Refugee Health Technical Assistance Center

Treatment of Parasitic Infections Before Arrival in U.S.  


CDC Pills

Parasitic infections take a tremendous toll in terms of human morbidity and mortality. Parasites, most notably malaria and soil-transmitted helminths, are highly prevalent in tropical and sub-tropical areas of the world from which many refugees originate.  Examples of adverse health affects from intestinal parasites are failure-to-thrive and anemia among young refugee children, many of whom are already nutritionally at risk.  


Beginning in 1999, refugees resettling in the U.S. underwent wide-scale presumptive pre-departure treatment with a single dose of albendazole. This treatment has proven to be very effective in fighting certain types of parasitic infections. More recently, morbidity and mortality of refugees have been attributed to invasive chronic parasites (i.e. Strongyloides stercoralis, Schistosoma spp), which may not be sufficiently treated by a single dose of albendazole.   In 2010, the Centers for Disease Control and Prevention revised and broadened its pre-departure guidelines for presumptive treatment to better combat these intestinal parasites as well as malaria.  


Read more about parasites and refugee health > 



  • Centers for Disease Control and Prevention (CDC) 
    Recommendations for overseas presumptive treatment of intestinal parasites and malaria for refugees destined for the U.S.
  • Domestic Guidelines for Intestinal Parasites
    Centers for Disease Control and Prevention (CDC)               
    Presumptive treatment and screening of refugees for Strongyloidiasis, Schistosomiasis and infections caused by soil-transmitted helmiths. Updated June 2013.
  • Domestic Guidelines for Malaria 

    Centers for Disease Control and Prevention (CDC)

    Presumptive treatment of P. falciparum malaria in refugees relocating from sub-Saharan Africa to the U.S.

  • Infectious Disease Challenges in Refugee Health Webinar

    Refugee Health Technical Assistance Center (RHTAC)

    This clinical webinar describes approaches for assessment of common infectious disease issues among refugees and identifies resources for information about diagnosis and management of parasitic infections in refugees.

New in the Literature


Hepatitis E outbreak, Dadaab Refugee Camp, Kenya, 2012.  (2013)

J Ahmed, E Moturi, P Spiegel, M Schilperoord, W Burton, N Kassim, A Mohamed, M Ochieng, L Nderitu, C Navarro-Colorado, H Burke, S Cookson, T Handzel, L Waiboci, J Montgomery, E Teshale, and N Marano. Emerg Infect Dis.

Investigation of hepatitis E outbreak among refugees- Upper Nile, South Sudan, 2012-2013.  (2013) Centers for Disease Control and Prevention (CDC). MMWR Morb Mortal Wkly Rep


Presumptive treatment and medical screening for parasites

in refugees resettling to the United States(2013) Stauffer WM, Cantey PT, Montgomery S, Fox L, Parise ME, Gorbacheva O, Weinberg M, Doney A, Rotz L, Cetron MS. Curr Infect Dis Rep.  


Suicide and suicidal ideation among Bhutanese refugees - United States, 2009-2012. (2013) Centers for Disease Control and Prevention (CDC). MMWR Morb Mortal Wkly Rep.


Physical activity among Somali men in Minnesota: Barriers, facilitators, and recommendations. (2013) Mohamed AA, Hassan AM, Weis JA, Sia IG, Wieland ML. Am J Mens Health.


Cervical cancer screening adherence among Somali immigrants and refugees to the United States. (2013) Morrison TB, Flynn PM, Weaver AL, Wieland ML. Health Care Women Int.


Assessing adherence to accepted national guidelines for immigrant and refugee screening and vaccines in an urban primary care practice: A retrospective chart review. (2013) Waldorf B, Gill C, Crosby SS. J Immigr Minor Health.


View more New in the Literature >

Lights, Camera, Action: ACA Videos to be Released this Fall!


RHTAC is filming a video called Refugees and the Affordable Care Act designed for newly arrived refugees to introduce them to health insurance in the U.S. and the benefits of the Affordable Care Act.  Refugees take center stage in the video by speaking on camera and providing narration.  The video will be posted on YouTube and available in six languages: English, Arabic, Karen, Kinyarwanda, Nepali, and Somali.  Stay tuned for the video's premiere this fall!


