Lead screening during the domestic medical examination for newly arrived refugees

Includes bibliographical references

Technical instructions for tuberculosis screening and treatment using cultures and directly observed therapy

"The medical screening for tuberculosis among persons overseas applying for U.S. immigration status and nonimmigrants who are required to have an overseas medical examination, hereafter referred to as applicants, is an essential component of the medical evaluation. Because tuberculosis is a challenging disease to diagnose, treat, and control, these instructions are designed to detect and treat tuberculosis disease among applicants and to reduce the risk of spread of tuberculosis among the U.S. population after immigration. The instructions in this document supersede all previous Technical Instructions, Updates to the Technical Instructions, memoranda and letters to panel physicians, and memoranda and letters to international refugee resettlement organizations. These instructions are to be followed for tuberculosis screening and treatment among all applicants." - prefacePreface -- Tuberculosis screening -- Tuberculosis screening results and travel clearance -- Tuberculosis treatment -- Waivers -- Tuberculosis treatment monitoring -- Contacts of tuberculosis cases -- Tuberculosis classifications and descriptions -- Documentation -- APPENDIX A. Glossary of Abbreviations -- APEENDIX B. Definitions -- APPENDIX C. Sputum Collection -- APPENDIX D. Useful Web Links -- APPENDIX E. Additional Instuctions for Large Refugee Resettlements -- APPENDIX F. Pre-Departure Evalution -- APPENDIX G. Tuberculosis Indicators"October 1, 2009.""For any questions about these Technical Instructions, please contact the Immigrant, Refugee, and Migrant Health Branch of the Division of Global Migration and Quarantine (DGMQ), Centers for Disease Control and Prevention (CDC)."Available via Internet from the National Center for Preparedness, Detection, and Control of Infectious Diseases Division of Global Migration and Quarantine web site as an Acrobat .pdf file (315.17 KB, 40 p.). Address as of 4/11/2011: http://www.cdc.gov/immigrantrefugeehealth/pdf/tuberculosis-ti-2009.pd

Marlaria

Each year 50-70,000 refugees are accepted for resettlement to the United States. Refugees from sub-Saharan Africa account for an increasing proportion of these newly arriving refugees and now constitute more than a third of new arrivals. The proportion of newly arriving refugees who originate in Africa has climbed from 9%, in 1998 to 39% in 2005. This shift in population has been accompanied by changing patterns of infection and illness in newly arriving refugees. Because of its potential virulence and dynamic epidemiology, including its high prevalence, malaria has emerged as a disease of particular concern in this population. Each year 50-70,000 refugees are accepted for resettlement to the United States. Refugees from sub-Saharan Africa account for an increasing proportion of these newly arriving refugees and now constitute more than a third of new arrivals. The proportion of newly arriving refugees who originate in Africa has climbed from 9%, in 1998 to 39% in 2005. This shift in population has been accompanied by changing patterns of infection and illness in newly arriving refugees. Because of its potential virulence and dynamic epidemiology, including its high prevalence, malaria has emerged as a disease of particular concern in this population. Malaria was endemic in most of the continental United States and much of Europe into the 20th century. Most of the continental United States has Anopheles mosquitoes (particularly An. quadramaculatus and An. freeborni) which are competent vectors under favorable conditions. Local U.S. vector-borne transmission has resulted in 156 known malaria cases in 63 U.S. outbreaks over the past 50 years. In addition, more than 1000 cases of malaria are reported annually in the U.S. with migration playing an important role in the importation of these cases. In endemic areas, malaria has historically plagued displaced populations, and this situation continues in many contemporary refugee camps. Refugees are often not included in the host country's national health programs, which may lead to higher rates of many diseases, including malaria and other parasitic infections.Summary and background -- Recommendations for pre-departure presumptive and directed treatment for P. falciparum Infection for refugees from sub-Saharan Africa -- Recommendations for post-arrival presumptive and directed treatment for malaria for refugees from sub-Saharan Africa -- Precautions and contraindications to presumptive treatment -- Refugees from other regions -- Strategies to prevent non-falciparum malaria in newly arriving refugees.November 13, 2012.Available via the World Wide Web as an Acrobat .pdf file (200 KB, 13 p.).Includes bibliographical references