{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:50:43Z","timestamp":1787169043641,"version":"build-2736575974"},"reference-count":36,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,3,7]]},"abstract":"<jats:p>\n                    With an unprecedented number of displaced persons worldwide, strategies for improving the health of migrating populations are critical. United States\u2013bound refugees undergo a required overseas medical examination to identify inadmissible conditions (e.g., tuberculosis) 2\u20136 months before resettlement, but it is limited in scope and may miss important, preventable infectious, chronic, or nutritional causes of morbidity. We sought to evaluate the feasibility and health impact of diagnosis and management of such conditions before travel. We offered voluntary testing for intestinal parasites, anemia, and hepatitis B virus infection, to U.S.-bound refugees from three Thailand\u2013Burma border camps. Treatment and preventive measures (e.g., anemia and parasite treatment, vaccination) were initiated before resettlement. United States refugee health partners received overseas results and provided post-arrival medical examination findings. During July 9, 2012 to November 29, 2013, 2,004 refugees aged 0.5\u201389 years enrolled. Among 463 participants screened for seven intestinal parasites overseas and after arrival, helminthic infections decreased from 67% to 12%. Among 118 with positive\n                    <jats:italic>Strongyloides<\/jats:italic>\n                    -specific antibody responses, the median fluorescent intensity decreased by an average of 81% after treatment. The prevalence of moderate-to-severe anemia (hemoglobin &lt; 10 g\/dL) was halved from 14% at baseline to 7% at departure (McNemar\n                    <jats:italic>P<\/jats:italic>\n                    = 0.001). All 191 (10%) hepatitis B\u2013infected participants received counseling and evaluation; uninfected participants were offered vaccination. This evaluation demonstrates that targeted screening, treatment, and prevention services can be conducted during the migration process to improve the health of refugees before resettlement. With more than 250 million migrants globally, this model may offer insights into healthier migration strategies.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.17-0725","type":"journal-article","created":{"date-parts":[[2017,12,19]],"date-time":"2017-12-19T02:01:03Z","timestamp":1513648863000},"page":"920-928","source":"Crossref","is-referenced-by-count":31,"title":["Impact of Enhanced Health Interventions for United States\u2013Bound Refugees: Evaluating Best Practices in Migration Health"],"prefix":"10.4269","volume":"98","author":[{"given":"Tarissa","family":"Mitchell","sequence":"first","affiliation":[{"name":"Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Weinberg","sequence":"additional","affiliation":[{"name":"Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Phares","sequence":"additional","affiliation":[{"name":"Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"James","sequence":"additional","affiliation":[{"name":"International Organization for Migration, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kittisak","family":"Amornpaisarnloet","sequence":"additional","affiliation":[{"name":"International Organization for Migration, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lalita","family":"Aumpipat","sequence":"additional","affiliation":[{"name":"International Organization for Migration, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gretchen","family":"Cooley","sequence":"additional","affiliation":[{"name":"Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Davies","sequence":"additional","affiliation":[{"name":"International Organization for Migration, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie Daw","family":"Tin Shwe","sequence":"additional","affiliation":[{"name":"International Organization for Migration, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasil","family":"Gajdadziev","sequence":"additional","affiliation":[{"name":"International Organization for Migration, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Gorbacheva","sequence":"additional","affiliation":[{"name":"International Organization for Migration, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chutharat","family":"Khwan-Niam","sequence":"additional","affiliation":[{"name":"International Organization for Migration, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Klosovsky","sequence":"additional","affiliation":[{"name":"International Organization for