Rapid malaria screening and targeted treatment of United States-bound Montagnard refugees from Cambodia in 2002.
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.
Causer
Louise M
LM
Division of Parasitic Diseases and Division of Global Migration and Quarantine, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA. lsc6@cdc.gov
Bishop
Henry S
HS
Sharp
Donald J
DJ
Flagg
Elaine W
EW
Calderon
Jaime F
JF
Keane
Vincent
V
Shah
J Jina
JJ
Macarthur
John R
JR
Maloney
Susan A
SA
Cetron
Martin S
MS
Bloland
Peter B
PB
D000962:Antimalarials / Q000627:therapeutic use; D002160:Cambodia / Q000453:epidemiology; D006801:Humans; D008288:Malaria / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D012036:Refugees
D000962:Antimalarials