Unresolved Splenomegaly in Recently Resettled Congolese Refugees - Multiple States, 2015–2018

Since 2014, a large number of resettling Congolese refugees have been found to have splenomegaly, which has not resolved in some patients despite treatment. Despite recommendations, most refugees with splenomegaly did not have documented receipt of primaquine after resettlement. Most patients were clustered within families. Approximately 50% of patients with available medical records had persistent splenomegaly >6 months after arrival; 63% of patients with splenomegaly had a hematologic abnormality. Eligible Congolese refugees with splenomegaly should be treated with primaquine, followed closely, and referred for specialty care if they fail to respond to treatment, and their family members should be proactively screened for splenomegaly.