AJTMH HINARI
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Am. J. Trop. Med. Hyg., 81(2), 2009, pp. 302-304
Copyright © 2009 by The American Society of Tropical Medicine and Hygiene

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Goswami, N. D.
Right arrow Articles by Stout, J. E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Goswami, N. D.
Right arrow Articles by Stout, J. E.

SHORT REPORT


Persistent Eosinophilia and Strongyloides Infection in Montagnard Refugees after Presumptive Albendazole Therapy

Neela D. Goswami*, J. Jina Shah, G. Ralph Corey, AND Jason E. Stout
Department of Medicine, Duke University Medical Center, Durham, North Carolina; Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia

 

ABSTRACT

Chronic helminth infections are common in refugee populations and may persist years after immigration. Asymptomatic Strongyloides stercoralis infection raises particular concern because of its potential for complications in immunosuppressed patients. We examined 172 Montagnard refugees resettled to Wake County, North Carolina from 2002 through 2003. Refugees were pretreated with albendazole for five days and screened for health conditions after arrival. Eosinophilia was present in 41 of 171 refugees at the first blood draw. Only 1 of 172 had a stool helminth (Fasciola) identified by microscopy. On repeat testing, 13 people had persistent eosinophilia. Results of serologic analysis for Strongyloides were available in 24 persons. Eosinophil counts decreased significantly after treatment with ivermectin in nine refugees (P = 0.039). Persistent eosinophilia, likely caused by Strongyloides infection, was common in this cohort of Montagnard refugees. Clinicians should understand the limitations of stool microscopy in diagnosis of strongyloidiasis, the limited effectiveness of albendazole in treating strongyloidiasis, and the importance of following-up refugees with persistent eosinophilia.

Received October 12, 2008. Accepted for publication May 1, 2009.

Acknowledgments: We thank Debra S. Turner, who served as refugee health nurse for the Wake County Human Services Clinic, and without whose assistance this study would not have been possible. We also thank Suzanna Young (North Carolina Refugee Health Program), Dr. Martin Cetron (Director, Division of Global Migration and Quarantine, CDC), and other members of the IOM and CDC team for assistance with the larger Enhanced Refugee Health Assessment Program in Cambodia and North Carolina within which this study is nested.

* Address correspondence to Neela D. Goswami, Division of Infectious Diseases, Duke University Medical Center, Box 102359, Durham, NC 27710. E-mail: dasgu001{at}mc.duke.edu

Authors’ addresses: Neela D. Goswami and Jason Stout, Division of Infectious Diseases, Duke University Medical Center, Box 102359, Durham, NC 27710, E-mails: dasgu001{at}mc.duke.edu and stout002{at}mc.duke.edu. J. Jina Shah, 280 W. MacArthur Street, Oakland, CA 94611, E-mail: jina.shah{at}gmail.com. G. Ralph Corey, PO Box 17969, Durham, NC 27715, E-mail: corey001{at}mc.duke.edu.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2009 by the American Society of Tropical Medicine and Hygiene.