RAPID MALARIA SCREENING AND TARGETED TREATMENT OF UNITED STATES–BOUND MONTAGNARD REFUGEES FROM CAMBODIA IN 2002

LOUISE M. CAUSER Division of Parasitic Diseases and Division of Global Migration and Quarantine, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Organization for Migration, Phnom Penh, Cambodia

Search for other papers by LOUISE M. CAUSER in
Current site
Google Scholar
PubMed
Close
,
HENRY S. BISHOP Division of Parasitic Diseases and Division of Global Migration and Quarantine, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Organization for Migration, Phnom Penh, Cambodia

Search for other papers by HENRY S. BISHOP in
Current site
Google Scholar
PubMed
Close
,
DONALD J. SHARP Division of Parasitic Diseases and Division of Global Migration and Quarantine, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Organization for Migration, Phnom Penh, Cambodia

Search for other papers by DONALD J. SHARP in
Current site
Google Scholar
PubMed
Close
,
ELAINE W. FLAGG Division of Parasitic Diseases and Division of Global Migration and Quarantine, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Organization for Migration, Phnom Penh, Cambodia

Search for other papers by ELAINE W. FLAGG in
Current site
Google Scholar
PubMed
Close
,
JAIME F. CALDERON Division of Parasitic Diseases and Division of Global Migration and Quarantine, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Organization for Migration, Phnom Penh, Cambodia

Search for other papers by JAIME F. CALDERON in
Current site
Google Scholar
PubMed
Close
,
VINCENT KEANE Division of Parasitic Diseases and Division of Global Migration and Quarantine, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Organization for Migration, Phnom Penh, Cambodia

Search for other papers by VINCENT KEANE in
Current site
Google Scholar
PubMed
Close
,
J. JINA SHAH Division of Parasitic Diseases and Division of Global Migration and Quarantine, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Organization for Migration, Phnom Penh, Cambodia

Search for other papers by J. JINA SHAH in
Current site
Google Scholar
PubMed
Close
,
JOHN R. MACARTHUR Division of Parasitic Diseases and Division of Global Migration and Quarantine, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Organization for Migration, Phnom Penh, Cambodia

Search for other papers by JOHN R. MACARTHUR in
Current site
Google Scholar
PubMed
Close
,
SUSAN A. MALONEY Division of Parasitic Diseases and Division of Global Migration and Quarantine, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Organization for Migration, Phnom Penh, Cambodia

Search for other papers by SUSAN A. MALONEY in
Current site
Google Scholar
PubMed
Close
,
MARTIN S. CETRON Division of Parasitic Diseases and Division of Global Migration and Quarantine, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Organization for Migration, Phnom Penh, Cambodia

Search for other papers by MARTIN S. CETRON in
Current site
Google Scholar
PubMed
Close
, and
PETER B. BLOLAND Division of Parasitic Diseases and Division of Global Migration and Quarantine, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; International Organization for Migration, Phnom Penh, Cambodia

Search for other papers by PETER B. BLOLAND in
Current site
Google Scholar
PubMed
Close
Restricted access

In 2002, a group of Montagnard refugees living in Cambodia was accepted for resettlement in the United States. Pre-departure malaria screening and targeted treatment was conducted to prevent morbidity, and minimize the potential for local malaria transmission post-arrival. We screened 902 of 906 refugees using rapid diagnostic tests (RDTs), microscopy, and polymerase chain reaction (PCR) analysis. Twelve (1.3%) RDT results were positive and 28 (3.1%) were indeterminate. Microscopy confirmed Plasmodium species in two of the positive RDT and one of the indeterminate results. Among a random 10% sample of negative RDT results (n = 86), none were positive by microscopy. The PCR confirmed the two microscopically (and RDT) positive specimens. The PCR result was negative for all other specimens tested. Eighteen (2.0%) refugees were treated with antimalarials. The RDTs were useful in this setting, facilitating timely, sensitive diagnosis and targeted treatment. Evaluations to determine the most appropriate interventions in other refugee settings should include cost-effectiveness analyses of alternative strategies.

Author Notes

Reprint requests: Louise M.Causer, Malaria Branch, Centers for Disease Control and Prevention, Mailstop F-22, 4770 Buford Highway, Atlanta, GA 30341, Telephone: 770-488 7782, Fax: 770-488 4206, E-mail: lsc6@cdc.gov.
  • 1

    United Nations High Commissioner for Refugees, 2002. Refugees by Numbers 2002. Available at http://www.unhcr.ch/cgi-bin/texis/vtx/home/opendoc.pdf?tbl=VISITORS&id=3c149b007. Accessed April 18, 2003.

    • PubMed
    • Export Citation
  • 2

    U.S. Immigration and Naturalization Service, 2003. Refugees, Asylees Fiscal Year 2001. Available at http://uscis.gov/graphics/shared/aboutus/statistics/Yearbook2001.pdf. Accessed April 18, 2003.

    • PubMed
    • Export Citation
  • 3

    Centers for Disease Control and Prevention, 2002. Medical Examinations of Aliens (Refugees and Immigrants). Available at http://www.cdc.gov/ncidod/dq/health.htm. Accessed November 19, 2002.

    • PubMed
    • Export Citation
  • 4

    Centers for Disease Control and Prevention, 2003. Instructions to Panel Physicians for Completing New US Department of State—Medical Examination for Immigrant or Refugee Applicant (DS-2053) and Associated Worksheets (DS-3024, DS-3025, and DS-3026). Available at http://www.cdc.gov/ncidod/dq/pdf/ds-forms-instructions.pdf. Accessed January 16, 2003.

