Prevalence of selected preventable and treatable diseases among government-assisted refugees: Implications for primary care providers.

OBJECTIVE

To discover the prevalence of 4 preventable and treatable diseases among newly arriving refugees.

DESIGN

Retrospective cohort study.

SETTING

An immigrant-friendly family medicine centre in Ottawa, Ont, that offers newly arriving refugees a clinical preventive program following a specially designed protocol.

PARTICIPANTS

A total of 112 adult government-assisted refugees seen during 2004 and 2005 within 6 months of arrival.

MAIN OUTCOME MEASURES: Demographic information and prevalence of HIV infection, latent tuberculosis (TB), chronic hepatitis B surface antigen-positive status, and intestinal parasites.

RESULTS

Descriptive analysis revealed that 71% of the adults were younger than 35 years and 83% of them had come from sub-Saharan Africa. Disease prevalence rates were 6.3% for HIV (95% confidence interval [CI] 1.8 to 10.8), 49.5% for latent TB (95% CI 39.5 to 49.8), 5.4% for chronic hepatitis B surface antigen-positive status (95% CI 1.2 to 9.5), and 13.6% for intestinal parasites (95% CI 7.2 to 20.0). Most refugees (83%) successfully completed the preventive care program. Performing chi(2) analysis revealed a statistically significant higher risk of latent TB among the men (P < .032). Most of the women had never had a Papanicolaou test.

CONCLUSION

Refugees are a vulnerable population with unique, but often preventable or treatable, health issues. This study demonstrated substantial differences in the prevalence of HIV, TB, chronic hepatitis B, and intestinal parasites between government-assisted refugees and Canadian residents. These health disparities and the emerging field of health settlement are new challenges for family physicians and other primary health care providers.