Infectious disease screening outcomes and reducing barriers to care for unaccompanied asylum-seeking children: a single-centre retrospective clinical analysis

OBJECTIVE: Evaluate the Unity Clinic’s infectious disease screening programme for unaccompanied asylum-seeking children (UASC), calculate rates of infection and identify further health needs. DESIGN: Retrospective audit of electronic patient data. SETTING AND PATIENTS: UASC who attended the Unity Clinic between 1 November 2019 and 22 March 2022. MAIN OUTCOME MEASURES: Baseline demographics, social, mental health and journey details, infection screening and investigation results. RESULTS: 155 UASC were reviewed: 89% (138 of 155) male, median age 17 years (IQR 16–17). Most frequent countries of origin were Sudan, Eritrea and Afghanistan. Median duration of travel to the UK (n=79) was 2 years (IQR 0.5–4); 35.6% (47 of 132) arrived by boat and 54.5% (72 of 132) by road. 44.8% (69 of 154) had one or more positive infection screening results: 22.7% (35 of 154) and 1.3% (2 of 154) positive for latent and active tuberculosis, respectively; 4.6% (7 of 152) chronic active hepatitis B and 17.1% (26 of 152) for past infection; 1.3% (2 of 154) for HIV; 13.0% (19 of 146) for Strongyloides. There were three cases of syphilis (n=152; 2.0%) and one chlamydia (n=148; 0.7%)—none of whom disclosed prior sexual activity during screening. 39.6% (61 of 154) and 27.9% (43/154) reported disturbances to mood or sleep, respectively. 55.2% (85 of 154) disclosed traumatic incidents during and/or prior to their journey, including physical and sexual assault. CONCLUSIONS: The Unity Clinic provides a thorough infectious disease screening service for UASC following national guidance. Results highlight the need for universal, non-judgemental screening for sexually transmitted infections, as targeted screening would not identify positive cases. High rates of well-being issues and previous abuse emphasise the need for multidisciplinary, collaborative approaches to care.