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Am. J. Trop. Med. Hyg., 80(3), 2009, pp. 425-430
Copyright © 2009 by The American Society of Tropical Medicine and Hygiene

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Community Based Parasitic Screening and Treatment of Sudanese Refugees: Application and Assessment of Centers for Disease Control Guidelines

Stephanie K. Brodine, Anne Thomas, Robert Huang, Judith Harbertson, Sanjay Mehta, John Leake, Thomas Nutman, Kathleen Moser, Jamie Wolf, Roshan Ramanathan, Peter Burbelo, John Nou, Patricia Wilkins, AND Sharon L. Reed*
San Diego State University Graduate School of Public Health, San Diego, California; Departments of Medicine and Pathology, University of California, San Diego School of Medicine, San Diego, California; Laboratory of Parasitic Diseases and Laboratory of Sensory Biology, National Institutes of Health, Bethesda, Maryland; Tuberculosis Control and Refugee Health Services Branch, County of San Diego Health and Human Services Agency, San Diego, California; Division of Parasitic Diseases, Centers for Disease Control, Atlanta, Georgia

Centers for Disease Control guidelines for schistosomiasis and strongyloidiasis in Sudanese and Somali refugees are not widely implemented. Given limited prevalence data, we conducted a seroprevalence study of schistosomiasis, strongyloidiasis, and loiasis in Sudanese refugees across diverse ages. Sudanese refugees, ages 4–78, were recruited via community organizations. Half of the patients (86/172), were seropositive for schistosomiasis (46/171; 26.9%), strongyloidiasis (56/172; 33%), or both (16/171; 9.4%). No Loa loa infections were detected. Infection rates were similar in adults and children except that no schistosomiasis was detected in children < 4 years of age at the time of immigration to the United States. The high prevalence of schistosomiasis and strongyloidiasis in a community-based sample of Sudanese confirms the urgency for compliance with CDC refugee health guidelines. We detected no co-infection with Loa loa using the most sensitive serologic techniques, allowing use of ivermectin, the most effective treatment of strongyloidiasis.

Received September 17, 2008. Accepted for publication November 26, 2008.

Acknowledgments: We thank Molly and Becky Moores for their dedication to the Sudanese refugees, all of the participating families, and the many volunteers who made this study possible. The high participation rate of the Sudanese community would not have been possible without the outreach and guidance of Diar Diar, Majur Malou, and Dep Tuany. We also thank Marianna Wilson of the CDC for her help and encouragement.

Financial support: Funding for the study was provided by the John and Rebecca Moores Foundation for New Americans and in part by the Division of Intramural Research, NIAID.

Disclosure: The authors report that there are no conflicts of interest.

* Address correspondence to Sharon L. Reed, UCSD Medical Center, 200 W. Arbor Drive, San Diego, CA 92103-8416. E-mail: slreed{at}ucsd.edu

Authors’ addresses: Stephanie Brodine, Anne Thomas, Judith Harbertson, and Jamie Wolf, Graduate School of Public Health MC 4162, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182. Robert Huang, Sanjay Mehta, and Sharon Reed, UCSD Medical Center, 200 W. Arbor Dr., San Diego, CA 92103-8416, Tel: 619-543-6146, Fax: 619-543-6614, E-mail: slreed{at}ucsd.edu. John Leake, Division of Infectious Diseases, Rady Children’s Hospital, 3020 Children’s Way, MC5041, San Diego, CA 92123. Thomas Nutman and Roshan Ramanathan, Laboratory of Parasitic Diseases, Bldg 4, Rm B1-3, 4 Center Dr., National Institutes of Health, Bethesda, MD 20892-0425. Kathleen Moser, Tuberculosis Control and Refugee Health Services Branch County of San Diego Health and Human Services Agency, 3851 Rosecrans St., MS P576, Suite 128, San Diego, CA 92110. Peter Burbelo, Laboratory of Sensory Biology, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892. John Nou and Patricia Wilkins, Reference Diagnostic Laboratory, Division of Parasitic Diseases, Centers for Disease Control, Atlanta, GA 30341.






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Copyright © 2009 by the American Society of Tropical Medicine and Hygiene.