Screening		Recommendation on arrival	Action
Hepatitis B		Screen all refugees from countries with greater than 2% prevalence of chronic hepatitis B (all countries in Africa, Asia, and the Middle East)	Order HBsAg and anti-HBs tests
Immunizations		Check vaccine record from prearrival; if unvaccinated or no documentation, vaccinate (except for varicella and hepatitis B)	Vaccinate per CDC age-appropriate guidelines if unvaccinated; order varicella zoster virus immunoglobulin G and anti-HBs tests before vaccinating
Laboratory screening tests		Order non–disease-specific laboratory tests as indicated (Table 4)	Order basic metabolic panel, CBC with differential, or urinalysis as indicated
Lead		Test all children 6 months to 16 years of age; repeat test in children 6 months to 6 years of age 3 to 6 months after resettlement	Order serum lead level
Mental health		Review prearrival records; obtain history and perform physical examination with a focus on trauma and maltreatment; perform mental status examination; screen for depression and PTSD; refer when indicated	Consider using a PTSD/depression/trauma screening tool
Nutrition and growth		Obtain anthropometric measurements and body mass index in all refugees; test all children 6 months to 59 months of age; screen for iron deficiency anemia in all refugees; test for or treat vitamin D deficiency and vitamin B12 deficiency*	Treat with age-appropriate multivitamin; order CBC with differential; consider testing serum 25-hydroxyvitamin D level or treat with vitamin D*; treat Bhutanese refugees with oral vitamin B12 and consider treatment in other populations*
Parasitic infections		Check prearrival empiric treatment documentation, and treat or test if results are undocumented or if no prearrival empiric treatment was given	See CDC guidelines (http://www.cdc.gov/immigrantrefugeehealth/pdf/intestinal-parasites-domestic.pdf)
	Helicobacter pylori*	Test refugees with epigastric pain or gastrointestinal symptoms	Order H. pylori stool antigen or breath test*
	Malaria	Empirically treat all refugees from sub-Saharan Africa who did not receive prearrival treatment (exceptions: test women who are pregnant or breastfeeding and children who weigh less than 5 kg [11 lb])	Treat with atovaquone/proguanil (Malarone) or artemether/lumefantrine (Coartem); order thick and thin blood smears
	Schistosomiasis	Test or treat all refugees from sub-Saharan Africa	Order serologic tests; treat with praziquantel (Biltricide)
	Soil-transmitted helminthes	Test or treat all refugees	Treat with albendazole (Albenza); order ova and parasite stool examination two times, plus CBC with differential
	Strongyloides	Test or treat all refugees (except those from Loa loa–endemic regions, because persons with loiasis can have severe adverse events when treated with ivermectin [Stromectol])†	Order serologic tests; treat with ivermectin
Pregnancy		Screen all females of childbearing age	Order urine pregnancy test
Sexually transmitted infections
	Gonorrhea and chlamydia	Test refugees based on age-appropriate recommendations, symptoms, urinalysis results positive for leukocyte esterase, or history of sexual assault	Order urine nucleic acid amplification test
	HIV	Test all refugees who have not been tested previously	Order 4th-generation HIV 1 and 2 antigen and antibody test
	Syphilis	Test all refugees older than 15 years if overseas test results are not available; test those younger than 15 years who have a history of sexual activity or assault, or a mother with syphilis	Order Venereal Disease Research Laboratory or rapid plasma reagin test
Tuberculosis		Assess risk with a targeted history and physical examination, and screen all refugees with tuberculin skin test or interferon-gamma release assay; if screen is positive, order chest radiography and treat active or latent tuberculosis (http://www.cdc.gov/tb/publications/ltbi/treatment.htm#treatmentRegimens)	Order tuberculin skin test (preferred in children younger than 5 years) or interferon-gamma release assay (preferred in persons with history of bacillus Calmette-Guérin vaccination)