Infectious disease screening outcomes and reducing barriers to care for unaccompanied asylum-seeking children: a single centre retrospective clinical analysis
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Published version
Author(s)
Cardoso Pinto, Alexandra
Seery, Paula
Foster, Caroline
Type
Journal Article
Abstract
Objective: Evaluate the Unity Clinic’s infectious disease screening programme for unaccompanied asylum-seeking children (UASC), calculate rates of infection and identify further health needs.
Design: Retrospective audit of electronic patient data.
Setting and patients UASC who attended the Unity Clinic between 1 November 2019 and 22 March 2022.
Main outcome measures: Baseline demographics, social, mental health and journey details, infection screening and investigation results.
Results: 155 UASC were reviewed: 89% (138 of 155) male, median age 17 years (IQR 16–17). Most frequent countries of origin were Sudan, Eritrea and Afghanistan. Median duration of travel to the UK (n=79) was 2 years (IQR 0.5–4); 35.6% (47 of 132) arrived by boat and 54.5% (72 of 132) by road. 44.8% (69 of 154) had one or more positive infection screening results: 22.7% (35 of 154) and 1.3% (2 of 154) positive for latent and active tuberculosis, respectively; 4.6% (7 of 152) chronic active hepatitis B and 17.1% (26 of 152) for past infection; 1.3% (2 of 154) for HIV; 13.0% (19 of 146) for Strongyloides. There were three cases of syphilis (n=152; 2.0%) and one chlamydia (n=148; 0.7%)—none of whom disclosed prior sexual activity during screening. 39.6% (61 of 154) and 27.9% (43/154) reported disturbances to mood or sleep, respectively. 55.2% (85 of 154) disclosed traumatic incidents during and/or prior to their journey, including physical and sexual assault.
Conclusions: The Unity Clinic provides a thorough infectious disease screening service for UASC following national guidance. Results highlight the need for universal, non-judgemental screening for sexually transmitted infections, as targeted screening would not identify positive cases. High rates of well-being issues and previous abuse emphasise the need for multidisciplinary, collaborative approaches to care.
Design: Retrospective audit of electronic patient data.
Setting and patients UASC who attended the Unity Clinic between 1 November 2019 and 22 March 2022.
Main outcome measures: Baseline demographics, social, mental health and journey details, infection screening and investigation results.
Results: 155 UASC were reviewed: 89% (138 of 155) male, median age 17 years (IQR 16–17). Most frequent countries of origin were Sudan, Eritrea and Afghanistan. Median duration of travel to the UK (n=79) was 2 years (IQR 0.5–4); 35.6% (47 of 132) arrived by boat and 54.5% (72 of 132) by road. 44.8% (69 of 154) had one or more positive infection screening results: 22.7% (35 of 154) and 1.3% (2 of 154) positive for latent and active tuberculosis, respectively; 4.6% (7 of 152) chronic active hepatitis B and 17.1% (26 of 152) for past infection; 1.3% (2 of 154) for HIV; 13.0% (19 of 146) for Strongyloides. There were three cases of syphilis (n=152; 2.0%) and one chlamydia (n=148; 0.7%)—none of whom disclosed prior sexual activity during screening. 39.6% (61 of 154) and 27.9% (43/154) reported disturbances to mood or sleep, respectively. 55.2% (85 of 154) disclosed traumatic incidents during and/or prior to their journey, including physical and sexual assault.
Conclusions: The Unity Clinic provides a thorough infectious disease screening service for UASC following national guidance. Results highlight the need for universal, non-judgemental screening for sexually transmitted infections, as targeted screening would not identify positive cases. High rates of well-being issues and previous abuse emphasise the need for multidisciplinary, collaborative approaches to care.
Date Issued
2022-12-30
Date Acceptance
2022-11-07
Citation
BMJ Paediatrics Open, 2022, 6 (1)
ISSN
2399-9772
Publisher
BMJ Publishing Group
Journal / Book Title
BMJ Paediatrics Open
Volume
6
Issue
1
Copyright Statement
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Publication Status
Published
Article Number
ARTN e001664
Date Publish Online
2022-12-30