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Use of Point-of-Care Handheld Ultrasound for Splenomegaly in United States–Bound Refugees: A Novel Technology with Far-Reaching Implications

Tim KummerDepartment of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota;

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Alexandra M. MedleyDivision of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;

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Alexander KlosovskyInternational Organization for Migration, Geneva, Switzerland;

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Erin MannCenter for Global Health and Social Responsibility, University of Minnesota, Minneapolis, Minnesota;

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Patricia MburuInternational Organization for Migration, Nairobi, Kenya;

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Karen EkernasDepartment of Emergency Medicine, Colorado Permanente Medical Group, Denver, Colorado;

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Betty BonassInternational Organization for Migration, Nairobi, Kenya;

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Jacob C. StaufferSchool of Public Health, University of Minnesota, Minneapolis, Minnesota;

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Stewart WalukagaSchool of Public Health, University of Minnesota, Minneapolis, Minnesota;

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Michelle WeinbergDivision of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia;

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Stephen J. DunlopDepartment of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota;
Global Medicine, University of Minnesota, Minneapolis, Minnesota

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William M. StaufferDepartment of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota;
Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, Minnesota;
School of Public Health, University of Minnesota, Minneapolis, Minnesota;
Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia;
Global Medicine, University of Minnesota, Minneapolis, Minnesota

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ABSTRACT.

Ultrasound (US) is an invaluable clinical tool. New point-of-care US technology holds great promise for hard-to-reach and mobile populations such as refugees. The implementation of US in unique and challenging settings has been hindered by cost, fragility of equipment, need for uninterrupted electricity, training, and difficulty in sharing data/image files impeding quality assurance. The recent development of more flexible, durable, high-quality, low-cost, handheld US technology has offered increased potential to address many of these barriers. We describe a pilot program using a new point-of-care US technology to identify and monitor splenomegaly in United States–bound Congolese refugees. This experience and model may hold lessons for planning and development of similar approaches in other hard-to-reach mobile populations.

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Author Notes

Address correspondence to William Stauffer, Departments of Medicine and Pediatrics, Global Medicine, Human Migration and Health, Center for Global Health and Social Responsibility, University of Minnesota, 420 Delaware St. SE, MMC 250, Minneapolis, MN 55455. E-mail: stauf005@umn.edu

These authors contributed equally to this work.

Financial support: This work is supported by International Organization for Migration Award No. NU50CK000495.

Disclosure: W. S. receives partial chapter royalties from UpToDate, consultant to BCTPartners and Haymarket Education.

Authors’ addresses: Tim Kummer, Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, E-mail: timkummer84@gmail.com. Alexandra M. Medley, Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: muv3@cdc.gov. Alexander Klosovsky, International Organization for Migration, Geneva, Switzerland, E-mail: aklosovsky@iom.int. Erin Mann, Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN, E-mail: mann0255@umn.edu. Patricia Mburu and Betty Bonass, International Organization for Migration, Nairobi, Kenya, E-mails: pmburu@iom.int and bbonass@iom.int. Karen Ekernas, Department of Emergency Medicine, Colorado Permanente Medical Group, Denver, CO, E-mail: karenbast@gmail.com. Jacob Stauffer and Stewart Walukaga, School of Public Health, University of Minnesota, Minneapolis, MN, E-mails: jacobcstauffer@gmail.com and walukagas@gmail.com. Michelle Weinberg, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: mpw5@cdc.gov. Stephen J. Dunlop and William Stauffer, Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, and Global Medicine, University of Minnesota, Minneapolis, MN, E-mails: stephenjdunlop@hotmail.com and stauf005@umn.edu.

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