#1 SAMPLE: 8,184 CHILDREN > Bhutan > Burma/Thailand > Burma/Malaysia > Democratic Republic of Congo > Ethiopia > Iraq > Somalia #2 EXAMINED DEMOGRAPHICS > Age at time of arrival in U.S. > Gender > Year of Arrival in the U.S. > Country of Origin > Country of Departure > Interval between the day of arrival in U.S. and Domestic Medical Exam #3 DOMESTIC MEDICAL EXAM > Blood Lead Level > Anemia > Hepatitis B Infection (HBV) > Tuberculosis (TB) > Strongyloides x 35,000 25% 20% 15% 10% 10% 5% 0% IGRA BLOOD TEST TUBERCULIN SKIN TEST 20% > _ 5mcg/dL Health Profiles of Newly-Arrived Refugee Children in the United States , 2006 – 2012 Data are necessary for developing public health screening guidelines, but this can be challenging when working with vulnerable, dispersed populations, such as resettled refugees. We created the first large-scale dataset for refugee children who arrived to the United States between 2006 and 2012. WHAT WE KNOW 35,000 children enter the US each year as refugees + 200,000 to 250,000 children receive permanent residency BUT Comprehensive guidelines for clinicians caring for children are lacking due to inconsistent data and analyses CDC developed new Domestic Medical Exam (DME) guidelines WHAT WE DID WHAT WE FOUND 1 in 5 children had blood lead levels greater than or equal to 5mcg/dL HBV was rare among children younger than 5 years (0.8% for children under 5 years vs. 4.4% for children 5 years and older) TB prevalence estimates were dependent upon test modality and were much lower for children evaluated using the IGRA blood test (one in ten) than for children who received the tuberculin skin test (one in five) In general, conditions were more common among children from Burma who had lived in Thailand, Democratic Republic of Congo, Ethiopia, and Somalia. Conditions were less common among children from Iraq and Burma who had lived in Malaysia. WHAT IT MEANS + = The CDC and state health departments should continue to collect screening data for refugee children and should pool and analyze these data in a timely manner, as refugee populations change significantly over time + = Such studies utilizing the DME data are feasible and can be used in a timely manner in order to inform ongoing public health programs and policies + = Data should be analyzed according to both children’s nationality groups and the countries in which they have lived before arrival in the U.S. HEPATITS B INFECTION ( HBsAg+ ) BY AGE IN YEARS, % 10 9 8 7 6 5 4 3 2 1 0 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 HBsAg+ Katherine Yun, MD, MHS et al. Health Profiles of Newly-Arrived Refugee Children in the United States, 2006-2012. American Journal of Public Health, published Nov. 12, 2015. http://doi.org/10.2105/AJPH.2015.302873