Expert opinion: Is screening for malaria necessary among asymptomatic refugees and immigrants coming from endemic countries?Archived
This article assesses the findings of a recent Canadian study which measured malaria prevalence among recently arrived asymptomatic refugees.
Monge-Maillo B, López-Vélez R.Expert Rev Anti Infect Ther. 2011 May;9(5):521-4
This article assesses the findings of a recent Canadian study which measured malaria prevalence among recently arrived asymptomatic refugees (Matisz CE, Naidu P, Shokoples SE et al. Post-arrival screening for malaria in asymptomatic refugees using real-time PCR. Am. J. Trop. Med. Hyg. 84, 161-165 (2010). A total of 324 refugees were screened for malaria, obtaining a global prevalence of 3.1% by PCR.
ECDC comment: Although malaria is now essentially limited to tropical countries there is a small potential for its reappearance in countries where it was previously eradicated and Anopheles mosquitoes are present, including Europe, where a large number of imported cases are reported every year. Given malaria’s potential impact on individual and public health out of the tropics where it affects mainly mobile population groups, such as travellers, immigrants and refugees who can be exposed at their countries of origin or transit, the authors suggest implementation of malaria screening among refugees and immigrants even if asymptomatic. In this study, the prevalence of malaria among screened asymptomatic refugees was 3.1%. Screening needs to be performed in specialized centres where PCR is available. However, the high cost of PCR and the necessary infrastructure can limit such a measure. On the other hand, pre-departure administration of malaria treatment has clearly been cost effective in some studies and reduced significantly the incidence of malaria. This study may help elaborate more specific protocols for screening and treatment of infectious diseases in these mobile populations. However, more studies of the prevalence on infectious diseases, including P. falciparum or P. vivax (as well as other plasmodium species) malaria, in recently arrived immigrants and refuges are needed to guide specific public health interventions which will vary between countries based on the number of the refugees and immigrants hosted and their country of origin.