Screening for infection in unaccompanied asylum seeking children - a clinical audit across two paediatric infectious disease clinics in london, uk.
Author(s): ,
Bhanu Williams
London Northwest University Healthcare NHS Trust
Zoe Cricks
London Northwest University Healthcare NHS Trust
Sarah Eisen
University College London
Jonathan Cohen
University College London
ESPID Education. Boullier M. May 8, 2019; 263111
Mary Boullier
Mary Boullier
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B. Williams1, M. Boullier2, Z. Cricks1, S. Eisen3, J. Cohen3.
1Northwick Park Hospital, Paediatrics, London, United Kingdom.
2St George's Hospital- Tooting- London, Paediatric Infectious Disease, London, United Kingdom.
3University College London, Paediatrics, London, United Kingdom.

Background and Aims:
There has been a significant increase in unaccompanied asylum seeking children (UASC) arriving in Europe in recent years. Many originate from countries with high rates of infections, often treatable in the asymptomatic stage preventing progression to severe disease and transmission to others. In the UK, referral to specialist clinics for TB testing is recommended, providing an opportunity to screen for other infections.
We carried out an audit across two hospitals to determine if UASC infection screening was offered as recommended by national guidance and to assess infection rates. Data were anonymously extracted from patient records into an Excel database for patients seen between January 2016 and December 2018.
252 individuals from 19 countries were included, 88% were male, median age was 17 years (range 11-18). 55 were from Afghanistan, 51 from Eritrea. 94% (238) were tested for TB, of whom 23% were positive (including 3 with active TB). 211 were tested for Hepatitis B, C and HIV, of whom 4.8% were positive for Hepatitis B, 0.5% for Hepatitis C and none for HIV. Of the 127 tested, 8.6% had giardia and 7% tapeworm. 14% of those tested were positive for schistosomiasis. Median time between arriving in the UK and infection screening was 6 months (range 1-60 months, data available on 197 children).
We demonstrate clinically significant rates of treatable infections. Patients were offered testing recommended by national guidance but delay in screening could delay treatment and lead to symptomatic disease and increased risk of transmission. Work is underway to reduce delays to appointment Our data suggest benefit in timely screening for infectious diseases for all UASC. More data are needed to inform formal guidance.
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