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Pre-departure and Post-arrival Management of P. falciparum Malaria in Refugees Relocating from Sub-Saharan Africa to the United States

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  • 1 Department of Medicine, Division of Infectious Diseases and International Medicine University of Minnesota, Minneapolis, Minnesota; Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Atlanta, Georgia; Centers for Disease Control and Prevention, Malaria Branch, Division of Parasitic Diseases, Atlanta, Georgia; Centers for Disease Control and Prevention/Kenya Medical Research Institute Field Station, Kisumu, Kenya
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Plasmodium infection, often sub-clinical, is common in migrating sub-Saharan refugee populations. Refugees who subsequently develop clinical malaria suffer illness and exact a cost on state and local health care facilities. Untreated infection is also of public health concern because of the potential for local transmission. In response to increasing numbers of refugees originating in sub-Saharan Africa guidelines for the management of malaria in refugees migrating to the United States have been broadened and updated. The guidelines are based on available evidence-based literature and recent public health experience. These guidelines were critically reviewed, assessed, and approved by multiple National and State entities as well as outside experts. These consensus guidelines recommend that sub-Saharan African refugees relocating to the United States receive presumptive treatment of P. falciparum malaria before departure or during the domestic refugee medical screening after arrival. Presumptive therapy is not currently recommended for either non-falciparum malaria or for refugees relocating from areas outside sub-Saharan Africa.

Author Notes

Reprint requests: William M. Stauffer, MD, MSPH, DTMH, University of Minnesota, Department of Medicine, Division of Infectious Diseases and International Medicine Department of Pediatrics, Infectious Diseases School of Public Health, Division of Epidemiology and Community Health, 420 Delaware Street SE, Mayo Building D407, MMC 250, Minneapolis, MN 55455, Tel: 612-624-9996, Pager: 612-899-7538, Fax: 612-624-4410, E-mail: stauf005@umn.edu.
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