1921
Volume 73, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

With continuing emigration from endemic countries, screening for parasitic infections remains a priority in U.S. communities serving refugee and immigrant populations. We report the prevalence of helminths and protozoa as well as demographic risk factors associated with these infections among 533 refugees seen at the Santa Clara County, California, Refugee Clinic between October 2001 and January 2004. Stool parasites were identified from 14% of refugees, including 9% found to have one or more protozoa and 6% found to have at least one helminth. Most common protozoan infections were (6%) and (3%), and for helminths, hookworm (2%). Protozoa were more frequent in refugees < 18 years of age (OR: 2.2 [1.2–4.2]), whereas helminths were more common in refugees from South Central Asia (OR: 8.0 [2.3–27.7]) and Africa (OR: 5.9 [1.6–21.6]) when compared with refugees from Eastern Europe and the Middle East. Among helminths, and hookworm were concentrated among South Central Asians (6 of 7 and 10 of 11 cases, respectively), whereas was predominantly found in Africans (5 of 7 cases). Although predeparture empirical treatment programs in Saharan Africa may have helped to reduce prevalence among arriving refugees from this region, parasitic infection is still common among refugees to the United States with helminth infections found in more specific populations. As refugees represent only a fraction of recent immigrants from endemic countries, current studies in nonrefugee groups are also needed.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.2005.73.386
2005-08-01
2017-11-18
Loading full text...

Full text loading...

/deliver/fulltext/14761645/73/2/0730386.html?itemId=/content/journals/10.4269/ajtmh.2005.73.386&mimeType=html&fmt=ahah

