INITIAL VISIT | | NOTES |
STOOL | Ova and parasites | 3 early-morning stools separated by 24 hours |
Giardia-specific antigen | 1 early-morning stool; note: if child has bloody diarrhea, consider Shigella, Salmonella, E. coli 0157 and Campylobacter stool studies. Recheck stool 2-3 weeks after completion of treatment |
URINE | Clean catch or bag urine for urinalysis | Urinalysis is a simple screen for renal and systemic disease. Schistosoma haematobium should be considered in the older IA who has asymptomatic hematuria if the country of origin is located in West Africa (where prevalence rates of S. haematobium can exceed 90%) |
BLOOD | Hemogram | Include red blood cell indices and white blood cell differential |
Iron studies | Ferritin, serum iron, iron saturation, CRP |
Vitamin D, Ca, Phos | 25 OH total vitamin D |
Hb Electrophoresis | Consider initially or at 6 mo follow-up if there is unexplained anemia |
Thyroid stimulating hormone, free thyroxine | |
G6PD | Areas where G6PD is common or if prescribing primaquine |
Hepatitis A total | If positive, then hepatitis A core IgM antibody |
Hepatitis B surface antigen | |
Hepatitis B core antibody | |
Hepatitis B surface antibody | |
Hepatitis C antibody | If positive, then hepatitis C RNA by PCR |
HIV types 1 and 2 antibodies | |
RPR, VDRL or Anti-treponemal EIA | |
Newborn metabolic screen | For infants (0 to 12 months) |
Malaria PCR | Endemic areas, known malarial illness in family1 |
Lead | |
Diphtheria anti-toxoid antibody2 | |
Tetanus anti-toxoid antibody2 | |
Poliovirus types I, II and III neutralizing antibody2 | |
Varicella | For children >12 years old or w/ history of infection |
Measles, mumps and rubella antibodies | If MMR documented |
TST | Tuberculin skin test | All children, regardless of BCG history |
| Growth | IGF1 and IGF BP-3 | If height is far below the 3rd percentile on presentation, or if catch-up growth is inadequate |
|
6 MONTHS POST INITIAL VISIT | BLOOD | Hepatitis B panel | Only if child did not have immunity at initial visit |
Hepatitis C antibody | |
HIV types 1 and 2 antibody | |
Iron studies | |
| Vitamin D, Ca, Phos | If initial screen was abnormal and follow-up has not been done by primary care |
TST | Tuberculin skin test | Only if first test was negative |
| | Growth | IGF1 and IGF BP-3 | If inadequate catch-up growth between first and second time periods |
