P3.125: Age-stratified analysis of Chief Complaints in Pediatric migrants and asylum-seekers on the U.S. - Mexico Border

Background: El Paso County is a significant point of entry for migrant and asylum-seeking populations arriving at the U.S.-Mexico border. Among this population are vulnerable pediatric patients who endure long, dangerous, and traumatic journeys who present with a wide range of medical needs influenced by migration-related stressors, limited prior healthcare access, and environmental exposures. Transitional community clinics provide urgent and primary medical care to these populations through collaborative efforts involving physicians, students, medical staff, and community workers. We explore chief complaints and medical presentations of pediatric patients stratified by age to better understand migration-related healthcare needs. Knowledge from this study seeks to better equip migrant and refugee transitional clinics (MRTC) in border communities to better serve pediatric patients.

Methods: A retrospective chart review was conducted on 189 pediatric patients (age 0–17) who received care through Texas Tech University Health Science Center - El Paso MRTC in 2024. A frequency analysis was conducted to identify and report the most common chief complaints and corresponding ICD-11 codes across age groups. Additionally, a thematic content analysis of the chart documentation was performed to identify migrant related concerns (e.g., trauma, displacement stress, housing insecurity), that were not adequately captured by ICD-11 codes. Corresponding care plans (e.g., medications, referrals) were reviewed to assess intervention patterns.

Results: Children most commonly presented with chief complaints related to acute respiratory (n= 52, 27.5%), dermatological (n=32, 16.9%), and gastrointestinal (n=31, 16.4%) issues. Less frequent chief complaints were related to wound care and burns (n=12, 6.4%), musculoskeletal concerns (n=8, 4.2%) and developmental concerns (n=8, 4.2%). Patients were stratified into standardized age groups 0-2 years old (n=36, 19.9%), 3-7 years old (n=66, 34.9), 8-13 years old (n=58, 30.8) 14-17 (n=29, 15.4) Most frequently used ICD-11 codes diagnosed patients with alteration in comfort, nasal congestion, respiratory infection, rash, diarrhea, dehydration, and viral gastroenteritis. Thematic content analysis highlighted that many patients had not received care adequately captured by ICD-11 codes alone. Recurring themes included lapses in medical care during migration, physical strain from long-term walking, environmental exposures, non-healing skin abscesses and severe burns. These issues were often underrepresented in coded diagnostic data but noted in the patient narrative and history. Care plan review indicated that 4.7% of patients were referred to the Emergency Department for further management. Other interventions included medication prescriptions, wound care management, and, when possible, referral to follow-up care using the Migrant Clinicians Network.

Conclusion: The project seeks to uncover trends and statistical probabilities of pediatric chief complaints in the US-Mexico border immigrant population. By determining common trends among pediatric patients, we aim to better inform physicians in community clinics as well as emergency rooms of common trends in presentations of patients and even develop culturally appropriate and trauma-informed treatment guidelines for this population.