Guideline Categories:

Infectious Diseases:

  1. Tuberculosis: Evidence Review for Newly Arriving Immigrants and Refugees: The source examines prevalence of tuberculosis in immigrants and refugees as well as the effectiveness of current screen techniques. The authors conclude that domestic screening programs perform sub-par as only approximately half of the people tested positive for tuberculosis through tuberculin skin tests receive treatment.  Further screening suggestions were discussed pertaining to respective age groups and risk of latent or active tuberculosis. Overall, the authors recommend increased funding into tuberculosis screening and prevention programs to increase the efficacy of current screening.
  2. Health Status of Newly Arrived Refugees in Toronto, Ontario, Part 1 – Infectious Diseases: This study reviews the prevalence of infectious diseases in newly arrived refugees and claimants at a refugee clinic in Toronto, Ont. The prevalence of various infectious diseases, such as HIV and hepatitis B, was considerably higher than in the Canadian-born population, and there was also a considerable burden of parasitic disease. The authors recommend targeted screening practices informed by both regional patterns of disease and individual patient circumstances.
  3. Countries A-Z- Health Needs Relating to Country of Origin: A resource that provides the key facts for primary care physicians on diseases or risk factors relevant to specific countries of origin.
  4. ProMED-mail: Information from the International Society for Infectious Diseases on outbreaks of infectious diseases and acute exposures to toxins affecting human health.
  5. Chagas Disease: Presents risk factors and its endemicity to Latin America. Describes the clinical presentation of acute and chronic infection, diagnosing and screening children and pregnant women, and benznidazole and nifurtimox treatment through the Health Canada Special Access Programme.
  6. Cysticercosis and Taeniasis: Explains the parasitic life cycle and its endemicity in Latin America, sub-Saharan Africa, and Asia. Describes its clinical presentation and informs diagnosis and prognosis.
  7. Dengue: Describes epidemiology in Latin America, South America, Sub-Saharan Africa, India, South-East Asia, as well as risk factors for various severities of dengue. Presents clinical cues, diagnosis, lab confirmation, and management.
  8. Enteric Fever (Typhoid Fever and Paratyphoid Fever): Describes epidemiology in South-East Asia and other developing countries its risk factors, clinical signs, diagnosis. Information on enteric fever management includes information on antimicrobial resistance and notifying public health.
  9. Helicobacter pylori Infections: Details the epidemiology and etiology of infections and its association with gastric cancer. Describes its clinical manifestations and screening, diagnostic tests, and treatment options.
  10. HIV/AIDS in Children and Youth: Describes the risk among newcomer youth, explaining its transmission, epidemiology, screening methods and counseling, implications for breast-feeding, and referral to services.
  11. Screening for Sexually Transmitted Diseases during the Domestic Medical Examination for Newly Arrived Refugees: CDC guidelines for the screening, clinical presentation, counseling, treatment, and case management for sexually transmitted diseases, including syphilis, granuloma inguinale, lymphogranuloma venereum, genital herpes, genital warts, chlamydia, trichomoniasis, gonorrhea, chancroid, and HIV.
  12. Minnesota Refugee Health Provider Guide- Sexually Transmitted Diseases: This guide details the process of screening for sexually transmitted diseases during the refugee health assessment. Treatment considerations are also described and additional related resources are available.
  13. Malaria: Describes the epidemiology, risk factors, and etiology of malaria, as well as clinical cues and diagnosis tools. The need for early diagnosis and treatment is presented, along with available therapies and links to treatment guidelines.
  14. Malaria- Domestic guidelines: CDC guidelines for drug treatments for malaria in newly arrived refugees from sub-Saharan Africa, including screening and presumptive treatment of asymptomatic and symptomatic malaria.
  15. Guidelines for the Treatment of Malaria in the United States: CDC guidelines for drug treatments for malaria of various severities and types.
  16. Minnesota Refugee Health Provider Guide: Malaria: This guide details the process of screening for malaria during the refugee health assessment. Treatment considerations are also described and additional related resources are available.
  17. Guidelines for the Treatment of Malaria: Evidence-based recommendations for diagnosis and treatment of all types of malaria in various groups.
  18. Onchocerciasis (River Blindness): Describes epidemiology in sub-Saharan Africa and the Middle East, as well as risk factors, clinical cues, diagnosis, and treatment.
  19. Intestinal Parasites: CDC guidelines for treating and screening for intestinal parasites in newly arrived refugees, including presumptive and directed treatment of strongyloidiasis, schistosomiasis, and helminths.
  20. Minnesota Refugee Health Provider Guide- Parasitic Infections: This guide details the process of screening for parasitic during the refugee health assessment. Treatment considerations are also described and additional related resources are available.
  21. Tuberculosis: Describes the epidemiology, risk factors, clinical cues, screening, infection and disease diagnoses of tuberculosis, along with information on treatment and drug resistance.
  22. Guidelines for Screening for Tuberculosis Infection and Disease during the Domestic Medical Examination of Newly Arrived Refugees: CDC guidelines on the screening of refugees for tuberculosis, including various diagnostic classifications and an overview of treatment strategies.
  23. Minnesota Refugee Health Provider Guide- Tuberculosis: This guide details the process of screening for tuberculosis during the refugee health assessment. Treatment considerations are also described and additional related resources on tuberculosis and refugee health are available.
  24. Screening for Hepatitis During the Domestic Medical Examination: CDC guidelines on screening refugees for various types of viral hepatitis at different stages and at different ages.
  25. Minnesota Refugee Health Provider Guide- Hepatitis B: This guide details the process of screening for Hepatitis B during the refugee health assessment. Treatment considerations are also described and additional related resources on Hepatitis B and refugee health are available.

