Guidelines for the U.S. Domestic Medical Examination for Newly Arriving Refugees
The following guidelines were developed by CDC to assist State public health departments and medical professionals/clinicians in determining the best tests to perform based on evidence during routine post-arrival medical screening of refugees. These guidelines are intended as recommendations rather than as mandates.
Checklist and Disease-Specific Guidelines for Medical Screening
Domestic Medical Screening Checklist
This checklist has been developed to summarize the guidelines. For more details about any specific task, click the links within the text to read specific sections of the complete guidelines.
Full Text of All Domestic Guidelines
Currently 12 guidelines are available.
- General Guidelines
- Guidelines for the History and Physical
- HIV Infection Screening Guidelines
- Immunizations Guidelines
- Intestinal Parasite Guidelines
- Lead Screening Guidelines
- Mental Health Screening Guidelines
- Malaria Guidelines
- Nutrition and Growth Guidelines
- Sexually Transmitted Diseases Guidelines
- Tuberculosis Guidelines
- Viral Hepatitis Guidelines
Information on presumptive therapy received
- All eligible refugees from the Middle East, South Asia, Southeast Asia and Africa are currently receiving a pre-departure single dose of predeparture albendazole for intestinal helminths (as of June 2010).
- All eligible sub-Saharan Africa refugees are currently receiving predeparture praziquantel for schistosomiasis (began January, 2010).
- As of July 4, 2011, presumptive ivermectin therapy for strongyloides is being offered to eligible Burmese refugees who are departing from Thailand. If received, this will be indicated on the pre-departure medical screening form along with other presumptive treatment they received.
- All eligible sub-Saharan African refugees are receiving combination artesunate therapy for malaria prior to departure (2008).
- Records of presumptive treatment received by the refugee are available in the IOM or Blue and White bag carried by the refugee. The provider may also check with the volunteer agency coordinating the refugee care if they have a copy of the records. In addition, records will be made available to State Refugee Health Coordinators through the Electronic Data Network (EDN) and through WRAPS. If documentation of treatment is not available it should be assumed the refugee did not receive presumptive therapy.
- Current Immunization Schedules for U.S.–Bound Refugees–September 2012
Development of the Guidelines / Authors
These guidelines are the culmination of a consensus process based on available evidence-based data. DGMQ began to develop the guidelines in September 2006. The guidelines are planned to encompass 14 areas to be addressed during the domestic medical screening visit or on the initial primary care follow-up visit. More
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