224 - A Descriptive Analysis of Screening Laboratory Evaluations of Newly Arrived Immigrant Pediatric Patients in a Federally Qualified Health Center

Poster Number: 224
Publication Number: 224.395

Background: Laboratory work-up for newly arrived immigrant children in the US is based on expert consensus, developed by professional societies; however there is a lack of epidemiological data on the prevalence of screened diseases among recent immigrants to the United States.

Objective: Our study aims to describe the outcomes of recommended laboratory evaluation among immigrant children presenting to a primary care clinic.

Design/Methods: We included all children seen in a federally qualified health center (FQHC) between October 1 2021 - October 31, 2022 who presented for their first preventative health visit after immigrating to the U.S. Standardized lab tests are described in Table 2. Normal vs abnormal results were defined by age specific thresholds. We described patient demographics, country of origin and the proportion of patients with an abnormal test for each of the lab screenings.

Results: Of 402 eligible patient visits, 249 had completed laboratory evaluations during the study period. Demographic characteristics are described in Table 1. Most common country of origin was Honduras (40%, 100/249) followed by Mexico (14%, 34/249). Table 2 describes the percentage of positive or abnormal results. The majority of the screening laboratory results yielded no abnormal values. Five patients (2.2%, 5/223) had positive serum Interferon-Gamma Release Assays (IGRA). Seven patients were positive for Strongyloides (3.4%, 7/203). Two adolescents were positive for Gonorrhea/Chlamydia (5.1%, 2/39). There were twenty-two cases of elevated blood lead levels (7%, 16/241). Two of these cases were significantly elevated requiring further monitoring and/or treatment ( < 1%, 2/241). The most common clinically significant findings on complete blood count were microcytic anemia and eosinophilia. Though clinically insignificant, it was noted that many patients had mild isolated thrombocytosis (52/249, 21%). All patients with positive findings were asymptomatic.

Conclusion(s): Although many screening tests yielded no abnormal results in this patient population, we diagnosed 24 patients with treatable conditions, including iron-deficiency anemia, latent tuberculosis, gonorrhea/chlamydia, elevated lead, and Strongyloides. None of these patients were symptomatic and may have had further delay in diagnosis without this screening. There is a need for ongoing, multicenter population studies and cost-benefit analysis to determine the most appropriate screening labs for new immigrants in pediatric primary care.