Malaria Among Refugee Children at Arrival in the United States

Maroushek, Stacene; Aguilar, E; Stauffer, William M.; Abd-Alla, Mohomed D.

doi:10.1097/01.inf.0000160948.22407.0d

Cited by 35 publications

(26 citation statements)

References 11 publications

(11 reference statements)

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“…The prevalence of asymptomatic malaria in our study was 3.1% by real-time PCR, much lower than the rates reported in other studies. 5,27,30 However, those studies selected specific populations, often with common demographic or geographic criteria and from groups thought to be at high risk of malaria. Our study represents a consecutive sample (except for the few missed because of administrative error) of all government-sponsored refugees coming to Edmonton during the study period.…”

Section: Discussionmentioning

confidence: 99%

“…24 The reported prevalence of asymptomatic malaria in refugees screened post-arrival ranges from 2.4% to 31.8%, depending on the target population and the method of diagnosis. 5,[25][26][27][28][29][30] Over the past decade, the risk of asymptomatic refugees developing clinical malaria has been underscored by the occurrence of two local outbreaks in North America. In 1992, an outbreak was reported in North Carolina in a group of 402 Montagnard refugees from Indochina 10 ; subsequent screening showed a malaria prevalence of 58% by microscopy.…”

Section: Introductionmentioning

confidence: 99%

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Post-Arrival Screening for Malaria in Asymptomatic Refugees Using Real-Time PCR

Matisz¹,

Naidu²,

Shokoples³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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Abstract. Malaria is a significant health risk to refugee populations originating from endemic areas, but there is little consensus on screening and/or treatment approaches for malaria in this population. Furthermore, detection of malaria in semi-immune asymptomatic refugees is limited by the sensitivity of diagnostic tests used for screening. We determined the prevalence of malaria by microscopy and real-time polymerase chain reaction (PCR) in a consecutive population of 324 asymptomatic refugees examined in Edmonton, Canada, during 2009-2010. Although all thick and thin blood smear results were negative, 10 subjects (3.1%) tested PCR positive for Plasmodium DNA. Interestingly, 6 of 10 PCR positive subjects are at risk of malaria relapse by P. vivax or P. ovale infections. These results suggest that appropriate guidelines for malaria screening should consider the risk of relapsing infections, and they highlight the potential usefulness of realtime PCR in the diagnosis of asymptomatic malaria.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Post-Arrival Screening for Malaria in Asymptomatic Refugees Using Real-Time PCR

Matisz¹,

Naidu²,

Shokoples³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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“…The prevalence among people from other malariaendemic areas is much lower. 324,352,[358][359][360]364,365 A limited number of follow-up studies suggest that the risk of development of symptomatic malaria after screening is 20% to 40%. [358][359][360]365 The burden of symptomatic malaria among Canadian migrants is difficult to ascertain.…”

Section: Malariamentioning

confidence: 99%

Evidence-based clinical guidelines for immigrants and refugees

Pottie¹,

Greenaway²,

Feightner³

et al. 2010

Canadian Medical Association Journal

395

333

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“…Finally, 8-60% of refugees from areas to which malaria is highly endemic have detectable P. falciparum parasitemias more than four weeks after resettlement in North America. [21][22][23] Because no widely available testing modality is sensitive enough to reliably detect persons with subclinical infection at the time of arrival medical screening, 22,23 alternatives to mass presumptive treatment of the control of subclinical infections are few.…”

Section: Discussionmentioning

confidence: 99%

Presumptive Treatment to Reduce Imported Malaria among Refugees from East Africa Resettling in the United States

Phares

Kapella²,

Doney³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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During May 4, 2007–February 29, 2008, the United States resettled 6,159 refugees from Tanzania. Refugees received pre-departure antimalarial treatment with sulfadoxine-pyrimethamine (SP), partially supervised (three/six doses) artemether-lumefantrine (AL), or fully supervised AL. Thirty-nine malaria cases were detected. Disease incidence was 15.5/1,000 in the SP group and 3.2/1,000 in the partially supervised AL group (relative change = –79%, 95% confidence interval = –56% to –90%). Incidence was 1.3/1,000 refugees in the fully supervised AL group (relative change = –92% compared with SP group; 95% confidence interval = –66% to –98%). Among 39 cases, 28 (72%) were in refugees < 15 years of age. Time between arrival and symptom onset (median = 14 days, range = 3–46 days) did not differ by group. Thirty-two (82%) persons were hospitalized, 4 (10%) had severe manifestations, and 9 (27%) had parasitemias > 5% (range = < 0.1–18%). Pre-departure presumptive treatment with an effective drug is associated with decreased disease among refugees.

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Malaria Among Refugee Children at Arrival in the United States

Cited by 35 publications

References 11 publications

Post-Arrival Screening for Malaria in Asymptomatic Refugees Using Real-Time PCR

Post-Arrival Screening for Malaria in Asymptomatic Refugees Using Real-Time PCR

Evidence-based clinical guidelines for immigrants and refugees

Presumptive Treatment to Reduce Imported Malaria among Refugees from East Africa Resettling in the United States

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