title: 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.
abstract: In 1997, enhanced health assessments were performed for 390 (10%) of approximately 4,000 Barawan refugees resettling to the United States. Of the refugees who received enhanced assessments, 26 (7%) had malaria parasitemia and 128 (38%) had intestinal parasites, while only 2 (2%) had Schistosoma haematobium eggs in the urine. Mass therapy for malaria (a single oral dose of 25 mg/kg of sulfadoxine-pyrimethamine) was given to all Barawan refugees 1-2 days before resettlement. Refugees >2 years of age and nonpregnant women received a single oral dose of 600 mg albendazole for intestinal parasite therapy. If mass therapy had not been provided, upon arrival in the United States an estimated 280 (7%) refugees would have had malaria infections and 1,500 (38%) would have had intestinal parasites. We conclude that enhanced health assessments provided rapid on-site assessment of parasite prevalence and helped decrease morbidity among Barawan refugees, as well as, the risk of imported infections.
authors.affiliation: Division of Quarantine, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Miller
authors.forename: H A
authors.initials: HA
authors.lastname: Boyd
authors.forename: S R
authors.initials: SR
authors.lastname: Ostrowski
authors.forename: S T
authors.initials: ST
authors.lastname: Cookson
authors.forename: M E
authors.initials: ME
authors.lastname: Parise
authors.forename: P S
authors.initials: PS
authors.lastname: Gonzaga
authors.forename: D G
authors.initials: DG
authors.lastname: Addiss
authors.forename: M
authors.initials: M
authors.lastname: Wilson
authors.forename: P
authors.initials: P
authors.lastname: Nguyen-Dinh
authors.forename: S P
authors.initials: SP
authors.lastname: Wahlquist
authors.forename: L H
authors.initials: LH
authors.lastname: Weld
authors.forename: R B
authors.initials: RB
authors.lastname: Wainwright
authors.forename: B D
authors.initials: BD
authors.lastname: Gushulak
authors.forename: M S
authors.initials: MS
authors.lastname: Cetron
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003048:Coccidiosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D003457:Cryptosporidiosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D016785:Cryptosporidium parvum / Q000302:isolation & purification; D004338:Drug Combinations; D016783:Eucoccidiida / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007223:Infant; D007411:Intestinal Diseases, Parasitic / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D016778:Malaria, Falciparum / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000706:statistics & numerical data; D008875:Middle Aged; D010963:Plasmodium falciparum / Q000302:isolation & purification; D011739:Pyrimethamine / Q000627:therapeutic use; D012036:Refugees; D012553:Schistosomiasis haematobia / Q000175:diagnosis / Q000453:epidemiology* / Q000652:urine; D012555:Schistosomiasis mansoni / Q000175:diagnosis / Q000453:epidemiology*; D012998:Somalia / Q000453:epidemiology; D013413:Sulfadoxine / Q000627:therapeutic use; D014481:United States
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011739:Pyrimethamine