References

  1. Allen JE, Maizels RM, 1996. Immunology of human helminth infection. Int Arch Allergy Immunol 109 : 3–10.
  2. Stanley SL Jr, 2003. Amoebiasis. Lancet 361 : 1025–1034.
  3. Walker PF, Jaranson J, 1999. Refugee and immigrant health care. Med Clin North Am 83 : 1103–1120.
  4. Larson L, 2003. The foreign-born population in the United States: 2003. Bureau USC, ed. Current Population Reports. Washington, DC: U.S. Department of Commerce, 1–12.
  5. Lifson AR, Thai D, O’Fallon A, Mills WA, Hang K, 2002. Prevalence of tuberculosis, hepatitis B virus, and intestinal parasitic infections among refugees to Minnesota. Public Health Rep 117 : 69–77.
  6. Geltman PL, Cochran J, Hedgecock C, 2003. Intestinal parasites among African refugees resettled in Massachusetts and the impact of an overseas pre-departure treatment program. Am J Trop Med Hyg 69 : 657–662.
  7. Sutherland JE, Avant RF, Franz WB 3rd, Monzon CM, Stark NM, 1983. Indochinese refugee health assessment and treatment. J Fam Pract 16 : 61–67.
  8. Parenti DM, Lucas D, Lee A, Hollenkamp RH, 1987. Health status of Ethiopian refugees in the United States. Am J Public Health 77 : 1542–1543.
  9. Parish RA, 1985. Intestinal parasites in Southeast Asian refugee children. West J Med 143 : 47–49.
  10. Winsberg GR, Sonnenschein E, Dyer AR, Schnadig V, Bonilla E, 1975. Prevalence of intestinal parasites in Latino residents of Chicago. Am J Epidemiol 102 : 526–532.
  11. Arfaa F, 1981. Intestinal parasites among Indochinese refugees and Mexican immigrants resettled in Contra Costa County, California. J Fam Pract 12 : 223–226.
  12. Salas SD, Heifetz R, Barrett-Connor E, 1990. Intestinal parasites in Central American immigrants in the United States. Arch Intern Med 150 : 1514–1516.
  13. Ortiz JS, 1980. The prevalence of intestinal parasites in Puerto Rican farm workers in western Massachusetts. Am J Public Health 70 : 1103–1105.
  14. Ungar BL, Iscoe E, Cutler J, Bartlett JG, 1986. Intestinal parasites in a migrant farmworker population. Arch Intern Med 146 : 513–515.
  15. Barnett ED, 2004. Infectious disease screening for refugees resettled in the United States. Clin Infect Dis 39 : 833–841.
  16. Maizels RM, Bundy DA, Selkirk ME, Smith DF, Anderson RM, 1993. Immunological modulation and evasion by helminth parasites in human populations. Nature 365 : 797–805.
  17. Sher A, Coffman RL, 1992. Regulation of immunity to parasites by T cells and T cell-derived cytokines. Annu Rev Immunol 10 : 385–409.
  18. Pit DS, Polderman AM, Baeta S, Schulz-Key H, Soboslay PT, 2001. Parasite-specific antibody and cellular immune responses in human infected with Necator americanus and Oesophagostomum bifurcum. Parasitol Res 87 : 722–729.
  19. Cunin P, Tchuem Tchuente LA, Poste B, Djibrilla K, Martin PM, 2003. Interactions between Schistosoma haematobium and Schistosoma mansoni in humans in north Cameroon. Trop Med Int Health 8 : 1110–1117.
  20. Cox FE, 2001. Concomitant infections, parasites and immune responses. Parasitology 122 (Suppl): S23–S38.
  21. Cooper PJ, Chico ME, Sandoval C, Espinel I, Guevara A, Kennedy MW, Urban JF Jr, Griffin GE, Nutman TB, 2000. Human infection with Ascaris lumbricoides is associated with a polarized cytokine response. J Infect Dis 182 : 1207–1213.
  22. Fox JG, Beck P, Dangler CA, Whary MT, Wang TC, Shi HN, Nagler-Anderson C, 2000. Concurrent enteric helminth infection modulates inflammation and gastric immune responses and reduces helicobacter-induced gastric atrophy. Nat Med 6 : 536–542.
  23. Le Hesran JY, Akiana J, Ndiaye el HM, Dia M, Senghor P, Konate L, 2004. Severe malaria attack is associated with high prevalence of Ascaris lumbricoides infection among children in rural Senegal. Trans R Soc Trop Med Hyg 98 : 397–399.
  24. Sacks D, Sher A, 2002. Evasion of innate immunity by parasitic protozoa. Nat Immunol 3 : 1041–1047.
  25. Hotez PJ, Brooker S, Bethony JM, Bottazzi ME, Loukas A, Xiao S, 2004. Hookworm infection. N Engl J Med 351 : 799–807.
  26. Catanzaro A, Moser RJ, 1982. Health status of refugees from Vietnam, Laos, and Cambodia. JAMA 247 : 1303–1308.
  27. Yazdanbakhsh M, Kremsner PG, van Ree R, 2002. Allergy, parasites, and the hygiene hypothesis. Science 296 : 490–494.
  28. 2002. Refugee Admissions and Resettlement Policy. CRS Report for Congress. Washington, DC: Department USS, ed.
  29. Cartwright CP, 1999. Utility of multiple-stool-specimen ova and parasite examinations in a high-prevalence setting. J Clin Microbiol 37 : 2408–2411.
  30. Geltman PL, Radin M, Zhang Z, Cochran J, Meyers AF, 2001. Growth status and related medical conditions among refugee children in Massachusetts, 1995–1998. Am J Public Health 91 : 1800–1805.
  31. Gyorkos TW, MacLean JD, Viens P, Chheang C, Kokoskin-Nelson E, 1992. Intestinal parasite infection in the Kampuchean refugee population 6 years after resettlement in Canada. J Infect Dis 166 : 413–417.
  32. Devidoff K BL, 2004. Evaluating components of international migration: estimates of the foreign-born population by migration status in 2000. Bureau USC, ed. Working Paper #58. Washington DC: U.S. Department of Commerce.
  33. Bentwich Z, Kalinkovich A, Weisman Z, Borkow G, Beyers N, Beyers AD, 1999. Can eradication of helminthic infections change the face of AIDS and tuberculosis? Immunol Today 20 : 485–487.
  34. Elias D, Wolday D, Akuffo H, Petros B, Bronner U, Britton S, 2001. Effect of deworming on human T cell responses to mycobacterial antigens in helminth-exposed individuals before and after bacille Calmette-Guerin (BCG) vaccination. Clin Exp Immunol 123 : 219–225.
  35. Kullberg MC, Pearce EJ, Hieny SE, Sher A, Berzofsky JA, 1992. Infection with Schistosoma mansoni alters Th1/Th2 cytokine responses to a non-parasite antigen. J Immunol 148 : 3264–3270.
  36. Cooper PJ, Chico M, Sandoval C, Espinel I, Guevara A, Levine MM, Griffin GE, Nutman TB, 2001. Human infection with Ascaris lumbricoides is associated with suppression of the interleukin-2 response to recombinant cholera toxin B subunit following vaccination with the live oral cholera vaccine CVD 103-HgR. Infect Immun 69 : 1574–1580.
  37. Stewart GR, Boussinesq M, Coulson T, Elson L, Nutman T, Bradley JE, 1999. Onchocerciasis modulates the immune response to mycobacterial antigens. Clin Exp Immunol 117 : 517–523.
  38. DeRiemer K, Chin DP, Schecter GF, Reingold AL, 1998. Tuberculosis among immigrants and refugees. Arch Intern Med 158 : 753–760.
  39. Perez-Stable EJ, Slutkin G, Paz EA, Hopewell PC, 1986. Tuberculin reactivity in United States and foreign-born Latinos: results of a community-based screening program. Am J Public Health 76 : 643–646.
  40. Muennig P, Pallin D, Sell RL, Chan MS, 1999. The cost effectiveness of strategies for the treatment of intestinal parasites in immigrants. N Engl J Med 340 : 773–779.
  41. Pickering L, Baker CJ, Overturf GD, Prober CG, 2003. RedBook Report of the Committee on Infectious Diseases. Elk Grove, IL: American Academy of Pediatrics.
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2005.73.386
Loading
/content/journals/10.4269/ajtmh.2005.73.386
Loading

Data & Media loading...

  • Received : 28 Sep 2004
  • Accepted : 20 Mar 2005

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error