Clinical Infectious Diseases
Volume 45, Issue 10, 2007, Pages 1310-1315

High prevalence and presumptive treatment of schistosomiasis and strongyloidiasis among African refugees (Article) (Open Access)

Posey D.L. , Blackburn B.G. , Weinberg M. , Flagg E.W. , Ortega L. , Wilson M. , Secor W.E. , Sanders-Lewis K. , Won K. , Maguire J.H.
  • a Division of Global Migration and Quarantine, National Center for Preparedness, Detection, and Control of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States, Epidemic Intelligence Service Program, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, GA, United States, Mailstop E-03, 1600 Clifton Rd., Atlanta, GA 30333, United States
  • b Division of Parasitic Diseases, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States, Epidemic Intelligence Service Program, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, GA, United States, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, United States
  • c Division of Global Migration and Quarantine, National Center for Preparedness, Detection, and Control of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
  • d Division of Global Migration and Quarantine, National Center for Preparedness, Detection, and Control of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
  • e Division of Global Migration and Quarantine, National Center for Preparedness, Detection, and Control of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
  • f Division of Parasitic Diseases, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
  • g Division of Parasitic Diseases, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
  • h Division of Parasitic Diseases, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
  • i Division of Parasitic Diseases, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
  • j Division of Parasitic Diseases, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States

Abstract

Background. Schistosomiasis and strongyloidiasis cause substantial morbidity and mortality among hundreds of millions of infected persons worldwide. In the United States, these infections are most commonly found among international travelers, immigrants, and refugees from areas of endemicity. Refugees resettled to the United States since 2000 include 13800 "Lost Boys and Girls" of Sudan and 8000 Somali Bantu. Many Lost Boys and Girls of Sudan reported chronic abdominal pain only since arrival, and some received diagnoses of schistosomiasis or strongyloidiasis. We assessed seroprevalence of these infections among these refugees and hypothesized an association between infection and abdominal pain. Methods. We offered a survey assessing chronic abdominal pain and serologic testing for schistosomiasis and strongyloidiasis to all 800 attendees of a Lost Boys and Girls of Sudan reunion in the United States. Serologic testing was performed on preimmigration specimens obtained from 100 United States-bound Somali Bantu refugees. Results. Of the 462 Sudanese refugees (58%) tested, 44% and 46% were seropositive for schistosomiasis (primarily due to Schistosoma mansoni) and strongyloidiasis, respectively; 24% of those who tested positive for schistosomiasis had S. mansoni antigenemia. Forty-six percent reported chronic abdominal pain, which was not associated with either infection. Among 100 Somali Bantu, 73% and 23% tested seropositive for schistosomiasis (primarily due to Schistosoma haematobium) and strongyloidiasis, respectively. Conclusions. The high seroprevalence of schistosomiasis and strongyloidiasis among Sudanese Lost Boys and Girls and Somali Bantu refugees supports presumptive treatment for these refugees. Current refugee resettlement policies inadequately address these diseases; our data support consideration of predeparture presumptive therapy for all refugees from areas of endemicity.

Author Keywords

[No Keywords available]

Index Keywords

Strongyloidiasis refugee abdominal pain human epidemiology Refugees middle aged Sudan controlled study priority journal Aged Animals ethnology animal United States Humans Adolescent male Schistosoma mansoni Aged, 80 and over preschool child Infant enzyme linked immunosorbent assay Child, Preschool Africa female immunology prevalence Schistosoma haematobium Article blood Antigens, Helminth parasite antigen major clinical study adult schistosomiasis serology Somalia Schistosoma hematobium Seroepidemiologic Studies Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-36048955243&doi=10.1086%2f522529&partnerID=40&md5=6c6988ca81610ba416bba55c2f879990
DOI: 10.1086/522529
ISSN: 10584838
Cited by: 80
Original Language: English