>Refugee Health

Refugee Health

This page as been put together to help GPs when it comes to meeting the health needs of Refugees in our community. Here you will find a Screening Protocol for the Investigation and Treatment of Newly Arrived Refugees, MD templates, links to various health conditions, services contact list, up to date information regarding MBS items numbers, regular news articles, plus much more.

Screening Protocol & Medical Director Templates

	Refugee Health Screening Protocol - Investigation & Treatment of Newly Arrived Refugees  by Migrant Health Service (124 Kb)
	Checklist for Refugee Health Assessment - Item 714 by Migrant Health Service, CNAHS, Adelaide (48.5 Kb
	Refugee Health Assessment (MD Template)  by SDGP and Migrant Health Service, CNAHS, Adelaide (weblink)
	Refugee Health Assessment (MD Template) by Dr Don Angus. (21.9 Kb)

Refugee Health Services Contact List for GPs

Refugee Health Links To Conditions In Templates

Herewith PDF weblinks to articles in AFP that deal with some of the important conditions dealt with in the Refugee Health template.

	Early Health Assessment of Refugees
	Schistosomiasis
	Catch up Immunisation
	Hepatitis B, C and D
	Vitamin D Deficiency
	Malaria

Regular Refugee Health News

Malaria

40% of the world's population is at risk and almost 3 million people die of malaria each year although mainly in Africa. Malaria article - AWGPN News June/July 08

Asymptomatic Schistosomiasis

For most GPs schistosomiasis (bilharzia) was an interesting tropical disease we learnt about in medical school and never thought we would see in our practices in South Australia. Of the 1300 refugees who settled in Australia in 2004-2005, 70% have come from Africa and 40% were infected with schistosomiasis. See attached article for more details.

MBS Item No. 714  (Oct 07)

MBS item No. 714 pays $195.50 for an initial health check for refugees with humanitarian visas who have been in Australia less than 12 months and meet other criteria.

GPs need to investigate, examine and develop a management plan for the patient, typically over two consultations because of the high incidence of positive pathology results. Investigations will depend on the country of origin, for example, if the patient is from Africa it will include schistosomiasis, malaria, other parasites and Vitamin D deficiency. For most countries TB, hepatitis B and C and nutritional deficiencies will be important. Issues such as Post Traumatic Stress Disorder, immunisation, child development and women's health are also a concern for most refugee families. 

An article with more information about the item no. can be accessed from the RACGP and a template is also available from the RACGP along with other resources for South Australia.

For more information please feel free to contact the Migrant Health Service on 8237 3900. (other details below). 

Hepatitis In Refugees (Oct 07)

The rate of hepatitis B (HBV) infection in Australia is 2.2 per 100,000 with 70% of those with chronic HBV born overseas. Refugees come from countries such as sub-Saharan Africa and Asia where 10% or more of the population have chronic HBV, the majority contracted in childhood. 25% of these will die of cirrhosis or hepatocellular carcinoma from the HBV. Screening and follow-up are important to reduce transmission, vaccinate family and assess eligibility for treatment.

The prevalence of hepatitis C (HCV) is high in many of the countries where refugees have been born or have stayed in transit. For example in Egypt, the prevalence of HCV antibodies is 15-20% because of transmission by health professionals during a vaccination program. It is important to do a qualitative PCR in those with antibodies to assess whether the patient has cleared the virus or needs to be considered for treatment.

P.E.A.C.E is a multicultural education and support service for those with HIV and hepatitis (08 8245 8100) and the Hepatitis C Council can be contacted by patients or GPs for information and support (08 8362 8443/1800 021 133 free call rural callers). The Migrant Health Service (21 Market St, Adelaide) has specialised GPs and other health professionals who can assist with information or see patients for culturally sensitive education or the development of a management plan (08 82373900). A recent article about Hepatitis in refugees published in the Australian Family Physician can be accessed at http://www.racgp.org.au/afp/200709/18552

Contact

Name:	Dr Jill Benson
Position:	Senior Medical Officer
Organisation:	Migrant Health Service
Email:	Jill.Benson@health.sa.gov.au
Address:	21 Market Street, Adelaide SA 5000
Phone:	08 8237 3900

The Migrant Health Service is a state-funded specialist primary health provider that offers comprehensive health screening and early intervention to newly arrived refugees and asylum seekers. Dr Jill Benson is there on a Tuesday and Wednesday morning as telephone support or to facilitate referrals, other GPs are there at various times and specialised nurses are there at all times.