Screening for sexually transmitted diseases during the domestic medical examination for newly arrived refugees
Published Date:April 16, 2012
Corporate Authors:National Center for Emerging and Zoonotic Infectious Diseases (U.S.). Division of Global Migration and Quarantine.
Description:Sexually transmitted infections (STIs) are a major cause of acute illness and infertility worldwide. The World Health Organization (WHO) estimates that 448 million new cases of curable STIs occur annually worldwide in adults aged 15-49 years. The largest number of new infections occurs in the region of South and Southeast Asia, followed by sub-Saharan Africa, Latin America, and the Caribbean. In low-income countries, STIs rank in the top five disease categories for which adults seek health care.
A complete overseas screening medical examination for syphilis consists of a medical history, physical examination, and serologic testing. Further testing is performed as necessary to confirm a suspected diagnosis. For the other STIs (i.e., gonorrhea, chancroid, lymphogranuloma venereum, and granuloma inguinale), the evaluation includes a medical history and physical examination. Therefore, with the exception of syphilis, negative overseas STI screening does not exclude STIs.
The prevalence of STIs in refugee populations is not well characterized and likely varies among populations. Because certain refugee groups are at potentially high risk for STIs, it is important to screen for certain STIs to minimize or prevent acute and chronic sequelae, as well as prevent transmission to others.
The Office of Refugee Resettlement and the Centers for Disease Control and Prevention recommend that all refugees receive a new-arrival medical evaluation on arrival to the United States. HIV testing is strongly encouraged in newly arriving refugee populations according to current CDC guidelines (www.cdc.gov/immigrantrefugeehealth/guidelines/refugee- guidelines.html). However, testing for HIV is particularly important and encouraged for any refugee with a confirmed non-HIV STI. In addition, the following STIs should be considered during this examination:
• Granuloma inguinale/donovanosis
• Lymphogranuloma venereum
• Genital herpes
• Genital warts
A complete screening medical examination for all STIs includes a thorough medical history, physical examination and, for specific disorders, diagnostic testing.
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