Malaria in the Australian refugee population.

BACKGROUND: Malaria is a serious health problem in many of the countries from which refugees come to Australia. Anopheles mosquitoes capable of transmitting malaria are present in the far north of Australia and in these areas, the detection and appropriate treatment of malaria is vital, not only for the health of the individuals and their families, but as a significant public health issue.
OBJECTIVE: This article outlines screening, assessment and management of malaria in the refugee population. DISCUSSION: Most malaria does not follow the classic pattern of periodic fever with paroxysms of cold, hot and sweating stages. There should be a high index of suspicion for anyone from an endemic area presenting with fever, vomiting, diarrhoea, headache and/or muscle pain, even if they have been tested or treated for malaria. What is most likely to be a nonspecific viral illness in someone who has never left Australia might be an urgent life threatening illness in a recently arrived refugee. Therefore all refugees from endemic areas, whether symptomatic or not, should be screened as soon as possible after arrival. Appropriate treatment is expensive and should be monitored by a hospital, but can be done as an outpatient in some individuals. Follow up with thick and thin films as a 'test of cure' should be done at 28 days.