Medication regimen and dosing for presumptive treatment of parasitic infections

Refugee population	Regimens by pathogen
Refugee population	Soil-transmitted helminths: Albendazole*	Strongyloidiasis: Ivermectin*	Schistosomiasis^¶: Praziquantel^Δ
Adults
Asia, Middle East, North Africa, Latin American, and Caribbean	Albendazole 400 mg orally (single dose)	Ivermectin 200 mcg/kg/day orally once a day for two days	Not recommended
Sub-Saharan Africa, non-Loa loa-endemic area	Albendazole 400 mg orally (single dose)	Ivermectin 200 mcg/kg/day orally once a day for two days	Praziquantel 40 mg/kg orally (single dose; may be divided and given in two doses for better tolerance)
Sub-Saharan Africa, Loa loa-endemic area	Albendazole 400 mg orally (single dose)	If Loa loa cannot be excluded, treatment may be deferred until after arrival in the United States OR Albendazole 400 mg orally twice a day for seven days	Praziquantel 40 mg/kg orally (single dose; may be divided and given in two doses for better tolerance)
Pregnant women
Asia, Middle East, North Africa, Latin America, and Caribbean	Not recommended	Not recommended	Not applicable
Sub-Saharan Africa	Not recommended	Not recommended	Praziquantel 40 mg/kg orally (single dose; may be divided and given in two doses for better tolerance)
Children
Asia, Middle East, North Africa, Latin America, and Carribean	12 to 23 months of age: Albendazole 200 mg orally (single dose) Presumptive therapy is not recommended for any infant less than 12 months of age	Ivermectin 200 mcg/kg/day orally once a day for two days Should not be used presumptively if less than or equal to 15 kg	Not applicable
Sub-Saharan Africa	12 to 23 months of age: Albendazole 200 mg orally for one day Presumptive therapy is not recommended for any infant less than 12 months of age	Ivermectin 200 mcg/kg/day orally once a day for two days Should not be used presumptively if less than or equal to 15 kg or from Loa loa-endemic country	Children ≤4 years of age should not receive presumptive treatment with praziquantel. Only for children from sub-Saharan Africa.

* Although the World Health Organization (WHO) states ivermectin and albendazole may be given concurrently, it is recommended that ivermectin be taken on an empty stomach and albendazole with fatty foods.
¶ All sub-Saharan African countries except Lesotho are considered endemic for schistosomiasis.
Δ Praziquantel, if not coadministered, should be administered at least one day prior to either ivermectin or albendazole. Praziquantel should be taken with liquids during a meal.

Reproduced from: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases. Guidelines for Overseas Presumptive Treatment of Strongyloidiasis, Schistosomiasis, and Soil-Transmitted Helminth Infections For Refugees Resettling to the United States. Centers for Disease Control and Prevention, Division of Global Migration and Quarantine 2013. Available at: http://www.cdc.gov/immigrantrefugeehealth/pdf/intestinal-parasites-overseas.pdf.

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Medication regimen and dosing for presumptive treatment of parasitic infections