    • PubMed
    • Export Citation
  • 5

    Miller JM, Boyd HA, Ostrowski SR, Cookson ST, Parise ME, Gonzaga PS, Addiss DG, Wilson M, Nguyen-Dinh P, Wahlquist SP, Weld LH, Wainwright RB, Gushulak BD, Cetron MS, 2000. Malaria, intestinal parasites, and schistosomiasis among Barawan Somali refugees resettling to the United States: a strategy to reduce morbidity and decrease the risk of imported infections. Am J Trop Med Hyg 62 :115–121.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Greenberg AE, Lobel HO, 1990. Mortality from Plasmodium falciparum malaria in travelers from the United States, 1959 to 1987. Ann Intern Med 113 :326–327.

  • 7

    Mundy SB, White AC Jr, Hines JS, Marino BJ, Young EJ, 1996. Mosquito-transmitted malaria acquired in Texas. South Med J 89 :616–618.

  • 8

    MacArthur JR, Holtz TH, Jenkins J, Newell JP, Koehler JE, Parise ME, Kachur SP, 2001. Probable locally acquired mosquito-transmitted malaria in Georgia, 1999. Clin Infect Dis 32 :E124–E128.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Brook JH, Genese CA, Bloland PB, Zucker JR, Spitalny KC, 1994. Brief report: malaria probably locally acquired in New Jersey. N Engl J Med 331 :22–23.

  • 10

    Centers for Disease Control and Prevention, 2000. Probable locally acquired mosquito-transmitted Plasmodium vivax infection—Suffolk County, New York, 1999. MMWR Morb Mortal Wkly Rep 49 :495–498.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Centers for Disease Control and Prevention, 2003. Local transmission of Plasmodium vivax malaria—Palm Beach County, Florida, 2003. MMWR Morb Mortal Wkly Rep 52 :908–911.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Centers for Disease Control and Prevention, 1993. Malaria in Montagnard refugees—North Carolina, 1992. MMWR Morb Mortal Wkly Rep 42 :180–183.

  • 13

    Paxton LA, Slutsker L, Schultz LJ, Luby SP, Meriwether R, Matson P, Sulzer AJ, 1996. Imported malaria in Montagnard refugees settling in North Carolina: implications for prevention and control. Am J Trop Med Hyg 54 :54–57.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Slutsker L, Tipple M, Keane V, McCance C, Campbell CC, 1995. Malaria in east African refugees resettling to the United States: development of strategies to reduce the risk of imported malaria. J Infect Dis 171 :489–493.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Snounou G, Viriyakosol S, Zhu X, Jarra W, Pinheiro L, do Rosario V, Thaithong S, Brown K, 1993. High sensitivity of detection of human malaria parasites by the use of nested polymerase chain reaction. Mol Biochem Parasitol 61 :315–320.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    World Health Organization, 2001. Roll Back Malaria in the WHO Western Pacific Region—Status in early 2001. Available at http://mosquito.who.int/cmc_upload/0/000/014/713/wpr.htm. Accessed January 17, 2003.

    • PubMed
    • Export Citation
  • 17

    World Health Organization, 2002. Malaria, Other Vectorborne and Parasitic Diseases—Country Profiles—Cambodia. Available at http://www.wpro.who.int/themes_focuses/theme1/focus2/t1f2cambodia.asp. Accessed August 15, 2002.

    • PubMed
    • Export Citation
  • 18

    World Health Organization, 2002. Malaria, Other Vectorborne and Parasitic Diseases – Country Profiles—Vietnam. Available at http://www.wpro.who.int/themes_focuses/theme1/focus2/t1f2vietnam.asp. Accessed May 8, 2002.

    • PubMed
    • Export Citation
  • 19

    Moody A, 2002. Rapid diagnostic tests for malaria parasites. Clin Microbiol Rev 15 :66–78.

  • 20

    World Health Organization, 2000. New Perspectives in Malaria Diagnosis. Report of a Joint WHO/USAID Informal Consultation, October 25–27, 1999. Geneva: World Health Organization, 1–57.

    • PubMed
    • Export Citation
  • 21

    Premji Z, Minjas JN, Shiff CJ, 1994. Laboratory diagnosis of malaria by village health workers using the rapid manual Para-Sight-F test. Trans R Soc Trop Med Hyg 88 :418.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22

    Coleman RE, Maneechai N, Rachapaew N, Kumpitak C, Soyseng V, Miller RS, Thimasarn K, Sattabongkot J, 2002. Field evaluation of the ICT Malaria Pf/Pv immunochromatographic test for the detection of asymptomatic malaria in a Plasmodium falciparum/vivax endemic area in Thailand. Am J Trop Med Hyg 66 :379–383.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23

    World Health Organization, 2003. Malaria Rapid Diagnosis—Making It Work. Meeting Report January 20–23, 2003. Geneva: World Health Organization. Regional Office for the Western Pacific.

    • PubMed
    • Export Citation
  • 24

    Rubio JM, Buhigas I, Subirats M, Baquero M, Puente S, Benito A, 2001. Limited level of accuracy provided by available rapid diagnosis tests for malaria enhances the need for PCR-based reference laboratories. J Clin Microbiol 39 :2736–2737.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 45 43 15
Full Text Views 256 49 0
PDF Downloads 46 15 0
 
Membership Banner
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save