Health problems of refugees.

BACKGROUND The United States has recently seen an increase in the number of refugees and a change in the ethnicity of these refugees. It would be helpful for family physicians providing medical care to these patients to have available health data on the largest groups of new refugees. METHODS Using the key words "refugee," "Vietnam," "Laos," "former Yugoslavia" (Bosnia-Herzegovina), "former Soviet Union," "Iraq," "Afghanistan," "Somalia," "Sudan," "Ethiopia," "Haiti," and "Cuba," the MEDLINE files were searched from 1991 to the present. Cross-references from these articles were also reviewed, including pertinent information published from 1981-91. Studies and experimental trials were discussed if they had information on conditions of refugees after arrival or on diseases currently reported from the countries of origin. RESULTS AND CONCLUSIONS With the exception of studies of Southeast Asian refugees, there are few clinical trials on the health problems of refugees after arrival in the United States. Tuberculosis, nutritional deficiencies, intestinal parasites, chronic hepatitis B infection, lack of immunization, and depression are major problems in many groups. There is great variation in the health and psychosocial issues, as well as cultural beliefs, among the refugees. In addition to a complete history and physical examination, tests for tuberculosis, hepatitis B surface antigen, and ova and parasites, as well as a hemoglobin measurement, are advised for most groups. Ongoing clinical trials are needed to explore more fully not only the medical and psychological problems of these patients but also their health beliefs.