Spectrum of illness in international migrants seen at geosentinel clinics in 1997-2009, part 1: US-bound migrants evaluated by comprehensive protocol-based health assessment

Elizabeth D. Barnett, Leisa H. Weld, Anne E. McCarthy, Heidi So, Patricia F. Walker, William Stauffer, Martin Cetron

Research output: Contribution to journalReview articlepeer-review

32 Scopus citations


Background. Many nations are struggling to develop structured systems and guidelines to optimize the health of new arrivals, but there is currently no international consensus about the best approach. Methods. Data on 7792 migrants who crossed international borders for the purpose of resettlement and underwent a protocol-based health assessment were collected from the GeoSentinel Surveillance network. Demographic and health characteristics of a subgroup of these migrants seen at 2 US-based GeoSentinel clinics for protocol-based health assessments are described. Results. There was significant variation over time in screened migrant populations and in their demographic characteristics. Significant diagnoses identified in all migrant groups included latent tuberculosis, found in 43% of migrants, eosinophilia in 15%, and hepatitis B infection in 6%. Variation by region occurred for select diagnoses such as parasitic infections. Notably absent were infectious tuberculosis, soil-transmitted helminths, and malaria. Although some conditions would be unfamiliar to clinicians in receiving countries, universal health problems such as dental caries, anemia, ophthalmologic conditions, and hypertension were found in 32%, 11%, 10%, and 5%, respectively, of screened migrants. Conclusions. Data from postarrival health assessments can inform clinicians about screening tests to perform in new immigrants and help communities prepare for health problems expected in specific migrant populations. These data support recommendations developed in some countries to screen all newly arriving migrants for some specific diseases (such as tuberculosis) and can be used to help in the process of developing additional screening recommendations that might be applied broadly or focused on specific at-risk populations.

Original languageEnglish (US)
Pages (from-to)913-924
Number of pages12
JournalClinical Infectious Diseases
Issue number7
StatePublished - Apr 1 2013

Bibliographical note

Funding Information:
Financial support. This work was supported by the GeoSentinel Surveillance Network through a cooperative agreement with the Centers for Disease Control and Prevention (CDC; grant number 5U50CI000359), and by funding from the International Society of Travel Medicine. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. Potential conflicts of interest. All authors: No reported conflicts.


  • Burmese and Somali refugees
  • Hepatitis
  • Noncommunicable diseases (NCDs)
  • Tuberculosis


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