{
  "abstract": "Why did you do this work? This audit reviews the infection screening outcomes for unaccompanied asylum seeking children (UASC) in our tertiary paediatric centre, Alder Hey Children’s Hospital from 2021 to 2024. 1 2 Trends including demographics and disease burden are compared over time and by country of origin. Most UASC originate from nations where there is a risk of acquiring strongyloides infection, which can be fatal due to autoinfection and disseminated disease during immunosuppression. Currently, there is variation in screening practice for this infection.3 What did you do? We retrospectively reviewed all UASC from 2021 and 2022 through examining clinic notes. After the introduction of strongyloides screening in May 2023 we collected the subsequent 12 months of data via serology results. Data was collected from electronic medical records and analysed using Microsoft Excel.What did you find? A total of 205 UASC were screened with an infection detected in 36.5%. Median age was 17 years (range 14–19) and 96% were male. In 2021, 30 UASC were screened, which increased to 140 in the 12 months between 2023–2024. Median waiting time from entry to the UK to screening reduced from 11.5 to 8.4 months as a result of increased clinic capacity. Over the study period there were no cases of HIV, hepatitis C, chlamydia or gonorrhoea. Figure 1 displays the percentage rates of notable infectious diseases per year with latent tuberculosis (TB) being the most commonly detected infection. In 2023–4, there were 2 cases of active TB and latent TB cases reduced from 38% in 2021 to 12% in 2023–24. Chronic active hepatitis B was identified in 2 patients each year and positive syphilis serology rates reduced from 6% in 2021 to 1% in 2023–24. Table 1 details rates of infection according to country of origin, with most number of infections detected from UASC entering from Sudan. In 2021–22 no patients were investigated for strongyloides. In 2023–24 all patients underwent strongyloides serology testing; 12.8% had abnormal results (11 positive & 7 equivocal results). A third had subsequent stool microscopy, helminth culture and molecular PCR testing for strongyloides which were all negative. 72% received ivermectin treatment.Abstract 7972 Figure 1Abstract 7972 Table 1What does it mean? Our clinic experienced a four-fold increase in the number of UASC screened per year compared to 2021, which may partly be explained by the current migration patterns to the UK, and service redesign with designated increased clinic capacity to meet demand. Patient demographics and rates of strongyloides infection (7.9%) is similar to published data from other UK centres. 4 5 Strongyloides serology screening is a useful tool in detecting asymptomatic strongyloides infection however in our experience, additional testing (stool, repeat serology) did not provide a high diagnostic yield and incurred additional test burden for the patient.References Refugee and asylum seeking children and young people – guidance for paediatricians. RCPCH Health policy team, 2018Migrant health guide gov.uk, Office for health improvement and disparities, 2023Ericsson C, et al. Clinical infectious diseases, 2001Pinto C, et al. BMJ Paediatrics Open. 2022.Williams B, et al. Archives of Disease in Childhood 2020.",
  "authors": [
    {
      "affiliations": [
        "Alder Hey NHS Foundation Trust"
      ],
      "name": "Rachel McGalliard"
    },
    {
      "affiliations": [
        "Alder Hey NHS Foundation Trust"
      ],
      "name": "Sruthi Ravichandran"
    },
    {
      "affiliations": [
        "Alder Hey NHS Foundation Trust"
      ],
      "name": "Ahmed Ali"
    },
    {
      "affiliations": [
        "Alder Hey NHS Foundation Trust"
      ],
      "name": "Cathryn Benson"
    },
    {
      "affiliations": [
        "Alder Hey NHS Foundation Trust"
      ],
      "name": "Will Wong"
    }
  ],
  "title": "7972 Infection screening outcomes in unaccompanied asylum seeking children in a UK tertiary centre and the utility of strongyloides testing: a three year analysis",
  "uid": "047b6838-bfd0-53b0-840b-7f90aada6538"
}