Preventive health care and screening of Latin American immigrants in the United States.
BACKGROUND
The Central and South American immigrant population in the United States is large and growing. A review of the preventive health care needs of this population has not previously been done but would be helpful to clinicians caring for immigrants in this country.


METHODS
Using MEDLINE, the literature related to immigrants and their health status was searched, using the key words "immigrant," "refugee," "South/Central/Latin America," "health status," "screening," "nutrition," "parasites," "stomach/gastric cancer," "children," and "psychological." The American Statistics Index and Index to International Statistics were also resources. The available literature was reviewed and led to the recommendations in this article.


RESULTS
Screening strategies for Latin American immigrants are discussed for intestinal parasites, tuberculosis, hepatitis B, schistosomiasis, leprosy, American trypanosomiasis (Chagas disease), malaria, human immunodeficiency virus (HIV) infection, cervical and gastric cancer, sickle cell trait, malnutrition, iron-deficiency anemia, incomplete immunizations, dental problems, psychological problems, impairment in the elderly, alcohol use, smoking, physical inactivity, and hypertension. There are not enough data to evaluate fully the screening strategies for most of these conditions, but recommendations are offered based on current knowledge.


CONCLUSIONS
Screening is recommended for intestinal parasites and schistosomiasis, tuberculosis, hepatitis B in prenatal patients, leprosy in immigrants from high-risk areas, yearly Papanicolaou smears, malnutrition, iron-deficiency anemia, incomplete immunizations, dental problems, history of violence, and depression. Screening for sickle cell trait in prenatal patients from South America and universal hepatitis B screening are less clearly indicated but could be appropriate. Screening for American trypanosomiasis (Chagas disease), malaria, and gastric cancer is not recommended. Screening for HIV infection, functional impairment in the elderly, alcohol use, cigarette smoking, physical inactivity, and hypertension should be the same as for the general population.
Weissman
A M
AM
Brown University Program in Family Medicine, Memorial Hospital of Rhode Island, Pawtucket 02860.
D002489:Central America / Q000453:epidemiology; D014355:Chagas Disease / Q000517:prevention & control; D003140:Communicable Disease Control; D003141:Communicable Diseases / Q000453:epidemiology; D004641:Emigration and Immigration; D015658:HIV Infections / Q000517:prevention & control; D006453:Hemoglobinopathies / Q000517:prevention & control; D006509:Hepatitis B / Q000517:prevention & control; D006630:Hispanic or Latino; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000517:prevention & control; D007918:Leprosy / Q000517:prevention & control; D008019:Life Style; D008288:Malaria / Q000517:prevention & control; D008403:Mass Screening; D008603:Mental Health; D009369:Neoplasms / Q000517:prevention & control; D012552:Schistosomiasis / Q000517:prevention & control; D013020:South America / Q000453:epidemiology; D014376:Tuberculosis / Q000517:prevention & control