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 Giardia lamblia (6%) and Dientamoeba fragilis (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, Ascaris lumbricoides and hookworm were concentrated among South Central Asians (6 of 7 and 10 of 11 cases, respectively), whereas Strongyloides stercoralis 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. Copyright © 2005 by The American Sociely of Tropical Medicine and Hygiene.

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Giardia intestinalis Strongyloides stercoralis Europe, Eastern Toxoplasma gondii refugee Asian Entamoeba histolytica human Taenia saginata Refugees Asia Middle East feces analysis controlled study Animals United States Ascaris lumbricoides Humans Helminths Adolescent California Infant, Newborn male giardia lamblia Schistosoma mansoni female Infant risk factor Risk Factors protozoal infection Africa Child, Preschool Ancylostomatoidea acetic acid ethyl ester Hymenolepis nana prevalence Protozoa Dientamoeba Article Vermes Dientamoeba fragilis polyvinyl alcohol zinc sulfate major clinical study adult Feces migration age Trichuris endemic disease helminthiasis Intestinal Diseases, Parasitic Emigration and Immigration intestine parasite Protozoan Infections hookworm Child