American Journal of Tropical Medicine and Hygiene
Volume 85, Issue 4, 2011, Pages 612-615

Presumptive treatment to reduce imported malaria among refugees from east Africa resettling in the United States (Article) (Open Access)

Phares C.R. , Kapella B.K. , Doney A.C. , Arguin P.M. , Green M. , Mekonnen L. , Galev A. , Weinberg M. , Stauffer W.M.*
  • a Division of Parasitic Diseases and Malaria, National Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, GA, United States, International Organization for Migration, Dar es Salaam, Tanzania
  • b Centers for Disease Control and Prevention, U.S. Embassy Annex, Hanoi, Viet Nam, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, GA, United States, International Organization for Migration, Dar es Salaam, Tanzania
  • c Division of Parasitic Diseases and Malaria, National Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, GA, United States, International Organization for Migration, Dar es Salaam, Tanzania
  • d Division of Parasitic Diseases and Malaria, National Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, GA, United States, International Organization for Migration, Dar es Salaam, Tanzania
  • e Division of Parasitic Diseases and Malaria, National Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, GA, United States, International Organization for Migration, Dar es Salaam, Tanzania
  • f International Organization for Migration, Addis Ababa, Ethiopia, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, GA, United States, International Organization for Migration, Dar es Salaam, Tanzania
  • g International Organization for Migration, Nairobi, Kenya, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, GA, United States, International Organization for Migration, Dar es Salaam, Tanzania
  • h Division of Parasitic Diseases and Malaria, National Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, GA, United States, International Organization for Migration, Dar es Salaam, Tanzania
  • i Department of Medicine, Division of Infectious Diseases and International Medicine, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN 55455, United States, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, GA, United States, International Organization for Migration, Dar es Salaam, Tanzania

Abstract

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 &λτ; 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 &γτ; 5% (range = &λτ; 0.1-18%). Pre-departure presumptive treatment with an effective drug is associated with decreased disease among refugees. Copyright © 2011 by The American Society of Tropical Medicine and Hygiene.

Author Keywords

[No Keywords available]

Index Keywords

pyrimethamine sulfadoxine hospitalization refugee clinical feature human Drug Combinations Refugees Malaria morbidity pyrimethamine plus sulfadoxine United States school child Humans Fluorenes Ethanolamines Adolescent Antimalarials male preschool child female Child, Preschool Africa clinical article Article Parasitemia Tanzania artemether plus benflumetol disease severity Artemisinins Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-80053927726&doi=10.4269%2fajtmh.2011.11-0132&partnerID=40&md5=66c174d9f1b8630f7b197d77d6c0c9a7
DOI: 10.4269/ajtmh.2011.11-0132
ISSN: 00029637
Cited by: 3
Original Language: English