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This study determines the nutritional status among refugee children entering one of the largest resettlement counties in the United States and identifies differences between incoming populations. Medical records of all newly arriving pediatric refugees (0-18 years) entering DeKalb County, Georgia between October 2010 and July 2011 were reviewed. Refugee children were grouped as African, Bhutanese, or Burmese (resettling from either Thailand or Malaysia) for comparative analysis. Approximately one in five refugees were anemic or malnourished, while a quarter had stool parasites, and nearly half had dental caries. African refugees had the highest anemia but the lowest underweight prevalence (p < 0.05). Compared to Burmese resettling from Malaysia, Burmese children from Thailand had a higher prevalence of anemia, underweight, and stool parasites (p < 0.05). Clinicians should use CDC medical screening guidelines for newly arriving pediatric refugees, as well as ensure proper nutritional support and follow-up care.

Background: Approximately 70,000 refugees are resettled to the United States each year. Providing vaccination to arriving refugees is important to both reduce the health-related barriers to successful resettlement, and protect the health of communities where refugees resettle. It is crucial to understand the process and resources expended at the state/local and federal government levels to provide vaccinations to refugees resettling to the United States., Objectives: We estimated costs associated with delivering vaccines to refugees at the Board of Health Refugee Services, DeKalb county, Georgia (DeKalb clinic)., Methods: Vaccination costs were estimated from two perspectives: the federal government and the DeKalb clinic. Data were collected at the DeKalb clinic regarding resources used for vaccination: staff numbers and roles; type and number of vaccine doses administered; and number of patients. Clinic costs included labor and facility-related overhead. The federal government incurred costs for vaccine purchases and reimbursements for vaccine administration., Results: The DeKalb clinic average cost to administer the first dose of vaccine was $12.70, which is lower than Georgia Medicaid reimbursement ($14.81), but higher than the State of Georgia Refugee Health Program reimbursement ($8.00). Federal government incurred per-dose costs for vaccine products and administrative reimbursement were $42.45 (adults) and $46.74 (children)., Conclusions: The total costs to the DeKalb clinic for administering vaccines to refugees are covered, but with little surplus. Because the DeKalb clinic 'breaks even,' it is likely they will continue to vaccinate refugees as recommended by the Centers for Disease Control and Prevention and the Advisory Committee on Immunization Practices., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Hepatitis B virus infection (HBV) remains highly endemic in many parts of the world. Refugees resettling in their host countries may carry a significant burden of disease due to HBV and may require long-term medical care. A retrospective descriptive study was conducted to assess the epidemiology of HBV and entry into medical care in refugee communities resettled in the State of Georgia over a five-year period: 2003-2007. Among 6,347 refugees (89.7% of those resettled) screened for HBV infection, six hundred and eighty (10.7%) were found to be HBsAg seropositive. Those between the ages of 10-39 years of age contributed to the majority of cases; and most originated from Africa (71%). All HBsAg positive cases were adequately referred to a primary care physician for further management but there are no formal feedback mechanisms in place to learn if those who tested positive for HBsAg accessed the primary healthcare system. HBV infection is a frequent infection among refugees resettled in the US. but their entry into healthcare to treat those with chronic infection is often unknown. Further efforts are required to assure their entry into the healthcare system. Primary care physicians caring for refugee patients should think about verifying HBV-infection status as part of health maintenance protocols.

A 27-year-old, previously healthy Somali refugee presented with infertility. Cultures of endometrial tissue were positive for fully susceptible tuberculosis and she was diagnosed with genital tuberculosis. After 12 months of antituberculosis therapy, she attempted to become pregnant; however, use of in vitro fertilization and surrogate carrier probably will be needed given the degree of scar tissue present before treatment. Due to the increasing numbers of US-resettled refugees, physicians should consider genital tuberculosis in any refugee woman presenting with infertility or amenorrhea.