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Prevalence of selected preventable and treatable diseases among government-assisted refugees

Implications for primary care providers

Praseedha Janakiram, MD CCFP
Recent graduate of the Department of Family Medicine at the University of Ottawa

Patricia Topp, RN(EC) MScN
Nurse practitioner in the Immigrant Health Visiting Friends and Relatives Program and a researcher at the C.T. Lamont Primary Health Care Research Centre

Anne McCarthy, MD MSc FRCPC DTM&H
The Director of the Tropical Medicine and International Health Clinic and the Adult Infectious Diseases Training Program and is an Associate Professor at the University of Ottawa

Correspondence to: Dr Kevin Pottie, Associate Professor, University of Ottawa, 75 Bruyère St, Ottawa, ON K1S 0P6; telephone 613 562-5800, extension 2461; fax 613 241-1846; e-mail kpottie{at}uottawa.ca

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 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.

This article has been cited by other articles:

				K. B. Gibney, S. Mihrshahi, J. Torresi, C. Marshall, K. Leder, and B.-A. Biggs The Profile of Health Problems in African Immigrants Attending an Infectious Disease Unit in Melbourne, Australia Am J Trop Med Hyg, May 1, 2009; 80(5): 805 - 811. [Abstract] [Full Text] [PDF]