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Common presenting problems Psychological and behavioural disorders, anaemia esp. iron deficiency, oro-dental disease, tropical diseases (e.g. helminths, malaria, schistosomiasis), Helicobacter pylori infection, vitamin deficiencies esp. vitamin D, disorder of special senses—skin, ears, eyes, chronic disease (e.g. diabetes).
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Important diseases that ‘must not be missed’ include malaria, tuberculosis, schistosomiasis, HIV, typhoid fever, Hepatitis B and C, haemoglobinopathies, e.g. sickle cell, G6PD deficiency, meningoencephalitis and severe pyschological illness such as psychosis, major depression esp. suicide risk, and separation anxiety.
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Key recommendations (ASID) All refugees should be offered a comprehensive health assessment, ideally within 1 mth of arrival. This should include screening for and treatment of TB, malaria, blood-borne viral infections, e.g. dengue, Hepatitis B and C, schistosomiasis, helminth infections esp. strongyloides, hookworm. Catch-up immunisation is important (see https://immunisationhandbook.health.gov.au/catch-up-vaccination).
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Basic screening investigations: FBE, CXR, antibodies for Hep. B and Hep. C, strongyloides, HIV, TB (Mantoux or IGRA). Others based on age, risk or country of origin. For general refugee information, see https://refugeehealthguide.org.au.