Document Detail

Presumptive treatment to reduce imported malaria among refugees from east Africa resettling in the United States.
MedLine Citation:
PMID:  21976559     Owner:  NLM     Status:  MEDLINE    
During May 4, 2007-February 29, 2008, the United States resettled 6,159 refugees from Tanzania. Refugees received pre-departure antimalarial treatment with sulfadoxine-pyrimethamine (SP), partially supervised (three/six doses) artemether-lumefantrine (AL), or fully supervised AL. Thirty-nine malaria cases were detected. Disease incidence was 15.5/1,000 in the SP group and 3.2/1,000 in the partially supervised AL group (relative change = -79%, 95% confidence interval = -56% to -90%). Incidence was 1.3/1,000 refugees in the fully supervised AL group (relative change = -92% compared with SP group; 95% confidence interval = -66% to -98%). Among 39 cases, 28 (72%) were in refugees < 15 years of age. Time between arrival and symptom onset (median = 14 days, range = 3-46 days) did not differ by group. Thirty-two (82%) persons were hospitalized, 4 (10%) had severe manifestations, and 9 (27%) had parasitemias > 5% (range = < 0.1-18%). Pre-departure presumptive treatment with an effective drug is associated with decreased disease among refugees.
Christina R Phares; Bryan K Kapella; Annelise C Doney; Paul M Arguin; Michael Green; Leul Mekonnen; Aleksander Galev; Michelle Weinberg; William M Stauffer
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of tropical medicine and hygiene     Volume:  85     ISSN:  1476-1645     ISO Abbreviation:  Am. J. Trop. Med. Hyg.     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-06     Completed Date:  2011-11-21     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  0370507     Medline TA:  Am J Trop Med Hyg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  612-5     Citation Subset:  AIM; IM    
Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, Georgia, USA.
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MeSH Terms
Antimalarials / administration & dosage,  therapeutic use*
Artemisinins / administration & dosage,  therapeutic use*
Child, Preschool
Drug Combinations
Ethanolamines / administration & dosage,  therapeutic use*
Fluorenes / administration & dosage,  therapeutic use*
Malaria / prevention & control*
Pyrimethamine / therapeutic use*
Sulfadoxine / therapeutic use*
Tanzania / ethnology
United States
Reg. No./Substance:
0/Antimalarials; 0/Artemisinins; 0/Drug Combinations; 0/Ethanolamines; 0/Fluorenes; 2447-57-6/Sulfadoxine; 37338-39-9/fanasil, pyrimethamine drug combination; 58-14-0/Pyrimethamine; C7D6T3H22J/artemether; F38R0JR742/lumefantrine

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