Pre-arrival health screening: children and adolescents

Written by on . Posted in Adolescents, Children

Pre arrival immigration medical examinations (IME) and screening for onshore protection visa applicants are outlined in the ASID guidelines[3] and DIBP information.[4] 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).[4] 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).[7]
  • 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.

Produced by

in consultation with

                  Refugee Health Network of Australia

Endorsed by

Funded by

The Australian Refugee Health Practice Guide was produced with funds from the Australian Government Department of Health.

Disclaimer

The information set out in the Australian Refugee Health Practice Guide (“the Guide”) is current at the date of first publication and is intended for use as a guide of a general nature only and may or may not be relevant to particular patients or circumstances. Nor is the Guide exhaustive of the subject matter. Persons implementing any recommendations contained in the Guide must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular circumstances when so doing. The statements or opinions that are expressed in the Guide reflect the views of the contributing authors and do not necessarily represent the views of the editors or Foundation House. Compliance with any recommendations cannot of itself guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional and the premises from which the health professional operates.

Whilst the information is directed to health professionals possessing appropriate qualifications and skills in ascertaining and discharging their professional (including legal) duties, it is not to be regarded as clinical advice and, in particular, is no substitute for a full examination and consideration of medical history in reaching a diagnosis and treatment based on accepted clinical practices.

Accordingly, Foundation House and its employees and agents shall have no liability (including without limitation liability by reason of negligence) to any users of the information contained in the Guide for any loss or damage (consequential or otherwise), cost or expense incurred or arising by reason of any person using or relying on the information contained in the Guide and whether caused by reason of any error, negligent act, omission or misrepresentation in the information. Although every effort has been made to ensure that drug doses and other information are presented accurately in the Guide, the ultimate responsibility rests with the prescribing clinician. For detailed prescribing information or instructions on the use of any product described herein, please consult the prescribing information issued by the manufacturer.