Aim: Children account for approximately half of the humanitarian refugees currently resettled in Australia. A multidisciplinary refugee health clinic (RHC) was established at the tertiary paediatric hospital in Western Australia to address burgeoning referrals of refugee children following voluntary post‐resettlement health assessment. The aim of this study is to describe the epidemiology of common conditions in resettled paediatric refugees attending a tertiary multidisciplinary RHC.
Methods: Standardised clinical and demographic data were routinely collected during first visit clinical assessment at the RHC. Descriptive analyses of the first 1026 children are presented.
Results: One thousand twenty‐six refugee children from 475 families and over 30 different ethnicities were described. Nine hundred twenty‐seven (90.4%) children were referred following post‐resettlement health assessment. Median age was 7.8 years. Common reasons for referral were: vitamin D deficiency (400, 39%), iron deficiency (226, 22%), positive Helicobacter pylori serology (206, 21%), poor appetite (175, 17.1%), and schistosomiasis (170, 16.6%). Comorbidities identified by the RHC included tinea capitis and corporis (297, 28.9%), and dental disease (228, 22.2%). Two‐thirds of children (680, 66.3%) had at least one abnormal finding on clinical examination that identified pathologies that were not evident from the history. Three hundred eighty children (37%) were referred to sub‐specialty services.
Conclusions: A multidisciplinary paediatric RHC facilitated and strengthened the management of refugee children with multiple and complex health needs. Evidenced–based culturally appropriate methods to identify developmental delay, psychological morbidity and quantify social needs of this vulnerable population remain uncertain. These findings are relevant to the continuing evolution of paediatric refugee health care in Australia and other high income countries.
Of a series of 37 non-puerperal women aged between 19 and 55 years who requested bottle feeding, 27 were known to have completed a lactation induction programme and 24 (89 per cent) of these women were known to be successfully breast feeding well nourished children. All 11 women who had never previously lactated were successful. Of the three mothers in whom induction was unsuccessful, two obtained a bottle from other sources and both their children were malnourished. This study indicates that given a high degree of motivation combined with medication, support, and encouragement, lactation induction is likely to be highly successful and may thus be an important factor in child survival.
A cross-sectional analysis of the prevalence of hepatitis B surface antigenaemia in cord blood from 50 newborn babies and in blood from 415 children admitted to the children's ward of Port Moresby General Hospital indicates that perinatal vertical transmission is likely to be important and that there is a high rate of horizontal transmission in the 1st few years of life. Thirteen per cent of infants aged 3-5 months and 29-30% of those over 2 years of age were strongly positive for hepatitis B surface antigen. Open sores and poor hygiene are likely to play a significant role in the high level of horizontal transmission of hepatitis B virus (HBV) in our context. Our findings give support and urgency to the current active immunization policy against HBV, beginning as soon as possible after birth.
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