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Beginning in 2005, the Centers for Disease Control and Prevention (CDC) expanded the overseas presumptive treatment of intestinal parasites with albendazole to include refugees from the Middle East. We surveyed the prevalence of helminths and protozoa in recent Middle Eastern refugees (2008–2010) in comparison with refugees from other geographical regions and from a previous survey (2001–2004) in Santa Clara County, California. Based on stool microscopy, helminth infections decreased, particularly in Middle Eastern refugees (0.1% versus 2.3% 2001–2004, P = 0.01). Among all refugees, Giardia intestinalis was the most common protozoan found. Protozoa infections also decreased somewhat in Middle Eastern refugees (7.2%, 2008–2010 versus 12.9%, 2001–2004, P = 0.08). Serology for Strongyloides stercoralis and Schistosoma spp. identified more infected individuals than stool exams. Helminth infections are increasingly rare in refugees to Northern California. Routine screening stool microscopy may be unnecessary in all refugees.
Financial support: This research was funded by the National Institutes of Health/National Institute of Allergy and Infectious Diseases, grants R01AI042801 and R01AI042801-10SI (J.P.), K23AI091688 (A.H.C.), and K23AI054443 (S.P.).
Authors' addresses: Alicia H. Chang, Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, E-mail: firstname.lastname@example.org. Sharon Perry, Medecins sans Frontieres, France Malawi/Chiradzulu, E-mail: email@example.com. Jenny N. T. Du, Touro University Nevada, Henderson, NV, E-mail: firstname.lastname@example.org. Abdulkareem Agunbiade, University of Chicago, Pritzker School of Medicine, Biological Sciences Learning Center, Chicago, IL, E-mail: email@example.com. Andrea Polesky, Tuberculosis Clinic and Refugee Health Assessment Program, San Jose, CA, E-mail: firstname.lastname@example.org. Julie Parsonnet, Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, E-mail: email@example.com.