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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

Minnesota Refugee Screening Protocol

Minnesota Department of Health

Infectious Disease Division

Immunizations, Tuberculosis and

International Health Section


Outline of recommended exam components
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


  • Recommended exam components
    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


    Exam process scheduling
    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


    Exam process scheduling cont
    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


    1st pre screening nurse visit
    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


    2nd pre screening nurse visit
    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


    3 rd visit provider exam
    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


    Minnesota refugee health program
    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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