Migration, Washington, DC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waritorn","family":"Madilokkowit","sequence":"additional","affiliation":[{"name":"International Organization for Migration, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Martin","sequence":"additional","affiliation":[{"name":"Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naing Zaw","family":"Htun Myint","sequence":"additional","affiliation":[{"name":"International Organization for Migration, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thi Ngoc","family":"Yen Nguyen","sequence":"additional","affiliation":[{"name":"International Organization for Migration, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas B.","family":"Nutman","sequence":"additional","affiliation":[{"name":"Laboratory of Parasitic Diseases, National Institutes of Health, Bethesda, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise M.","family":"O\u2019Connell","sequence":"additional","affiliation":[{"name":"Laboratory of Parasitic Diseases, National Institutes of Health, Bethesda, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Ortega","sequence":"additional","affiliation":[{"name":"Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sugunya","family":"Prayadsab","sequence":"additional","affiliation":[{"name":"International Organization for Migration, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chetdanai","family":"Srimanee","sequence":"additional","affiliation":[{"name":"International Organization for Migration, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wasant","family":"Supakunatom","sequence":"additional","affiliation":[{"name":"International Organization for Migration, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vattanachai","family":"Vesessmith","sequence":"additional","affiliation":[{"name":"International Organization for Migration, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William M.","family":"Stauffer","sequence":"additional","affiliation":[{"name":"Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia;"},{"name":"Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","author":"United Nations High Commissioner for Refugees (UNHCR)","year":"2015"},{"key":"b2","author":"U.S. Department of State","year":"2016"},{"key":"b3","author":"Centers for Disease Control and Prevention (CDC)","year":"2014"},{"key":"b4","author":"Centers for Disease Control and Prevention (CDC)","year":"2014"},{"key":"b5","series-title":"PLoS Negl Trop Dis","first-page":"e004910","article-title":"Economic analysis of the impact of overseas and domestic treatment and screening options for intestinal helminth infection among US-bound refugees from Asia","volume":"10","author":"Maskery","year":"2016"},{"key":"b6","series-title":"Hepatology","first-page":"S35","article-title":"Recommendations for identification and public health management of persons with chronic hepatitis B virus infection","volume":"49","author":"Weinbaum","year":"2009"},{"key":"b7","author":"Centers for Disease Control and Prevention (CDC)","year":"2014"},{"key":"b8","author":"Centers for Disease Control and Prevention (CDC)","year":"2013"},{"key":"b9","series-title":"J Pediatr","first-page":"791","article-title":"Serum erythropoietin levels during infancy: associations with erythropoiesis","volume":"128","author":"Kling","year":"1996"},{"key":"b10","series-title":"PLoS Negl Trop Dis","first-page":"e0004699","article-title":"Integration of multiplex bead assays for parasitic diseases into a national, population-based serosurvey of women 15\u201339 years of age in Cambodia","volume":"10","author":"Priest","year":"2016"},{"key":"b11","series-title":"Diagn Microbiol Infect Dis","first-page":"19","article-title":"Application of enzyme immunoassay for postchemotherapy evaluation of human strongyloidiasis","volume":"18","author":"Kobayashi","year":"1994"},{"key":"b12","series-title":"Parasit Vectors","first-page":"38","article-title":"Multi-parallel qPCR provides increased sensitivity and diagnostic breadth for gastrointestinal parasites of humans: field-based inferences on the impact of mass deworming","volume":"9","author":"Easton","year":"2016"},{"key":"b13","series-title":"Lancet Infect Dis","first-page":"498","article-title":"Safety and efficacy of PfSPZ vaccine against Plasmodium falciparum via direct venous inoculation in healthy malaria-exposed adults in Mali: a randomised, double-blind phase 1 trial","volume":"17","author":"Sissoko","year":"2017"},{"key":"b14","author":"World Health Organization","year":"2016"},{"key":"b15","first-page":"187","author":"Averhoff","year":"2017"},{"key":"b16","series-title":"Asian Am Pac Isl J Health","first-page":"162","article-title":"The declining prevalence of hepatitis B virus