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Poor conditions in refugee camps make malaria screening difficult: expert
Although it would have been preferable to have screened some African refugees for malaria before the disease was discovered after their arrival in Canada, a Montreal tropical disease specialist says the rudimentary laboratory facilities available in refugee camps make such screening difficult or impossible. "In hindsight it is easy to say that yes, these people should have been screened, but to screen in a refugee camp is no easy matter," Dr. Dick MacLean said of the 12 cases of malaria diagnosed among 240 refugees who arrived in Canada in August from a refugee camp in Burundi. He also said that such cases are not new among refugees arriving in Canada. "We certainly saw cases when Southeast Asians arrived in large numbers from Vietnam, Laos and Cambodia in the early 1980s, but the amount of malaria found in the refugee camps in Burundi and the Central Congo is probably greater than it was in the Asian camps." MacLean, senior physician at the Montreal General Hospital, said his hospital sees 25 to 30 patients a year who have malaria, while the Toronto General Hospital sees 30 to 40. He said the cost of treating them is relatively small. "The cost is not in the price of the pills but in diagnosing the disease," he said. Diagnosis can be delayed because most Canadian physicians are not familiar with malaria. MacLean, director of the McGill Centre for Tropical Disease, said new cases of malaria will be identified among the African refugees for 2 to 3 more months. Health Canada says the cases involving the Africans may lead to new screening recommendations for Immigration Canada. Meanwhile, MacLean says the 12 cases should be treated "as a learning experience rather than as something to panic over." — Patrick Sullivan, CMAJ
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