Alfred Health, Melbourne, VIC
Royal Children's Hospital, Melbourne, VIC.
Med J Aust. 2017 Apr 17;206(7):310-315. doi: 10.5694/mja16.00826.
In 2009, the Australasian Society of Infectious Diseases published guidelines on the post-arrival health assessment of recently arrived refugees. Since then, the number of refugees and asylum seekers reaching Australia has increased substantially (17 555 refugees in 2015-16) and the countries of origin have changed. These groups are likely to have had poor access to health care pre-arrival and, consequently, are at risk of a range of chronic and infectious diseases. We established an advisory group that included infectious diseases physicians, general practitioners, public health specialists, paediatricians and refugee health nurses to update the 2009 guidelines.Main recommendations: All people from refugee-like backgrounds, including children, should be offered a tailored comprehensive health assessment and management plan, ideally within 1 month of arrival in Australia. This can be offered at any time if initial contact with a GP or clinic is delayed. Recommended screening depends on history, examination and previous investigations, and is tailored based on age, gender, countries of origin and transit and risk profile. The full version of the guidelines is available at http://www.asid.net.au/documents/item/1225.Changes in management as a result of this guideline: These guidelines apply to all people from refugee-like backgrounds, including asylum seekers. They provide more information about non-communicable diseases and consider Asia and the Middle East as regions of origin as well as Africa. Key changes include an emphasis on person-centred care; risk-based rather than universal screening for hepatitis C virus, malaria, schistosomiasis and sexually transmissible infections; updated immunisation guidelines; and new recommendations for other problems, such as nutritional deficiencies, women's health and mental health.
2009 年,澳大拉西亚传染病学会发布了关于最近抵达难民抵达后健康评估的指南。此后,抵达澳大利亚的难民和寻求庇护者人数大幅增加(2015-16 年有 17555 名难民),原籍国也发生了变化。这些人群在抵达前可能很难获得医疗保健,因此,他们面临一系列慢性和传染病的风险。我们成立了一个咨询小组,其中包括传染病医生、全科医生、公共卫生专家、儿科医生和难民健康护士,以更新 2009 年的指南。主要建议:所有来自类似难民背景的人,包括儿童,都应提供量身定制的全面健康评估和管理计划,理想情况下应在抵达澳大利亚后 1 个月内提供。如果最初与全科医生或诊所的联系延迟,则可以随时提供。推荐的筛查取决于病史、检查和以前的调查结果,并根据年龄、性别、原籍国和过境国以及风险状况进行定制。指南的全文可在 http://www.asid.net.au/documents/item/1225. 由于本指南而改变的管理:本指南适用于所有来自类似难民背景的人,包括寻求庇护者。它们提供了有关非传染性疾病的更多信息,并考虑了亚洲和中东作为原籍国以及非洲。主要变化包括强调以人为本的护理;基于风险而非普遍筛查丙型肝炎病毒、疟疾、血吸虫病和性传播感染;更新免疫接种指南;以及针对其他问题(如营养缺乏、妇女健康和心理健康)的新建议。