Changing faces: A review of infectious disease screening of refugees by the Migrant Health Unit, Western Australia in 2003 and 2004.

OBJECTIVE To document demographic characteristics and prevalence of infectious diseases in refugees and humanitarian entrants attending the Migrant Health Unit (MHU) in Perth for health assessment from 1 January 2003 to 31 December 2004. DESIGN Retrospective case series. PARTICIPANTS All refugees and humanitarian entrants arriving in Western Australia on subclass 200 and subclass 202 visas who were invited to attend the MHU. MAIN OUTCOME MEASURES Demographic details, results of Mantoux tests, and blood and faecal tests for infectious diseases and parasites. RESULTS WA accepted 2781 refugee and humanitarian entrants in 2003 and 2004; 2617 were invited to attend the MHU, and 2111 (81%) actually attended for screening. Over three-quarters arrived from Africa. Overall, 25% had a positive Mantoux test result, 5% were carriers of hepatitis B, and 5% had positive serological test results for syphilis. People arriving from sub-Saharan Africa had the highest prevalence of most diseases, with 8% having malaria, 7% schistosomiasis, 5% hookworm, and 2% strongyloidiasis. CONCLUSION Disease prevalence varied greatly between refugees from different countries and was particularly high in those arriving from sub-Saharan Africa, the origin of most of Australia's refugee and humanitarian entrants. These data support the need for refugees and humanitarian entrants from countries with high rates of disease to have access to a comprehensive postarrival medical assessment and appropriate follow-up health care. Health services must provide beneficial and cost-effective services that protect the health of both individual refugees and the wider community.