Paeds Cases · infectious-diseases
Explaining a positive hepatitis B result and the household plan — OSCE
Communication OSCE on explaining to a newly arrived refugee family that their well-looking daughter's hepatitis B surface antigen test is positive, what chronic hepatitis B means, what further tests are needed, the household-contact vaccination plan, and the safety-net for the long term — delivered through a trained interpreter in plain, non-alarmist language that holds the family's trust and frames the result as a manageable, monitored condition rather than a crisis.
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Candidate instructions (8-minute station)
You are the paediatric registrar in the refugee-health clinic. A six-year-old girl who arrived two months ago had her comprehensive post-arrival infection screen last week. She is growing normally and feels well. Her hepatitis B surface antigen test has come back positive and you have confirmed it on a repeat sample in your own laboratory. The family has a trained interpreter present. [9]
Your tasks are: [8]
- Explain to her parents, through the interpreter, what a positive hepatitis B surface antigen means and what it does not mean — that she is not sick today, but that she is carrying the virus and needs monitoring. [8]
- Outline the further tests needed to stage the infection and the plan to test and vaccinate the household contacts. [4]
- Hold the family's trust, acknowledge their worry, and frame the result as a manageable, monitored condition with a clear safety-net, rather than a crisis or a sentence. [7]
You are not expected to give detailed antiviral dosing, to discuss liver transplant, or to manage acute liver failure. [9]
References4ShowHide
- [4]Barnett ED Immunizations and infectious disease screening for internationally adopted children. Pediatr Clin North Am, 2005.PMID 16154464
- [8]Abu-Shamsieh A; Maw S Pediatric Care for Immigrant, Refugee, and Internationally Adopted Children. Pediatr Clin North Am, 2022.PMID 34794672
- [9]Chaves NJ; Paxton GA; Biggs BA; et al The Australasian Society for Infectious Diseases and Refugee Health Network of Australia recommendations for health assessment for people from refugee-like backgrounds: an abridged outline. Med J Aust, 2017.PMID 28403765
- [7]Shetty AK Infectious Diseases among Refugee Children. Children (Basel), 2019.PMID 31783605