Newly arrived migrant

Infectious diseases · Prevention, screening, pregnancy · updated 2026-10-29

BioMG follows French guidelines. Adapt it to the guidelines and the tests available where you practise.

Frequency: A flow, not a prevalence: 345 587 first residence permits issued in France in 2024 to third-country nationals (338 877 in 2023), according to Eurostat ^[1]. Permits valid for at least 3 months, excluding European Union citizens; they do not count asylum seekers without a permit, nor people without a permit.

Adult

Laboratory tests

FBC with blood film
Serum creatinine
AST
ALT
Fasting plasma glucose (or capillary glucose)if neededAged 45 or over; 35 or over if origin from the Indian subcontinent, Middle East or Africa, family history of diabetes, history of gestational diabetes, cardiovascular risk factor or overweight.
Urine dipstick
HIV serology
Hepatitis B serology (HBsAg, anti-HBs antibodies, anti-HBc antibodies)
Hepatitis C serology
Syphilis serology
Chlamydia trachomatis and Neisseria gonorrhoeae NAAT (PCR) (on urine, vaginal, anal and/or pharyngeal sample)if neededSexually active person aged 25 or under, or sexual behaviour exposing to STIs (unprotected intercourse with casual partners, multiple partners, MSM, sex work, precariousness exposing to sexual vulnerability even if not verbalised). Sites according to sex and practices.
hCGif neededWoman of childbearing potential with a possible pregnancy (late period, mention of pregnancy) on history.
Lipid profileif neededMan aged 40 or over, woman aged 50 or over, cardiovascular risk factor, or woman before hormonal contraception.
hepatitis A serology (IgG)if neededMan who has sex with men, with a view to catch-up vaccination against hepatitis A (the page’s note adds plans to travel to an endemic area).
strongyloidiasis serology (strongyloidosis)if neededOrigin from a strongyloidiasis-endemic area: Central and South America, Caribbean, Africa, Central, South and South-East Asia, Indonesia, Eastern Europe. Routine in this case.
varicella serologyif neededPerson aged 12 to 40 with no history of chickenpox on history, to vaccinate if serology is negative.
bilharziasis serologyif neededOrigin from sub-Saharan Africa or Egypt (routine in this case).
filariasis serologyif neededOrigin from the forested areas of Central Africa (Angola, Cameroon, Gabon, Equatorial Guinea, Nigeria, Congo, Central African Republic, DRC, South Sudan, Chad). May be waived if the stay was exclusively urban.
search for daytime microfilaraemiaif neededSame people as for filariasis serology (forested areas of Central Africa), with a daytime sample. Often not accessible in primary care: serology alone is then enough.
HTLV-1 serologyif neededWoman of childbearing potential from sub-Saharan Africa, Latin America, the Caribbean or Japan.
Chagas disease serologyif neededWoman of childbearing potential from South America, or whose mother is from there. Sometimes outside the fee schedule in primary care.
haemoglobin electrophoresisif neededPlan to become parents or pregnancy (before 12 weeks of gestation) in a person from sub-Saharan Africa, North Africa, the Middle East, the Indian subcontinent, South-East Asia, intertropical Latin America or the Caribbean; or microcytosis on FBC.
stool parasitology over 3 daysif neededOrigin from an endemic area (Central and South America, Caribbean, Africa, Central, South and South-East Asia, Indonesia), if the person agrees: 3 samples collected a few days apart.
24-hour urine parasitology (or failing that, on a complete morning void sample)if neededOrigin from sub-Saharan Africa only (testing for urinary schistosomiasis), if the person agrees.
tetanus antibodies 4-8 weeks after the dTPca boosterif neededVaccination status unknown: check 4 to 8 weeks after a first dTcaP booster.
anti-HBs antibodies 4-8 weeks after the hepatitis B boosterif neededVaccination status unknown with entirely negative hepatitis B serology: check 4 to 8 weeks after a first dose of hepatitis B vaccine.
IGRA (interferon-gamma release assay) or tuberculin skin testif neededAdult aged 18 to 40 from a country where the incidence of tuberculosis exceeds 100/100 000, with or likely to have young children around them, or working in health care or early childhood, or immunocompromised.

