Pre-arrival health screening: children and adolescents
Pre arrival immigration medical examinations (IME) and screening for onshore protection visa applicants are outlined in the ASID guidelines and DIBP information. The IME for Humanitarian entrants includes urinalysis (5 years and older), interferon gamma release assay (IGRA) or tuberculin skin test (TST) (2–10 years), chest x-ray (11 years and older, or if clinically indicated), HIV screening (15 years and older, or if risk factors are identified) and syphilis screening (15 years and older). Unaccompanied minors (all ages) also have screening for HIV and hepatitis B surface antigen (HBsAg). Refugee entrants may undergo an additional Departure Health Check,[5, 6] and extended screening and vaccinations have been introduced for the recent Syrian/Iraqi cohorts. In practice, children have more limited screening compared to adolescents/adults due to these age cut points.
It is important for clinicians to be aware of the pre-arrival health screening process, as this process has implications for post-arrival healthcare:
- Check available offshore paperwork.
- Offshore vaccinations should be entered onto the Australian Immunisation Register (AIR).
- Children 2-10 years may have had additional tuberculosis screening (commenced from late 2015).
- TST (screening for tuberculosis (TB) exposure) should not be performed within 1 month of a live viral vaccine (e.g. MMR vaccine given pre-arrival).
- Albendazole (given as part of the DHC) may result in false negative serology for Strongyloides infection.
- People from the same source country may have different patterns of offshore health screening depending on their migration pathway and visa type.