Treatment Schedules for Presumptive Parasitic Infections
This table describes presumptive anti-parasitic treatment currently provided to the largest groups of U.S.-bound refugees. The first three columns list the region, departure country, and ethnicity/national origin of the refugees. The fourth column lists recommended presumptive treatment for parasites (including malaria).
|Region||Country of Processing||Principal Refugee Groups (location)||Presumptive Parasite Treatment for Eligible Refugeesb,c||Comments|
Multiple (Addis Ababa)
|Artemether-lumefantrine since Oct 2007|
Somalis, Sudanese, Congolese (Kakuma);
|Artemether-lumefantrine since fall 2007.|
Ivermectin since Sep 2013.
|Tanzania||Congolese, Burundians (Kigoma)||Albendazole|
|Artemether-lumefantrine since July 2007|
|Rwanda, South Africa, Uganda||Somalis, Congolese||Albendazole|
|Asia||Malaysia||Burmese (Kuala Lumpur)||Albendazole|
|Albendazole for children 1-2 yo since Nov 2011.|
Ivermectin since Feb 2013.
|Nepal||Bhutanese (Beldangi, Sanischare, Khudunabari); other (urban)||Albendazole|
|Albendazole for children 1-2 yo since Feb 2012.|
Ivermectin since Jan 2013.
|Thailand||Burmese (Thailand-Burma border);|
|Albendazole for children 1-2 yo since Oct 2011.|
Ivermectin since July 2011.
|Mideast||Iraq||Iraqis (Baghdad, Al Walid camp)||Albendazole||N/A|
|Lebanon, Syria, Turkey, Egypt||Multiple||None||N/A|
|Europe||Russia, Ukraine, Moldova||Russians, Afghanis, Ukranians, Moldovans||None||N/A|
|Americas||Cuba, other||Cubans, Colombians||None||N/A|
a Information provided by the International Organization for Migration (IOM) during required overseas refugee medical exam.
b Presumptive parasite treatments: Albendazole (for soil-transmitted helminths), 400 mg for refugees ≥ 2 yo; Albendazole, 200 mg for those 1-2 yo; Ivermectin (for strongyloides), 200 μg/kg x 2 d; and Praziquantel (for schistosomiasis), 40 mg/kg divided in 2 doses. See http://www.cdc.gov/immigrantrefugeehealth/guidelines/overseas/intestinal-parasites-overseas.html. Arthemether-lumifantrine (AL, for malaria) 6-dose treatment. See http://www.cdc.gov/immigrantrefugeehealth/guidelines/overseas/malaria-guidelines-overseas.html#opl.
c Over 75% compliance rates with administration of presumptive parasite treatment have been documented for the countries listed on this table. If a country does not appear on this table, then compliance rates in that country are uncertain, so clinicians should use their judgment on a screening vs. presumptive treatment approach.