infection among Asian and Pacific Islander children","volume":"9","author":"Vryheid","year":"2001"},{"key":"b17","series-title":"Am J Public Health","first-page":"1460","article-title":"Increasing hepatitis B vaccine prevalence among refugee children arriving in the United States, 2006\u20132012","volume":"106","author":"Yun","year":"2016"},{"key":"b18","author":"Centers for Disease Control and Prevention (CDC)","year":"2016"},{"key":"b19","series-title":"PLoS One","first-page":"e78548","article-title":"Hepatitis B screening and vaccination strategies for newly arrived adult Canadian immigrants and refugees: a cost-effectiveness analysis","volume":"8","author":"Rossi","year":"2013"},{"key":"b20","series-title":"Vaccine","first-page":"1393","article-title":"Cost-benefit comparison of two proposed overseas programs for reducing chronic hepatitis B infection among refugees: is screening essential?","volume":"33","author":"Jazwa","year":"2015"},{"key":"b21","series-title":"PLoS One","first-page":"e27717","article-title":"The increasing burden of imported chronic hepatitis B\u2014United States, 1974\u20132008","volume":"6","author":"Mitchell","year":"2011"},{"key":"b22","series-title":"Curr Opin Infect Dis","first-page":"458","article-title":"Screening, prevention, and treatment for hyperinfection syndrome and disseminated infections caused by Strongyloides stercoralis","volume":"25","author":"Mejia","year":"2012"},{"key":"b23","series-title":"Chest","first-page":"3681","article-title":"Strongyloides hyperinfection presenting as acute respiratory failure and gram-negative sepsis","volume":"128","author":"Newberry","year":"2005"},{"key":"b24","series-title":"Clin Vaccine Immunol","first-page":"732","article-title":"Comparison of three immunoassays for detection of antibodies to Strongyloides stercoralis","volume":"21","author":"Anderson","year":"2014"},{"key":"b25","series-title":"PLoS Negl Trop Dis","first-page":"e2002","article-title":"The laboratory diagnosis and follow up of strongyloidiasis: a systematic review","volume":"7","author":"Requena-M\u00e9ndez","year":"2013"},{"key":"b26","series-title":"Can J Infect Dis Med Microbiol","first-page":"93","article-title":"Eosinophilia: a poor predictor of Strongyloides infection in refugees","volume":"24","author":"Naidu","year":"2013"},{"key":"b27","series-title":"Open Forum Infect Dis","first-page":"ofw029","article-title":"Strongyloides stercoralis, eosinophilia, and type 2 diabetes mellitus: the predictive value of eosinophilia in the diagnosis of S. stercoralis infection in an endemic community","volume":"3","author":"Hays","year":"2016"},{"key":"b28","series-title":"Bull World Health Organ","first-page":"562","article-title":"Mass treatment with ivermectin: an underutilized public health strategy","volume":"82","author":"Speare","year":"2004"},{"key":"b29","series-title":"N Engl J Med","first-page":"773","article-title":"The cost effectiveness of strategies for the treatment of intestinal parasites in immigrants","volume":"340","author":"Muennig","year":"1999"},{"key":"b30","series-title":"Curr Opin Microbiol","first-page":"47","article-title":"An up-date on Giardia and giardiasis","volume":"34","author":"Einarsson","year":"2016"},{"key":"b31","series-title":"Acta Trop","first-page":"17","article-title":"Age-dependent decline and association with stunting of Giardia duodenalis infection among schoolchildren in rural Huye district, Rwanda","volume":"145","author":"Heimer","year":"2015"},{"key":"b32","author":"World Health Organization (WHO)","year":"2016"},{"key":"b33","series-title":"Cochrane Database Syst Rev","first-page":"CD006589","article-title":"Oral iron supplements for children in malaria-endemic areas","volume":"2","author":"Neuberger","year":"2016"},{"key":"b34","author":"The Border Consortium","year":"2016"},{"key":"b35","series-title":"Pediatrics","first-page":"e392","article-title":"Lead poisoning in United States-bound refugee children: Thailand\u2013Burma border, 2009","volume":"129","author":"Mitchell","year":"2012"},{"key":"b36","author":"Sphere Project","year":"2011"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/98\/3\/article-p920.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/98\/3\/article-p920.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/98\/3\/article-p920.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T19:06:31Z","timestamp":1722452791000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/98\/3\/article-p920.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,7]]},"references-count":36,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.17-0725","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,7]]}}}