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625. Association of Eosinophilia with Parasites in Rhode Island Refugees, 2015-2020
BACKGROUND: Newly arrived refugees in the United States have high rates of parasitic infections that may contribute to morbidity and mortality. There is little consensus on testing for eosinophils to screen for parasites. We hypothesized that eosinophilia was a useful biomarker for various parasites...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10677880/ http://dx.doi.org/10.1093/ofid/ofad500.691 |
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author | Cruz-Sanchez, Margarita Marin, Benjamin Gallo Osorio, Marcela Teferi, Maranatha Ding, Ann Lorenz, Matthew Michelow, Ian C |
author_facet | Cruz-Sanchez, Margarita Marin, Benjamin Gallo Osorio, Marcela Teferi, Maranatha Ding, Ann Lorenz, Matthew Michelow, Ian C |
author_sort | Cruz-Sanchez, Margarita |
collection | PubMed |
description | BACKGROUND: Newly arrived refugees in the United States have high rates of parasitic infections that may contribute to morbidity and mortality. There is little consensus on testing for eosinophils to screen for parasites. We hypothesized that eosinophilia was a useful biomarker for various parasites that could help guide the management of refugees in the future. METHODS: We performed a retrospective chart review of all pediatric and adult refugees attending the only three refugee clinics in Rhode Island from 01/2015 to 12/2020. Individuals whose initial evaluation was delayed or took place in another state were excluded. Data were systematically collated in RedCap, and descriptive statistics were performed. RESULTS: Of 812 eligible refugees, 147 (18.1%) had eosinophilia ( ⪰ 450/uL). The majority of refugees (505, 62.2%) were from Africa, 242 (29.8%) from Asia, 32 (3.9%) each from the Americas, Europe, and 1 (0.1%) from Australia. Eosinophilia was mild (450-1499/uL) in 113 (76.9%), moderate (1500-4999/uL) in 30 (20.4%), and severe ( ⪰ 5000/uL) in 4 refugees (2.7%)(Table 1). The prevalence of symptoms ranged from none (bloody stools) to 17.1% (abdominal pain). 48 (32.7%) refugees with eosinophilia tested positive for a parasite in their stool by O&P and/or PCR assay. The most prevalent organisms were Giardia (n=25) and Blastocystis hominis (n=22). An additional 22 (15%) tested positive for Schistosoma or Strongyloides (Table 2). Forty-six (31.3%) refugees with eosinophilia were treated with antiparasitic agents. Sixty-three (42.9%) had no follow-up eosinophil tests. Of the 84 patients who did have monitoring of their eosinophilia during the first year after arriving in the US, eosinophilia resolved in only 53 (64.6%). One patient (0.7%) had a severe complication: Strongyloides hyperinfection syndrome. Five patients (3.4%) received alternative diagnoses that explained their eosinophilia, including eczema, myelofibrosis, and a drug allergy. [Figure: see text] [Figure: see text] CONCLUSION: Eosinophilia occurred in almost 1/5 of newly arrived refugees in RI. Diagnostic, therapeutic, and follow-up practices varied substantially. Approximately 1/3 of evaluable refugees had persistent eosinophilia at one year. A standardized screening approach for eosinophilia is needed to inform appropriate management. DISCLOSURES: All Authors: No reported disclosures |
format | Online Article Text |
id | pubmed-10677880 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-106778802023-11-27 625. Association of Eosinophilia with Parasites in Rhode Island Refugees, 2015-2020 Cruz-Sanchez, Margarita Marin, Benjamin Gallo Osorio, Marcela Teferi, Maranatha Ding, Ann Lorenz, Matthew Michelow, Ian C Open Forum Infect Dis Abstract BACKGROUND: Newly arrived refugees in the United States have high rates of parasitic infections that may contribute to morbidity and mortality. There is little consensus on testing for eosinophils to screen for parasites. We hypothesized that eosinophilia was a useful biomarker for various parasites that could help guide the management of refugees in the future. METHODS: We performed a retrospective chart review of all pediatric and adult refugees attending the only three refugee clinics in Rhode Island from 01/2015 to 12/2020. Individuals whose initial evaluation was delayed or took place in another state were excluded. Data were systematically collated in RedCap, and descriptive statistics were performed. RESULTS: Of 812 eligible refugees, 147 (18.1%) had eosinophilia ( ⪰ 450/uL). The majority of refugees (505, 62.2%) were from Africa, 242 (29.8%) from Asia, 32 (3.9%) each from the Americas, Europe, and 1 (0.1%) from Australia. Eosinophilia was mild (450-1499/uL) in 113 (76.9%), moderate (1500-4999/uL) in 30 (20.4%), and severe ( ⪰ 5000/uL) in 4 refugees (2.7%)(Table 1). The prevalence of symptoms ranged from none (bloody stools) to 17.1% (abdominal pain). 48 (32.7%) refugees with eosinophilia tested positive for a parasite in their stool by O&P and/or PCR assay. The most prevalent organisms were Giardia (n=25) and Blastocystis hominis (n=22). An additional 22 (15%) tested positive for Schistosoma or Strongyloides (Table 2). Forty-six (31.3%) refugees with eosinophilia were treated with antiparasitic agents. Sixty-three (42.9%) had no follow-up eosinophil tests. Of the 84 patients who did have monitoring of their eosinophilia during the first year after arriving in the US, eosinophilia resolved in only 53 (64.6%). One patient (0.7%) had a severe complication: Strongyloides hyperinfection syndrome. Five patients (3.4%) received alternative diagnoses that explained their eosinophilia, including eczema, myelofibrosis, and a drug allergy. [Figure: see text] [Figure: see text] CONCLUSION: Eosinophilia occurred in almost 1/5 of newly arrived refugees in RI. Diagnostic, therapeutic, and follow-up practices varied substantially. Approximately 1/3 of evaluable refugees had persistent eosinophilia at one year. A standardized screening approach for eosinophilia is needed to inform appropriate management. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2023-11-27 /pmc/articles/PMC10677880/ http://dx.doi.org/10.1093/ofid/ofad500.691 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Abstract Cruz-Sanchez, Margarita Marin, Benjamin Gallo Osorio, Marcela Teferi, Maranatha Ding, Ann Lorenz, Matthew Michelow, Ian C 625. Association of Eosinophilia with Parasites in Rhode Island Refugees, 2015-2020 |
title | 625. Association of Eosinophilia with Parasites in Rhode Island Refugees, 2015-2020 |
title_full | 625. Association of Eosinophilia with Parasites in Rhode Island Refugees, 2015-2020 |
title_fullStr | 625. Association of Eosinophilia with Parasites in Rhode Island Refugees, 2015-2020 |
title_full_unstemmed | 625. Association of Eosinophilia with Parasites in Rhode Island Refugees, 2015-2020 |
title_short | 625. Association of Eosinophilia with Parasites in Rhode Island Refugees, 2015-2020 |
title_sort | 625. association of eosinophilia with parasites in rhode island refugees, 2015-2020 |
topic | Abstract |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10677880/ http://dx.doi.org/10.1093/ofid/ofad500.691 |
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