Nutrition:

  1. Malnutrition: Provides an overview of malnutrition, including definitions, diagnosis, and treatment. Includes a table of common sources of macro- or micro-nutrients.
  2. Health Canada Dietary Reference Intakes: Presents the Health Canada recommendations for daily intake of micronutrients and macronutrients by age and gender.
  3. Guidelines for Evaluation of the Nutritional Status and Growth in Refugee Children During the Domestic Medical Screening Examination: CDC guidelines for the evaluation of growth among refugee children, as well as screening, managing, and preventing nutrient deficiencies.
  4. Culturally Effective Care Toolkit- Nutrition, Feeding, and Body Image Perspectives: This toolkit, developed by the American Association of Pediatrics, includes a summary and a list of practical resources to support providers in promoting healthy nutrition and body image while respecting diverse cultural norms and beliefs.
  5. Folic Acid Deficiency: Describes the prevalence of folic acid deficiency among pregnant women in resource-scarce countries. Explains its consequences and etiology in gastrointestinal illness and drug effects. Diagnostic and preventive information is included, including folic acid sources through diet and supplementation.
  6. Iodine Deficiency: Presents the prevalence and consequences of iodine deficiency, as well as diagnosis and treatment.
  7. Iron Deficiency: Presents the prevalence of iron deficiency, various definitions of anemia by hemoglobin levels, dietary and non-dietary etiologies, screening, and treatment.
  8. Vitamin A Deficiency: Presents the prevalence of vitamin A deficiency, as well as consequences of cretinism, developmental abnormalities, goiter, and hypothyroidism. Provides recommendations for diagnosis and treatment.
  9. Vitamin B12 Deficiency: Describes the etiologies of B12 deficiency in diet, absorption, and pregnancy, as well as consequences, diagnosis, and treatment.
  10. Vitamin D Deficiency: Describes its prevalence among refugee children, as well as etiologies (diet, sun exposure, pregnancy, and breastfeeding) consequences (secondary parahyperthryoidism and skeletal deformity), diagnosis, and treatment.
  11. Zinc Deficiency: Describes its prevalence among refugee and displaced populations, etiologies (diet, absorption, and liver or kidney disease), consequences (reduced immune response or growth retardation), diagnosis, and treatment.

