Intestinal parasites in refugee claimants: a case study for selective screening?

The medical profiles of 1,967 refugee claimants to Montreal, Quebec, Canada from January 1987 to July 1987 were reviewed to evaluate the importance of imported intestinal parasite infection in this group and to re-examine the screening policy governing these infections. An overall infection rate of 29.3% was obtained for pathogenic parasites, where helminths were four times more frequently found than the protozoa Entamoeba histolytica and Giardia lamblia. Age, sex, years of schooling, country of origin and level of eosinophilia were found to be associated with infection, with country of origin being the strongest predictor of infection. These results document the parasite infection in a select group of immigrants which would not have been identified and treated if a special program of screening were not in operation. We suggest that the present immigration policy of no screening for intestinal parasite infection be at least modified to include a recommendation that new arrivals, who are considered to be at high risk for parasite infection, be informed that an examination for parasites would be beneficial to their personal health.