HEALTH-STATUS OF PEDIATRIC REFUGEES IN BUFFALO, NY

Objective: To characterize the health status of recent pediatric refug ees. Research Design: Medical records of 107 pediatric refugees who un derwent screening during a recent 24-month period were reviewed. Setti ng: A county hospital pediatric clinic in a metropolitan area with a p opulation of 1 189 000. The majority of pediatric refugees who come to the Buffalo, NY, area receive a health screening in this clinic. Resu lts: Most of the children were from Vietnam (67%), the Soviet Republic s (19%), or Africa (14%). The median age was 8 years 2 months (range, 1 to 18 years). Only 39% of the children had evidence of adequate immu nizations for age (39 of the children from Vietnam, two children from Africa, and one from the Soviet Republics). In 30%, physical examinati ons exposed conditions that required follow-up or referral to a medica l or surgical specialist. Forty-two percent of the children required d ental referral. Seven children were anemic; three had microcytic anemi a. Of 81 children who underwent screening for hepatitis B, six (7%) we re carriers, 35 (43%) were positive for hepatitis B surface antibody, and only four (5%) related a history of hepatitis exposure. Stool spec imens were examined for ova and parasites in 87 children; 19 had patho genic parasites with multiple organisms in two. Thirteen (24%) of 55 c hildren who were tested from Vietnam, five (36%) of 14 children who we re tested from Africa, and one (5%) of 18 children who were tested fro m the Soviet Republics had pathogenic parasites. Parasites included As caris lumbricoides (n = 8), Necator americanus or Ancylostoma duodenal e (n = 5), Giardia lamblia (n = 3), Trichuris trichiura (n = 2), Dient amoeba fragilis (n = 2), and Entamoeba histolytica (n = 1). Skin testi ng for tuberculosis with purified protein derivative (tuberculin) was completed in 83 children, and 17 (20%) had reactive tests (21% [12/58] from Vietnam, 11% [1/9] from Africa, and 25% [4/16] from the Soviet R epublics). Conclusions: Refugee children who come to the United States frequently have conditions that put them at risk of future morbidity and may require utilization of substantial health care resources. Some of these conditions represent public health concerns.