Exploring an Infectious Disease Service Pathway for Unaccompanied Asylum-Seeking Children: An Audit and Retrospective...

Area of Science:

• Public Health
• Infectious Diseases
• Paediatrics

Background:

• Unaccompanied asylum-seeking children (UASC) have a high burden of infectious diseases (IDs) and significant unmet needs.
• The UK lacks a standardized framework for implementing ID screening guidance for UASC, leading to inconsistent care.
• This variability necessitates an evaluation of current ID screening pathways to identify areas for improvement.

Purpose of the Study:

• To explore the infectious disease (ID) pathway for UASC within a South-East UK local authority.
• To identify gaps and successes in the current ID screening process for UASC.
• To inform service improvement recommendations for a more robust UASC ID pathway.

Main Methods:

• Retrospective review of anonymised patient data for all UASC under local authority care over one year.
• Audit of UASC ID referrals against Royal College of Paediatrics and Child Health (RCPCH) guidance.
• Analysis of referral and attendance rates for specific infectious diseases, including tuberculosis (TB) and blood-borne viruses (BBVs), and reasons for non-completion.

Main Results:

• The study analysed data from 37 UASC across two trusts, including one with a 'one-stop' clinic.
• Referral and attendance rates for Tuberculosis (TB) and blood-borne virus (BBV) testing were higher than in previous single-centre studies.
• Gaps were identified in screening for schistosomiasis and strongyloidiasis, with lower appointment completion rates for 'out of area' patients.

Conclusions:

• The current ID pathway for UASC shows variable success, with specific testing and completion rates needing improvement.
• Further research is crucial to develop a more robust and potentially county-wide ID screening pathway for UASC.
• Standardizing the ID screening pathway is essential to address the health needs of this vulnerable population.