Causer Louise M, Bishop Henry S, Sharp Donald J, Flagg Elaine W, Calderon Jaime F, Keane Vincent, Shah J Jina, Macarthur John R, Maloney Susan A, Cetron Martin S, Bloland Peter B
Division of Parasitic Diseases and Division of Global Migration and Quarantine, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
Am J Trop Med Hyg. 2005 Jun;72(6):688-93.
In 2002, a group of Montagnard refugees living in Cambodia was accepted for resettlement in the United States. Pre-departure malaria screening and targeted treatment was conducted to prevent morbidity, and minimize the potential for local malaria transmission post-arrival. We screened 902 of 906 refugees using rapid diagnostic tests (RDTs), microscopy, and polymerase chain reaction (PCR) analysis. Twelve (1.3%) RDT results were positive and 28 (3.1%) were indeterminate. Microscopy confirmed Plasmodium species in two of the positive RDT and one of the indeterminate results. Among a random 10% sample of negative RDT results (n = 86), none were positive by microscopy. The PCR confirmed the two microscopically (and RDT) positive specimens. The PCR result was negative for all other specimens tested. Eighteen (2.0%) refugees were treated with antimalarials. The RDTs were useful in this setting, facilitating timely, sensitive diagnosis and targeted treatment. Evaluations to determine the most appropriate interventions in other refugee settings should include cost-effectiveness analyses of alternative strategies.
2002年，一群居住在柬埔寨的蒙塔格纳德难民被美国接纳重新安置。出发前进行了疟疾筛查和针对性治疗，以预防发病，并尽量减少抵达后当地疟疾传播的可能性。我们使用快速诊断测试（RDT）、显微镜检查和聚合酶链反应（PCR）分析对906名难民中的902人进行了筛查。12例（1.3%）RDT结果呈阳性，28例（3.1%）结果不确定。显微镜检查在2例阳性RDT结果和1例不确定结果中确认了疟原虫种类。在随机抽取的10%的阴性RDT结果样本（n = 86）中，显微镜检查均未呈阳性。PCR确认了2例显微镜检查（以及RDT）呈阳性的标本。其他所有检测标本的PCR结果均为阴性。18名（2.0%）难民接受了抗疟治疗。RDT在这种情况下很有用，有助于及时、敏感地诊断和针对性治疗。确定其他难民环境中最合适干预措施的评估应包括对替代策略的成本效益分析。
