SCREENING IN SPECIAL POPULATIONS - A CASE-STUDY OF RECENT VIETNAMESE IMMIGRANTS

PURPOSE: TO determine how the medical and social profile of a particul ar special population, Vietnamese immigrants, should be used to tailor screening protocols that differ from those designed for the general p opulation. PATIENTS AND METHODS: A consecutive series of Vietnamese im migrants living in the United States for less than 6 months were evalu ated by interviewer-administered standardized questionnaire and medica l record review. A total of 99 new Vietnamese immigrants (47 women and 52 men) aged 19 to 71 years presenting for primary care to two neighb orhood health centers between October 1994 and June 1995 were identifi ed. Data collect;ed included smoking status, alcohol use (CAGE questio nnaire), depression (Vietnamese Depression Scare [VDS]), PPD status, s tool ova and parasites, hepatitis B and syphilis serologies. RESULTS: Overall, 32% were smokers and significantly more men than women smoked (54% vs. 9%) (P < .00001). Although 24% of patients used alcohol, non e responded positively to any of the CAGE questions. Using the VDS, 17 % (17 of 99) were depressed; age 40 and older was the only sociodemogr aphic factor associated with depression (P < .00001). Ova or parasites were found in 51% (41 of 80), and 63% of those infected (26 of 41) re quired treatment for pathogenic infections. Seventy percent (66 of 94) tested positive on the tuberculin skin test (PPD), and antituberculou s medication was recommended in 39% (37 of 94). Eighty-three percent ( 80 of 96) had been exposed to hepatitis B, and 14% (13 of 96) were chr onic hepatitis B carriers. CONCLUSIONS: Caring for special populations provides an opportunity to institute appropriate unique screening tes ts not recommended for the general population. in the case of new Viet namese immigrants, routine screening protocols should include the foll owing: testing for tuberculosis by PPD, stool ova and parasite examina tions, hepatitis B serologies, and assessment for depression and smoki ng status. The CAGE questionnaire may not bean effective instrument fo r detecting alcohol abuse in this particular population. (C) 1997 by E xcerpta Medica, Inc.