Abstract：
OBJECTIVE: To examine refugee health assessments in Syrian and Iraqi children in the context of changes to offshore immigration screening, updated Australian refugee health guidelines and the primary care refugee health model in Victoria.
METHODS: This is a retrospective audit of Syrian and Iraqi children aged 0-17 years attending a specialist immigrant health service from January 2015 to September 2017.
RESULTS: We saw 128 children (7 months-16 years, 64.8% male). Prior to arrival, 58.9% of children had experienced trauma, and 67.9% had missed at least 1 year of school. Almost all children (93.3%) were linked with a regular general practitioner in Australia, and 23.6% children were linked with a refugee health nurse; offshore health records were infrequently available. Of school-aged children, 25% were not enrolled in school 3 months after arrival. Only 2 of 113 (1.8%) children had completed a recommended refugee health assessment, and 55.1% had commenced appropriate catch-up vaccination in primary care. After screening completion, the most prevalent conditions were low vitamin D (63.6%); growth/nutrition (24.2%), neurological/metabolic (16.4%), learning/behaviour (15.6%) and mental health (12.5%) concerns; latent tuberculosis infection (11.8%); and developmental delay (10.2%). Sixteen children required surgery after arrival, and six children had life-threatening medical conditions on arrival - only one had an offshore critical alert; care for the other five children resulted in 133 unanticipated hospital admission days.
CONCLUSIONS: There are substantial challenges with the current primary care screening model in Victoria. Disability, developmental and mental health concerns were prominent in this cohort, and many children had delays in education access, compounding prior disadvantage.
METHODS: This is a retrospective audit of Syrian and Iraqi children aged 0-17 years attending a specialist immigrant health service from January 2015 to September 2017.
RESULTS: We saw 128 children (7 months-16 years, 64.8% male). Prior to arrival, 58.9% of children had experienced trauma, and 67.9% had missed at least 1 year of school. Almost all children (93.3%) were linked with a regular general practitioner in Australia, and 23.6% children were linked with a refugee health nurse; offshore health records were infrequently available. Of school-aged children, 25% were not enrolled in school 3 months after arrival. Only 2 of 113 (1.8%) children had completed a recommended refugee health assessment, and 55.1% had commenced appropriate catch-up vaccination in primary care. After screening completion, the most prevalent conditions were low vitamin D (63.6%); growth/nutrition (24.2%), neurological/metabolic (16.4%), learning/behaviour (15.6%) and mental health (12.5%) concerns; latent tuberculosis infection (11.8%); and developmental delay (10.2%). Sixteen children required surgery after arrival, and six children had life-threatening medical conditions on arrival - only one had an offshore critical alert; care for the other five children resulted in 133 unanticipated hospital admission days.
CONCLUSIONS: There are substantial challenges with the current primary care screening model in Victoria. Disability, developmental and mental health concerns were prominent in this cohort, and many children had delays in education access, compounding prior disadvantage.
摘要：
目标：在改变离岸移民筛查的背景下，审查叙利亚和伊拉克儿童的难民健康评估，更新了澳大利亚难民健康指南和维多利亚州的初级保健难民健康模式。
方法：这是对2015年1月至2017年9月在专业移民卫生服务机构就诊的0-17岁叙利亚和伊拉克儿童的回顾性审计。
结果：我们看到128名儿童（7个月至16岁，64.8%男性）。在抵达之前,58.9％的儿童经历过创伤，67.9%的学生至少缺课1年。在澳大利亚，几乎所有儿童（93.3％）都与正规全科医生联系在一起，23.6%的儿童与难民健康护士有联系;很少有离岸健康记录.学龄儿童，25％的人在到达后3个月未入学。113名儿童中只有2名(1.8%)完成了推荐的难民健康评估，55.1%已在初级保健机构开始适当的追赶疫苗接种。筛选完成后,最普遍的情况是维生素D低(63.6%)；生长/营养(24.2%)，神经/代谢（16.4%），学习/行为（15.6％）和心理健康（12.5％）关注;潜伏性结核感染（11.8％）;和发育迟缓（10.2％）。16名儿童抵达后需要手术，6名儿童在抵达时出现了危及生命的医疗状况-只有1名儿童出现了近海危急警报;对其他5名儿童的护理导致了133个意外入院日。
结论：维多利亚州目前的初级保健筛查模式存在重大挑战。残疾,在这个队列中，发展和心理健康问题很突出，许多孩子在接受教育方面有延误，复合先前的劣势。
方法：这是对2015年1月至2017年9月在专业移民卫生服务机构就诊的0-17岁叙利亚和伊拉克儿童的回顾性审计。
结果：我们看到128名儿童（7个月至16岁，64.8%男性）。在抵达之前,58.9％的儿童经历过创伤，67.9%的学生至少缺课1年。在澳大利亚，几乎所有儿童（93.3％）都与正规全科医生联系在一起，23.6%的儿童与难民健康护士有联系;很少有离岸健康记录.学龄儿童，25％的人在到达后3个月未入学。113名儿童中只有2名(1.8%)完成了推荐的难民健康评估，55.1%已在初级保健机构开始适当的追赶疫苗接种。筛选完成后,最普遍的情况是维生素D低(63.6%)；生长/营养(24.2%)，神经/代谢（16.4%），学习/行为（15.6％）和心理健康（12.5％）关注;潜伏性结核感染（11.8％）;和发育迟缓（10.2％）。16名儿童抵达后需要手术，6名儿童在抵达时出现了危及生命的医疗状况-只有1名儿童出现了近海危急警报;对其他5名儿童的护理导致了133个意外入院日。
结论：维多利亚州目前的初级保健筛查模式存在重大挑战。残疾,在这个队列中，发展和心理健康问题很突出，许多孩子在接受教育方面有延误，复合先前的劣势。
