The health of newly arrived refugees to the Top End of Australia: results of a clinical audit at the Darwin Refugee Health ServiceVanessa Johnston A D , Le Smith B and Heather Roydhouse C
A Menzies School of Health Research, Charles Darwin University and Northern Territory Centre for Disease Control, PO Box 41096, Casuarina, NT 0811, Australia.
B General Practice Network NT, PO Box 552, Noonamah, NT 0837, Australia.
C Royal Children’s Hospital, Flemington Road, Parkville, Vic. 3052, Australia.
D Corresponding author. Email: email@example.com
Australian Journal of Primary Health 18(3) 242-247 http://dx.doi.org/10.1071/PY11065
Submitted: 14 June 2011 Accepted: 5 October 2011 Published: 9 December 2011
Accurate data on the health of refugees in primary care is vital to inform clinical practice, monitor disease prevalence, influence policy and promote coordination. We undertook a retrospective clinical audit of newly arrived refugees attending the Darwin refugee primary health service in its first 12 months of operation. Data were collected from the clinic files of refugee patients who attended for their initial health assessment from 1 July 2009 to 30 June 2010 and were analysed descriptively. Among 187 refugees who attended in 2009–2010, ~60% were from Asia and 42% were female. The most common diagnoses confirmed by testing were vitamin D deficiency (23%), hepatitis B carrier status (22%), tuberculosis infection (18%), schistosomiasis (17%) and anaemia (17%). The most common documented health conditions recorded by the GPs were vitamin D deficiency or insufficiency (66%), followed by schistosomiasis (24%) and dental disease (23%). This clinical audit adds to a limited evidence base suggesting a high prevalence of infectious disease, nutrient deficiency and dental disease among refugees arriving to Australia. GPs involved in the care of refugees must be aware of the epidemiology of disease in this group, as some diseases are rare among the general Australian population. Our results also highlight the ongoing need for advocacy to address service constraints such as limited public dental access for this population.
ReferencesAdams KM, Gardiner LD, Assefi N, Adams KM, Gardiner LD, Assefi N (2004) Healthcare challenges from the developing world: post-immigration refugee medicine. British Medical Journal 328, 1548–1552.
| Healthcare challenges from the developing world: post-immigration refugee medicine.CrossRef | 15217874PubMed |
Benson J, Skull S (2007) Hiding from the sun - vitamin D deficiency in refugees. Australian Family Physician 36, 355–357.
Burnett A, Peel M (2001a) Asylum seekers and refugees in Britain. The health of survivors of torture and organised violence. British Medical Journal 322, 606–609.
| Asylum seekers and refugees in Britain. The health of survivors of torture and organised violence.CrossRef | 1:STN:280:DC%2BD3M7pvVSgsQ%3D%3D&md5=1090d5b7e16361662816007d2d20112dCAS | 11238163PubMed |
Burnett A, Peel M (2001b) Health needs of asylum seekers and refugees. British Medical Journal 322, 544–547.
| Health needs of asylum seekers and refugees.CrossRef | 1:STN:280:DC%2BD3M7pvVOhtw%3D%3D&md5=941963b805b3cfdd92e2a870d01233dcCAS | 11230074PubMed |
Chaves NJ, Gibney KB, Leder K, O’Brien DP, Marshall C, Biggs B-A (2009) Screening practices for infectious diseases among Burmese refugees in Australia. Emerging Infectious Diseases 15, 1769–1772.
Davidson N, Skull S, Calache H, Murray SS, Chalmers J (2006) Holes a plenty: oral health status a major issue for newly arrived refugees in Australia. Australian Dental Journal 51, 306–311.
| Holes a plenty: oral health status a major issue for newly arrived refugees in Australia.CrossRef | 1:STN:280:DC%2BD2s%2FltlKksA%3D%3D&md5=2af187908a970e37504f635eec658ae7CAS | 17256304PubMed |
DIAC (2009) Department of Immigration and Citizenship Annual Report 2008–09. Department of Immigration and Citizenship, Canberra.
DIAC (2011a) ‘Settlement reporting: Providing statistical data on permanent arrivals to Australia.’ Available at http://www.immi.gov.au/settlement/#sr=step_3 [Verified 6 September 2011].
