ORIGINAL ARTICLE The epidemiology of health conditions of newly arrived refugee children: A review of patients attending a specialist health clinic in Sydney Mohamud Sheikh, 1,2 Abhijit Pal, 3 Shu Wang, 4 C Raina MacIntyre, 2 Nicholas J Wood, 1 David Isaacs, 1 Hasantha Gunasekera, 1 Shanti Raman, 5 Katherine Hale 1 and Alison Howell 1 1 The Children’s Hospital, Westmead, 2 School of Public Health and Community Medicine, 4 School of Medical Science, University of New South Wales, New South Wales, 3 Faculty of Medicine, University of Sydney, Sydney and 5 Sydney South West Area Health, Sydney, New South Wales, Australia Aim: To determine the prevalence of common diseases in newly arrived refugee children, resettled in Sydney, by region of birth. To identify health needs of refugee children in Australia. Methods: We prospectively screened for common diseases in refugee children attending a specialist paediatric refugee clinic, the Children’s Hospital, Westmead, between May 2005 and December 2006. Screening tests included full blood count, Mantoux, vitamin D level, hepatitis B serology, syphilis serology, Schistosomiasis serology and malarial antigens. Results: There were 239 patients, the majority (75%) from Africa, with 127 girls and 112 boys. Thirty-six percent were 0–7 years old, 45% were 8–12 years old and 19% were 13–17 years old. Of those tested, 16% had Schistosomiasis, 5% had malaria and 4% were hepatitis B carriers. Of 216 children who had Mantoux tests, 33% were 10 mm and 24% were 15 mm, including four children with active disease (2 lymphadenitis, 1 pulmonary and 1 gastric). Vitamin D deficiency was the most common diagnosis: 61% had serum 25(OH)D3 <50 nmol/L. Anaemia was present in 15%. Disease prevalence was higher in children from Africa than Asia or the Middle East, and most of the children were asymptomatic. Given that we have only seen about 10% of the refugee children resettled in New South Wales, our results may not be generalisable to all refugees. Conclusion: Our findings suggest that screening refugee children for common treatable conditions, even if they are asymptomatic, is paramount. In addition to infectious diseases screening, nutritional deficiencies should routinely be screened for. Key words: epidemiology; health assessment; paediatric; public health; refugees. The United Nations High Commission for Refugees (UNHCR) estimates that there are over 20 million people displaced from their homes and classified as refugees. They may either be living within or outside the borders of their home countries, some in refugee camps. 1 Many refugees remain in refugee camps for long periods, and some children have spent their entire lives in refugee camps. For some of the refugees, when there is no resolution of the circumstances causing their original flight, assistance with resettlement is provided by the UNHCR. 1 Aus- tralia is one of many countries offering humanitarian reset- tlement to such people. Having considered the extended hopelessness and unchanged circumstances of protracted refu- gees, the Australian government has recently increased the humanitarian resettlement quota from 13 000 to 13 500 people annually. 2 By early 2006, 40% of the 12 758 resettlement visas granted to refugees in Australia settled in New South Wales (NSW), most in the Sydney metropolitan area. 3 Because of the high prevalence of disease, poor access to quality health care in their countries of origin and poor conditions in refugee camps, refu- gees are an at-risk group for hepatitis B, tuberculosis (TB), malaria and malnutrition. These conditions may have been undiagnosed, untreated or chronically under treated. For example, nearly a third of Africa’s population may suffer from TB. 4 In one study of 124 people screened within one year of entry into the United States, 14% had active TB. 5 Key Points 1 Refugee children are at significant risk of infectious diseases and nutritional deficiencies. 2 Many of the health conditions refugee children come with are treatable, but if undiagnosed or managed inappropriately, could lead to serious adverse health consequences. 3 This study demonstrates the importance of health assessment as a gateway to better integration and healthier communities. Correspondence: Dr Mohamud Sheikh, The Children’s Hospital, West- mead and the University of New South Wales, Locked Bag 4001 Westmead, Sydney, NSW 2170, Australia. Fax: +61 2 9385 6185; email: m.sheikh@ unsw.edu.au Declaration of conflict of interest: The authors declare that they have no competing interests. Authors’ contributions: MS, RM and AP conceived the study. MS, AP and SW entered data and analysed data. All authors participated in the draft writing, reading and review. All authors approved the final submitted manuscript. Accepted for publication 10 February 2009. doi:10.1111/j.1440-1754.2009.01550.x Journal of Paediatrics and Child Health 45 (2009) 509–513 © 2009 The Authors Journal compilation © 2009 Paediatrics and Child Health Division (Royal Australasian College of Physicians) 509