title: Presumptive treatment and medical screening for parasites in refugees resettling to the United States.
abstract: More than 50,000 refugees are resettled to the United States annually, many from areas highly endemic for parasites. Some of these infections present little clinical consequence after migration, but others are responsible for morbidity and mortality. The Centers for Disease Control and Prevention has issued predeparture presumptive treatment and postarrival medical guidelines for the management of parasites. Although these guidelines are evidence based, there remain significant challenges to presumptive treatment programs in refugees. Gaps in the evidence continue; resettling populations are continually changing, thus altering the epidemiology; and there are logistical and cost barriers to fully implementing recommendations. This article will review the evolution and status of current guidelines, as well as identify gaps and challenges to full implementation. It is imperative for clinicians serving this population to be familiar with interventions received by refugees, since previous treatment will impact screening, diagnostic evaluation, and treatment decisions.
authors.affiliation: Department of Medicine, Division of Infectious Diseases and International Medicine, University of Minnesota, 420 Delaware Street SE, Mayo Building D407, MMC 250, Minneapolis, MN, 55455, USA, Stauf005@umn.edu.
authors.forename: William M
authors.initials: WM
authors.lastname: Stauffer
authors.forename: Paul T
authors.initials: PT
authors.lastname: Cantey
authors.forename: Susan
authors.initials: S
authors.lastname: Montgomery
authors.forename: Leanne
authors.initials: L
authors.lastname: Fox
authors.forename: Monica E
authors.initials: ME
authors.lastname: Parise
authors.forename: Olga
authors.initials: O
authors.lastname: Gorbacheva
authors.forename: Michelle
authors.initials: M
authors.lastname: Weinberg
authors.forename: Annelise
authors.initials: A
authors.lastname: Doney
authors.forename: Lisa
authors.initials: L
authors.lastname: Rotz
authors.forename: Martin S
authors.initials: MS
authors.lastname: Cetron