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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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Minnesota refugee screening protocol l.jpg

Minnesota Refugee Screening Protocol

Minnesota Department of Health

Infectious Disease Division

Immunizations, Tuberculosis and

International Health Section

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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

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    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

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    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

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    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

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    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

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    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

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    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

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    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


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