What question did this study set out to answer?

This study aims to evaluate the cascade of care after positive screenings for infectious diseases among newly arrived refugees in Denmark.

February 12, 2026International Journal of Environmental Research and Public Health2 citationsOpen Access

The Cascade of Care for Infectious Diseases in Newly Arrived Refugees

MNMie Fryd NielsenAarhus University Hospital JAJane Agergaard RMRebecca Vigh MargolinskyAarhus University Hospital

Key Points

This study aims to evaluate the cascade of care after positive screenings for infectious diseases among newly arrived refugees in Denmark.
Conducted a retrospective cohort study with 1506 newly arrived refugees.
Reviewed clinical records to assess progression through the cascade of care.
Focused on individuals with positive screening results for HBV, HCV, HIV, and syphilis.
2.2% of screened refugees had at least one positive screening result.
43% of individuals with hepatitis B attended follow-up, while 57% were lost to care.
Both participants screened positive for HCV had different subsequent care trajectories.
Only one participant diagnosed with HIV successfully linked to care.

Abstract

(1) Background: Post-arrival screening for infectious diseases is routinely offered to newly arrived refugees in Denmark, including tests for hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis. This study aimed to examine the cascade of care following positive screening results in a local cohort of refugees in Denmark, with a focus on subsequent clinical management, follow-up, and outcomes. (2) Methods: This retrospective cohort study included 1506 newly arrived refugees of all ages and countries of origin. All were offered a post-arrival infectious disease screening in Denmark. Clinical records were reviewed to assess progression through the cascade of care, including referral, evaluation, follow-up, and clinical outcomes among individuals with positive screening results. (3) Results: Of the 1506 screened refugees, 33 (2.2%) had at least one positive screening result. Among the 15 individuals with detectable hepatitis B surface antigen, six (43%) attended regular follow-up, while eight (57%) were lost during the cascade of care. Two participants screened positive for HCV antibodies; both underwent initial clinical evaluation, but their subsequent care trajectories differed due to repeated non-attendance or undocumented reasons. Only one participant with non-specific syphilis antibodies completed follow-up in accordance with national guidelines. One participant was diagnosed with HIV and successfully linked to care. (4) Conclusions: The prevalence of screened infectious diseases in this local Danish refugee cohort was low and consistent with findings from comparable settings. Although post-arrival screening facilitates the identification of infectious diseases, substantial loss to follow-up occurred after initial diagnosis, limiting the effectiveness of follow-up and treatment. These findings highlight the need for targeted, interdisciplinary strategies addressing organisational, social, and individual barriers to improve continuity of care following screening.

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