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Treatment Schedules for Presumptive Parasitic Infections

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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).

Treatment Schedules for Presumptive Parasitic Infections for U.S.-Bound Refugees, administered by IOMa—January 2014
RegionCountry of ProcessingPrincipal Refugee Groups (location)Presumptive Parasite Treatment for Eligible Refugeesb,cComments
AfricaEthiopiaEritreans (Shimelba);
Somalis (Kebribeya);
Multiple (Addis Ababa)
Albendazole
Praziquantel
Ivermectin
Artemether-lumefantrine
Artemether-lumefantrine since Oct 2007
Ivermectin since Jan 2014
KenyaSomalis (Dadaab);
Somalis, Sudanese, Congolese (Kakuma);
Multiple (Nairobi)
Albendazole
Praziquantel
Ivermectin
Artemether-lumefantrine
Artemether-lumefantrine since fall 2007.
Ivermectin since Sep 2013.
TanzaniaCongolese, Burundians (Kigoma)Albendazole
Praziquantel
Artemether-lumefantrine
Artemether-lumefantrine since July 2007
Rwanda, South Africa, UgandaSomalis, CongoleseAlbendazole
Praziquantel
Artemether-lumefantrine
N/A
AsiaMalaysiaBurmese (Kuala Lumpur)Albendazole
Ivermectin
Albendazole for children 1-2 yo since Nov 2011.
Ivermectin since Feb 2013.
NepalBhutanese (Beldangi, Sanischare, Khudunabari); other (urban)Albendazole
Ivermectin
Albendazole for children 1-2 yo since Feb 2012.
Ivermectin since Jan 2013.
ThailandBurmese (Thailand-Burma border);
other (urban)
Albendazole
Ivermectin
Albendazole for children 1-2 yo since Oct 2011.
Ivermectin since July 2011.
MideastIraqIraqis (Baghdad, Al Walid camp)AlbendazoleN/A
JordanIraqis (Amman)AlbendazoleN/A
Lebanon, Syria, Turkey, EgyptMultipleNoneN/A
EuropeRussia, Ukraine, MoldovaRussians, Afghanis, Ukranians, MoldovansNoneN/A
AmericasCuba, otherCubans, ColombiansNoneN/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.

 
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