Malaria Quick Guide - Clinicians should have a high index of
suspicion for malaria, particularly for refugees from tropical
and subtropical areas who have fever of unknown origin or other
characteristic symptoms. Asymptomatic Subclinical Infection -
Sub-Saharan Africans frequently originate in highly endemic
areas where potentially asymptomatic subclinical infection is
common and should undergo either presumptive treatment on
arrival (preferred) if there is no documentation of pre-
departure therapy, or have laboratory screening. - Pregnant
women, lactating women, and persons with other contraindications
such as allergy or hypersensitivity to medications are excluded
from all presumptive regimens. These individuals should undergo
diagnostic testing and receive directed treatment if they are
found to have malaria and may need to be referred to a
specialist for therapy. - For all other refugees, subclinical
infection is rare and testing should be performed only in
individuals with signs or symptoms suggestive of