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

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.