Detailed explanation and international comparison (in French): read it in English (machine translation)

Child

Laboratory tests

FBC with blood film
Serum creatinine
AST
ALT
Urine dipstick
Blood leadif neededChild under 16 years, in particular from a country with a high prevalence of lead poisoning (map on leadpollution.org); attach the Cerfa form.
TSHif neededChild aged 1 month to 2 years (routine); after 2 years, only if there is a clinical pointer (TSH and T4). Before 1 month: Guthrie test.
Serum ferritinif neededFerritin in every child aged 5 or under, and after 5 if risk factor (undernutrition, pubertal adolescent girl, haemoglobinopathy). CRP only if fever or suspected infection.
CRPif neededFerritin in every child aged 5 or under, and after 5 if risk factor (undernutrition, pubertal adolescent girl, haemoglobinopathy). CRP only if fever or suspected infection.
Serum albuminif neededProteinuria on dipstick (with urine protein:creatinine ratio and serum creatinine), or clinical undernutrition justifying a wider nutritional work-up.
Haemoglobin electrophoresisif neededChild from sub-Saharan Africa, North Africa, the Middle East, South-East Asia, intertropical Latin America or the Caribbean. May be deferred after correction of iron deficiency.
G6PD assayif neededHistory of haemolysis or jaundice, family cases, work-up before a treatment at risk of haemolysis, or other identified red cell disease.
HIV serologyRecommended for every newly arrived migrant child, whatever the region of origin (same criteria as for adults: for everyone).
Hepatitis B serology (HBsAg, anti-HBs antibodies, anti-HBc antibodies)Recommended for every newly arrived migrant child, whatever the region of origin (same criteria as for adults: for everyone).
Hepatitis C serologyRecommended for every newly arrived migrant child, whatever the region of origin (same criteria as for adults: for everyone).
Syphilis serologyif neededMinor sexually exposed (unaccompanied minors are included automatically), or risk of congenital syphilis in the infant (unmonitored pregnancy, clinical signs).
Chlamydia trachomatis and Neisseria gonorrhoeae NAAT (PCR) (on urine, vaginal, anal and/or pharyngeal sample)if neededAdolescent and/or suspected sexual exposure; unaccompanied minors are considered exposed.
hCGif neededAdolescent girl at risk of pregnancy (doubt on history).
hepatitis A serology (IgG)if neededChild aged 1 to 18 likely to stay again in an endemic area, with a view to catch-up vaccination against hepatitis A.
strongyloidiasis serology (strongyloidosis)if neededChild who learned to walk in a strongyloidiasis-endemic area (Central and South America, Caribbean, Africa, Central, South and South-East Asia, Indonesia, Eastern Europe).
varicella serologyif neededAdolescent aged 12 or over with no history of chickenpox, to vaccinate if serology is negative.
bilharziasis serologyif neededChild from sub-Saharan Africa or Egypt (same criteria as for adults).
filariasis serologyif neededChild from the forested areas of Central Africa (Angola, Cameroon, Gabon, Equatorial Guinea, Nigeria, Congo, Central African Republic, DRC, South Sudan, Chad), unless the stay was exclusively urban.
search for daytime microfilaraemiaif neededSame children as for filariasis serology (forested Central Africa), before any ivermectin treatment. If not accessible in primary care, serology alone is enough.
HTLV-1 serologyif neededAdolescent girl of childbearing age from sub-Saharan Africa, Latin America, the Caribbean or Japan.
Chagas disease serologyif neededAdolescent girl of childbearing age from South America, or whose mother is from there.
stool parasitology over 3 daysif neededIn children, only if there are clinical or laboratory signs of deficiency or malnutrition.
24-hour urine parasitology (or failing that, on a complete morning void sample)if neededChild from sub-Saharan Africa (or Egypt according to table 2), especially if schistosomiasis serology is positive or if collection is easy.
IGRA (in vitro interferon-gamma release assay) or tuberculin skin testif neededChild aged 18 or under from a country where the incidence of tuberculosis exceeds 40/100 000 and arrived in France less than 5 years ago (chest X-ray only if the test is positive or symptoms). IGRA reimbursed before age 15; from 15 to 18, CLAT (TB control centre, free of charge) or tuberculin skin test (IDR).

Detailed explanation and international comparison (in French): read it in English (machine translation)

Do not order

Routine stool parasitology in an asymptomatic child: not recommended (limited feasibility); reserve for clinical or laboratory warning signs ^[2].
Chest X-ray straight away in a child: only if IGRA or tuberculin skin test is positive, or symptoms suggestive of tuberculosis (in adults, by contrast, it is indicated straight away if the country’s incidence exceeds 40/100 000) ^[2].

Sources (9)