10

  • 1 Alfred Health, Melbourne, VIC
  • 2 cohealth Kensington, Melbourne, VIC
  • 3 Royal Children's Hospital, Melbourne, VIC
  • 4 University of Melbourne, Melbourne, VIC
  • 5 Humanitarian Entrant Health Service, Department of Health Western Australia, Perth, WA
  • 6 Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, VIC
  • 7 Migrant Health Service, Central Adelaide Local Health Network, Adelaide, SA
  • 8 New South Wales Refugee Health Service, Sydney, NSW
  • 9 Menzies School of Health Research, Darwin, NT
  • 10 John Hunter Hospital, Newcastle, NSW

Correspondence: n.chaves@alfred.org.au

Acknowledgements: 

We thank the following people for their input to the full version of the guideline: chapter authors Marion Bailes, Sarah Cherian, Vanessa Clifford, Benjamin Cowie, Justin Denholm, Rebecca Dunn, Josh Francis, Debbie Hocking, David Isaacs, Margaret Kay, Karen Kiang, Chris Lemoh, Jennifer Maclachlan, Christine Phillips, Sahema Saberi, Thomas Schulz, Gillian Singleton, Kasha Singh, Kate Walker and Shanti Narayanasamy; expert reviewers John Furler, Peter Greenberg, Karin Leder, James McCarthy, Ric Price, Regina Quiazon, Nathan Ryder, Harsha Sheorey, Rebecca Szabo, Alfred Chin Yen Tay, Justin Waring and Mary Webberley; Refugee Health Nurse Subcommittee members Jan Williams, Merilyn Spratling, Sandy Eagar and Lindy Marlow; proofreaders and editors Linny Kimly Phuong, Shanti Narayanasamy, Kudzai Kanhutu and Deborah Norberry.

Competing interests:

Nadia Chaves received funding from the Victorian Department of Health and Human Services to coordinate the production of this resource as the 2015 Royal Melbourne Hospital Refugee Health Fellow based at the Peter Doherty Institute for Infection and Immunity. Joanne Gardiner, Thomas Schulz and Karen Kiang were also funded as Victorian Refugee Health Fellows. Joshua Davis holds a career development fellowship of the National Health and Medical Research Council (1083105).

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