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. Copyright © 2009 by The American Society of Tropical Medicine and Hygiene.

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parasitology Strongyloidiasis Strongyloides stercoralis Vietnam Eosinophilia refugee fascioliasis Fasciola Anthelmintics follow up human Refugees anthelmintic agent feces analysis North Carolina ivermectin Animals drug efficacy ethnology animal United States human cell Treatment Failure Humans human tissue male female Albendazole Viet Nam Africa serodiagnosis Article Vermes drug substitution major clinical study adult Strongyloides immune deficiency repeat procedure