New research from the University of Adelaide has discovered a high prevalence of vitamin B12 deficiency among refugees, prompting calls for refugees to be routinely screened for the problem soon after they arrive.
Vitamin B12 deficiency is a sign of severe malnourishment and can result in permanent damage to the nervous system. For women of child-bearing age, vitamin B12 deficiency can lead to developmental defects in their unborn children. If left untreated, the deficiency could be fatal.
In the first study of its kind in the world, researchers from the University of Adelaide's School of Population Health studied more than 900 newly arrived refugees in Australia and found that 16.5% had vitamin B12 deficiency.
As many as one third of the refugees tested from Iran and Bhutan, and one quarter of those from Afghanistan, suffered from the deficiency.
The results of this study - which have implications for other countries such as the United States and Canada - are now published online in the international journal PLOS ONE.
"Vitamin B12 deficiency is a serious problem," says study leader Dr Jill Benson AM, Director of the Health in Human Diversity Unit at the University of Adelaide.
"Although we were expecting to find a reasonable number of vitamin B12 deficiency cases in this study, we were not expecting to see such a significant problem.
"You would not expect to see this kind of deficiency occurring in the population of a typical Western nation. What we're dealing with here is a highly vulnerable population, people who come from countries that experience extreme food security issues, and therefore they suffer from a wide range of medical conditions.
"Screening for vitamin B12 is not currently part of the standard health check for refugees entering Australia, but based on the results of our study, we firmly believe this screening should occur," Dr Benson says.
"With the United States, Canada and Australia being the three biggest nations receiving refugees from the same source countries, it stands to reason that this health problem will also be strongly prevalent among refugees in North America.
"Health authorities in each of these countries should consider providing specialized health services to refugees on arrival and in the months following their arrival," she says.
Dr Benson says general practitioners also require specialist training in refugee health. "Because of the wide variety of health conditions they might bring from their countries of origin, refugees require a much broader spectrum of health investigation than GPs may be used to," she says.
The results of this study will also be discussed at the North American Refugee Health Conference in Toronto in June. Clinicians involved in the Refugee Health Network of Australia collaborated on this research.