Immigrants

Question 1

What should be included in the care and treatment of new immigrants?

Answer 1

Assess vaccination status and update vaccines
Get a interpreter when required
Consider the cultural context
Screen for depression
Assess patients for availability of resources for support
Inquire about the use of alternative healers, practices, and/or medications

Ask about previous abuse or torture (as per the 99 topics, but the CCIRH EB GL recommends being alert to possible PTSD, but not to routinely ask about it)

Question 2

What tests/investigations are ordered as part of immigrant or refugee medical examination?

Answer 2

CXR to screen for TB
Syphilis
HIV
Urinalysis

Question 3

What are recommend labs/investigations as part of the first visit of a new immigrant or refugee? What about the second visit (2-7 days later)?

Answer 3

CBCD (females and children)
Varicella serology 
Other serologies for infectious disease depends on the region they originate from (e.g. strongyloidiasis and schistosomiasis from Africa)
Ensure vaccines are UTD
Screen for unmet contraceptive needs 
Screen for depression 

2nd Visit
Visual acuity
Dental/mouth exam

Remain alert for adjustment stress, child neglect, IPV