Hereditary Anemias:

  1. Hereditary Anemias – An Overview: Provides an overview of screening for iron deficiency and hereditary anemias.
  2. G6PD Deficiency: Describes the global prevalence and triggers of G6PD deficiency, as well as its symptoms and diagnosis.
  3. Sickle Cell Disease: Describes the epidemiology, genetics, pathophysiology, and types of sickle cell disease, and their clinical presentation, complications, and specialized care.
  4. Thalassemia: Describes the epidemiology of thalassemia and differentiates between Alpha and Beta thalassemias. Includes a link to the Canadian guidelines for caring for thalassemia patients.

Lead Toxicity:

  1. Lead Toxicity: Describes the epidemiology, pre- and post-migration risk factors, clinical presentation and screening, management, and prevention of lead exposure in newcomers and refugees.
  2. Lead Screening Guidelines: CDC guidelines on screening for lead toxicity among newly arrived refugees. Includes epidemiology, clinical presentation, and treatment of lead poisoning.
  3. Lead Poisoning Prevention in Newly Arrived Refugee Children- Tool Kit: This tool-kit includes self-guided modules providing information on the CDC recommendations for identifying children with elevated blood lead levels and early post-arrival medical evaluation and therapy.
  4. Minnesota Refugee Health Provider Guide- Child Lead Screening: This guide details the process of screening for child lead poisoning during the refugee health assessment. Risk reduction strategies are also described and additional related resources are available.

Non-Communicable Diseases, Injury, & Health Promotion:

  1. Health Status of Newly Arrived Refugees in Toronto, Ont, Part 2 – Chronic Diseases: This study reviews the prevalence of infectious diseases in newly arrived refugees and claimants at a refugee clinic in Toronto, Ont. The prevalence of various infectious diseases, such as HIV and hepatitis B, was considerably higher than in the Canadian-born population, and there was also a considerable burden of parasitic disease. The authors recommend targeted screening practices informed by both regional patterns of disease and individual patient circumstances.
  2. Prenatal Risk Factors for Developmental Delay in Newcomer Children: Explores the prenatal (infection, chronic illness, toxin exposure, malnutrition) and perinatal (birth complications and infections) causes of developmental delay. Includes guidelines for screening and prevention during pregnancy.
  3. International Organization for the Study of Pain- Chronic Pain in Survivors of Torture: This journal article reviews the chronic pain that may be experienced by survivors of torture, and how this can be recognized and addressed in a sensitive and safe manner by the healthcare provider.
  4. Primary Care Management of Non-English-Speaking Refugees Who Have Experienced Trauma: Clinical review of best practices in primary care for refugees who have experienced trauma and do not speak English. Sensitivity, obtaining a history, setting priorities, and devising a management plan are described.
  5. Adapting Models of Chronic Care to Provide Effective Diabetes Care for Refugees: Article published in the Clinical Diabetes journal framing how physicians can adapt their approach to chronic care for refugees to account for the unique cultures, experiences, and concepts of health and illness.
  6. Female Genital Mutilation/Cutting: Presents the prevalence, complications, treatment, and legal status of genital mutilation in Canada. Provides guidelines on sensitive discussion to gather perspectives and prevent genital mutilation.
  7. Obesity in Immigrant Children and Youth: Describes newcomer-specific risk factors of obesity, screening and assessment of obesity, and its comorbidities. Provides guidelines on prevention and exploring cultural beliefs and newcomer-specific barriers to preventive care.
  8. Breastfeeding: Helps providers understand common reasons for not breastfeeding, when women should not breastfeed, and how to encourage breastfeeding appropriately give
  9. Injury Prevention: Helps providers understand child injuries as a social determinant of health, and apply better prevention strategies among newcomer populations.
  10. Hearing Screening: Describes the prevalence of hearing loss in newcomer populations, as well as recommendations for recognizing signs, screening, referring for intervention, and preventing hearing loss among newcomer patients.
  11. Vision Screening: Presents the risk factors of visual impairments, age-appropriate vision screening, specific conditions associated with poverty, and barriers to eye care unique to newcomers and what health professionals can do to address them.
  12. Oral Health Screening: Describes the epidemiology and unmet dental care needs of newcomers, risk factors, screening, preventive measures, and referral for dental care with respect to dental care access, coverage, and publicly-funded programs.
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