Infections in Asymptomatic Unaccompanied Asylum-seeking Children in London 2016–2022

Abstract

Background: Unaccompanied asylum-seeking children are at increased risk of infections and experience barriers to healthcare access. There is a lack of evidence to underpin existing national and international guidance regarding asymptomatic infection screening in this population. We describe the results from routine infection screening of 1104 unaccompanied asylum-seeking children attending for testing at 3 London centers. Methods: We performed a retrospective analysis of routinely collected data from all unaccompanied asylum-seeking children seen in 3 services in London, United Kingdom, between 2016 and 2022. Results: A total of 1104 unaccompanied asylum-seeking children attended clinic; all accepted screening. The median age was 16 years (range 11–18 years) and 987 (89%) were male. 407 (37%) had at least 1 infection; 116 (11%) had multiple infections. Tuberculosis infection and schistosomiasis were common (found in 18% and 17%, respectively). Hepatitis B infection was identified with a prevalence of 3.9%. Giardia 7.7%, tapeworm 3.3% and Strongyloides 2.8% were also commonly identified. Conclusions: We report the largest known dataset to our knowledge of infection screening in asymptomatic unaccompanied asylum-seeking children in Europe to date. This data supports recommendations for routine asymptomatic screening in this high-risk cohort, based on the significant prevalence identified of infections of both personal and public health significance.