DIAC (2011b) ‘Health requirements for visa applicants.’ (Department of Immigration and Citizenship) Available at http://www.immi.gov.au/allforms/health-requirements/ [Verified 3 March 2011].
DOHA (2006) ‘Pre-departure communicable diseases health screening protocols for refugees arriving from Africa.’ (Department of Health and Ageing) Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-cdna-health-screen-protocol.htm [Verified 3 March 2011].
DOHA (2010) ‘Medicare Benefits Schedule (MBS) Health assessment for refugees and other humanitarian entrants.’ (Department of Health and Ageing) Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/mbsprimarycare_mbsitem_refugees [Verified 15 April 2011].
Gibney KB, Mihrshahi S, Torresi J, Marshall C, Leder K, Biggs BA (2009) The profile of health problems in African immigrants attending an infectious disease unit in Melbourne, Australia. The American Journal of Tropical Medicine and Hygiene 80, 805–811.
Johnson D (2007) ‘Rates of infectious diseases and nutritional deficiencies in newly arrived African refugees.’ (Central Northern Adelaide Health Service South Australia: Adelaide)
Kay M, Jackson C, Nicholson C (2010) Refugee health: a new model for delivering primary health care. Australian Journal of Primary Health 16, 98–103.
| Refugee health: a new model for delivering primary health care.CrossRef | 21133306PubMed |
Martin JA, Mak DB (2006) Changing faces: A review of infectious disease screening of refugees by the Migrant Health Unit, Western Australia in 2003 and 2004. The Medical Journal of Australia 185, 607–610.
Melaleuca Refugee Centre (2010) Annual Report 2009–10. Melaleuca Refugee Centre, Torture and Trauma Survivors Service, Darwin.
Murray SB, Skull SA (2005) Hurdles to health: immigrant and refugee health care in Australia. Australian Health Review 29, 25–29.
| Hurdles to health: immigrant and refugee health care in Australia.CrossRef | 15683352PubMed |
Murray RJ, Davis JS, Burgner DP, Australasian Society for Infectious Diseases Refugee Health Guidelines Writing Group, Hansen-Knarhoi M, Krause V, Biggs BA, Lemoh C, Benson J, Cherian S, Buttery J, Paxton G (2009) The Australasian Society for Infectious Diseases guidelines for the diagnosis, management and prevention of infections in recently arrived refugees: an abridged outline. The Medical Journal of Australia 190, 421–425.
Sheikh-Mohammed M, Macintyre CR, Wood NJ, Leask J, Isaacs D (2006) Barriers to access to health care for newly resettled sub-Saharan refugees in Australia. The Medical Journal of Australia 185, 594–597.
Smith MM (2006) Refugees in Australia: changing faces, changing needs. The Medical Journal of Australia 185, 587–588.
Stauffer WM, Weinberg M, Stauffer WM, Weinberg M (2009) Emerging clinical issues in refugees. Current Opinion in Infectious Diseases 22, 436–442.
| Emerging clinical issues in refugees.CrossRef | 19587590PubMed |
Tiong AC, Patel MS, Gardiner J, Ryan R, Linton KS, Walker KA, Scopel J, Biggs B-A (2006) Health issues in newly arrived African refugees attending general practice clinics in Melbourne. The Medical Journal of Australia 185, 602–606.
WHO (1994) ‘Schistosomes, liver flukes and Helicobacter pylori. IARC Monograph Vol. 61.’ (International Agency for Research on Cancer, World Health Organization: Lyons, France)
WHO (2010) ‘Global tuberculosis control 2010.’ (World Health Organization: Geneva)
Woodland L, Burgner D, Paxton G, Zwi K (2010) Health service delivery for newly arrived refugee children: A framework for good practice. Journal of Paediatrics and Child Health 46, 560–567.
| Health service delivery for newly arrived refugee children: A framework for good practice.CrossRef | 20626581PubMed |
Young MK, McCall BJ, Heel K (2010) The impact of pre-departure screening and treatment on notifications of malaria in refugees in south-east Queensland. Communicable Diseases Intelligence 34, 37–40.