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Severe Plasmodium falciparum malaria in refugee children despite reported predeparture antimalarial treatment

Sarah Cherian, Joanna M Fagan, Aesen Thambiran, Janet Geddes and David Burgner
Med J Aust 2006; 185 (11): . || doi: 10.5694/j.1326-5377.2006.tb00728.x
Published online: 4 December 2006

To the Editor: Predeparture screening and treatment for Plasmodium falciparum malaria is increasingly administered to humanitarian refugees from malaria-endemic areas immediately before resettlement in Australia. It is undertaken by the International Organization for Migration (IOM), under contract from the Department of Immigration and Multicultural Affairs (DIMA).1 Combination therapy (usually an artemisinin derivative in combination with another drug, or chloroquine) is used for both adults and children. The first dose (of what is usually a 3–5-dose treatment course) is supervised, and written documentation of the treatment should accompany the refugee to Australia.1 Giving predeparture antimalarial treatment has the potential benefit of reducing the incidence of malaria after arrival, as well as reducing the risk of local transmission in malaria-receptive areas of Australia.


  • 1 School of Paediatrics and Child Health, University of Western Australia, Perth, WA.
  • 2 Princess Margaret Hospital for Children, Perth, WA.
  • 3 Migrant Health Unit, North Metropolitan Area Health Service, Perth, WA.


Correspondence: dburgner@meddent.uwa.edu.au

Acknowledgements: 

We thank Dr Ronan Murray for his helpful advice and input into this manuscript.

  • 1. Humanitarian Business Process Section, Australian Government Department of Immigration and Multicultural Affairs. Health screening protocols for refugee and special humanitarian program entrants to Australia from east and west Africa. Version 1.4. Canberra: DIMA, 2006: 1-10.
  • 2. Pan American Health Organization. Position of WHO’s Roll Back Malaria Department on malaria treatment policy. http://www.paho.org/English/AD/DPC/CD/mal-who-position-paper.htm (accessed July 2006).
  • 3. Greenwood BM, Bojang K, Whitty CJ, Targett GA. Malaria. Lancet 2005; 365: 1487-1498.
  • 4. Piola P, Fogg C, Bajunirwe F, et al. Supervised versus unsupervised intake of six-dose artemether-lumefantrine for treatment of acute, uncomplicated Plasmodium falciparum malaria in Mbarara, Uganda: a randomised controlled trial. Lancet 2005; 365: 1467-1473.
  • 5. Snow RW, Guerra CA, Noor AM, et al. The global distribution of clinical episodes of Plasmodium falciparum malaria. Nature 2005; 434: 214-217.
  • 6. John CC. Malaria. In: Rudolph C, Rudolph A, editors. Rudolph’s pediatrics. 21st ed. New York: McGraw-Hill, 2003: 1136-1143.
  • 7. Rowe AK, Rowe SY, Snow RW, et al. The burden of malaria mortality among African children in the year 2000. Int J Epidemiol 2006; 35: 691-704.
  • 8. United Nations High Commissioner for Refugees. Refugees by numbers. 2006 edition. Geneva: UNHCR, 2005. http://www.unhcr.org/cgi-bin/texis/vtx/basics/opendoc.htm?tbl=BASICS&id=3b028097c (accessed Nov 2006).

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