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Minnesota Refugee Screening Protocol

Minnesota Refugee Screening Protocol . Minnesota Department of Health Infectious Disease Division Immunizations, Tuberculosis and International Health Section. Outline of Recommended Exam Components. Health History Immunization review and update Screen for: Tuberculosis Hepatitis B

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Minnesota Refugee Screening Protocol

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  1. Minnesota Refugee Screening Protocol Minnesota Department of Health Infectious Disease Division Immunizations, Tuberculosis and International Health Section

  2. Outline of Recommended Exam Components • Health History • Immunization review and update • Screen for: • Tuberculosis • Hepatitis B • Intestinal Parasites • Lead poisoning (6 months - 16 years) • Evaluate for STI and malaria risk • Screen per provider discretion • Physical Exam • Assessment for Dental, Vision, Mental Health • Refer or initiate primary care

  3. Recommended Exam Components • Use national guidance provided by CDC • http://www.cdc.gov/ncidod/dq/refugee/rh_guide/index.htm • Questions about national guidelines: • 24 Hours/Every Day • 800-CDC-INFO (800-232-4636) • cdcinfo@cdc.gov

  4. Exam Process / Scheduling To increase compliance with screening…. • Schedule refugees as a family unit • Use 2 or 3-visit model • 1st / 2nd visit • pre-screening nurse visit • 3RD visit • schedule provider visit when labs / chest x-ray results are available

  5. Exam Process/Scheduling cont. To increase compliance and return visit: • Schedule a trained medical interpreter for all visits or use Language Line • Arrange transportation to clinic if needed • Make reminder calls for each clinic visit • If unable to locate/contact family, work with Volag caseworker to find

  6. 1st Pre-Screening Nurse Visit* • Medical histories on all arrivals • Check for documentation of pre-departure treatment of malaria and parasitic infection • Screen for acute medical or social issues • Plot children on growth charts • Collect urinalysis • Urine pregnancy test (females 13 -45) • Give stool containers with direction for collection or check absolute eosinophil count (per national guidelines) • Administer Tuberculin Skin Test (TST) or drawQuantiFERON • Schedule return appointment in 2 to 3 days *adapted from Hennepin County Public Health Clinic

  7. 2nd Pre-screening Nurse Visit* • Read TST • Obtain PA and Left Lateral CXR for all with positive TSTs/QFR • Obtain Labs: CBC, HBsAg, HBsAB, comprehensive panel, RPR (13 and older) and blood lead (6 mo -16 yrs) • Collect stool containers for O&P • Hearing and vision check • Schedule refugee 3rd visit / provider exam in 1-2 weeks when all lab results are available *adapted from Hennepin County Public Health Clinic

  8. 3rd Visit: Provider Exam* • Use medical interpreter • Review test and lab results and treat based on findings • Administer presumptive therapy for malaria for refugees from sub-Saharan Africa, as indicated • Immunize • Growth and Development Screening • Mental Health Screening • Perform physical exam, include vision, hearing, cursory dental assessment • Make referrals if needed (hearing, vision, dental, family planning, WIC, peds, other specialties) *adapted from Hennepin County Public Health Clinic

  9. Minnesota Refugee Health Program Phone: 651-201-5414 or 1-877-676-5414 Web site:http://www.health.state.mn.us/refugee Address: Minnesota Department of Health Refugee Health Program Freeman Building 625 N. Robert Street Box 64975 St. Paul, MN 55164-0975 8/08

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