See more RHTAC resources about ACA >
ACA Updates


Outreach and Enrollment Assistance
Health centers around the country received $150 million from the U.S. Department of Health and Human Services to help people access new health coverage options available through the Affordable Care Act. 

Updated Website 
The website now contains more information for consumers about the Health Insurance Marketplace and Open Enrollment that begins on October 1, 2013. 

States and their Health Insurance Marketplaces
Profiles on each state's progress towards establishing and funding their health insurance marketplace.

Get Ready for Obamacare Video  

The Kaiser Family Foundation released a new animated video that walks through the basic changes in the way Americans will get health coverage and what it will cost when major parts of the Affordable Care Act go into effect in 2014. 

The YouToons Get Ready for Obamacare (Kaiser Family Foundation)


Learn more about ACA > 


Upcoming Events & Trainings 


2013 National Refugee and Immigrant Conference

October 10-11, 2013, Chicago, IL


American Society for Tropical Medicine and Hygiene Annual Meeting

November 13-17, 2013, Washington, DC


National Integration Conference

November 17-18, 2013, Miami, FL


North America Region Conference, International Union Against TB and Lung Diseases

February 27 - March 1, 2014, Boston, MA

Deadline for abstract submission: October 7, 2013


North American Refugee Health Conference
June 19-21, 2014, Rochester, NY


Iatrogenic Blood-borne Viral Infections in Refugee Children from War and Transition Zones (Online CME Activity)

Sponsored by Medscape and Emerging Infectious Diseases Journal.


View more events and trainings > 

Funding Opportunities  


Research to Characterize and Reduce Stigma to Improve Health

U.S. National Institutes of Health
Open date (earliest submission date): September 16, 2013. Promotes research addressing the health-related aspects of stigma, including its impact on physical and mental health; its influence on health behaviors and use, access to, and quality of received healthcare services; its contribution to health disparities; and intervention strategies to reduce health-related stigma.

  U.S. National Institutes of Health
Due January 7, 2014. Suggested research areas include: biobehavioral studies of multiple factors that influence child health disparities, studies that target specific health promotion needs of children with known illness and/or disability, and/or studies that test and evaluate comparative effectiveness of health promotion interventions.


RHTAC is a project of the Refugee and Immigrant Health Program, Massachusetts Department of Public Health, in collaboration with the Center for Refugee Trauma and Resilience at Children's Hospital Boston, the Bellevue/NYU Program for Survivors of Torture, the Cultural Orientation Resource Center at Center for Applied Linguistics, and JSI Research and Training Institute, Inc. The information contained in RHTAC newsletters do not necessarily represent the views or opinions of RHTAC's partner agencies or its funders.  RHTAC is funded by the Office of Refugee Resettlement, Administration for Children and Families, U.S. Department of Health and Human Services. Grant #90RB0042.    


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Refugee Cultural Profiles
Refugee Health Vancouver
Profiles about the culture and history of Myanmar, Bhutan, Somalia, the Democratic Republic of the Congo, Iran and Iraq.  The website also contains patient handouts in various refugee languages.


Caring for Kids New to Canada
Canadian Pediatric Society
A guide for health professionals working with immigrant and refugee children and youth with information on assessments and screenings, medical conditions, mental health, and culturally competent care.  

Role of Spirituality in the Treatment of Torture Survivors
Gulf Coast Jewish Family and Community Services
Informational guide discusses spirituality as a protective factor and strength for torture survivors as well as the importance of spirituality in torture rehabilitation.


Know Hepatitis B
U.S. Centers for Disease Control and Prevention
A national, multilingual communication campaign to increase testing for hepatitis B among Asian Americans and Pacific Islanders. The campaign delivers culturally relevant messages in English, Chinese, Korean, and Vietnamese through a variety of multimedia channels.


Rainbow Welcome Videos
Heartland Alliance
Two new videos highlight the courageous stories of gay, lesbian, and transgender refugees and their allies. 


View more resources > 



Webinar Archive   


Free CME/CEC available!    

Tools and Strategies for Refugee Mental Health Screening: Introducing the RHS-15 

Presenter: Michael Hollifield, M.D.


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