Department of Medicine, Division of Infectious Diseases, Immunology, and International Medicine, University of Illinois at Chicago, 808 South Wood, M/C 735, Chicago, IL, 60612, USA.
University of Illinois at Chicago School of Public Health, Chicago, IL, USA.
Parasitol Res. 2020 Mar;119(3):1139-1148. doi: 10.1007/s00436-020-06608-4. Epub 2020 Feb 1.
Parasitic infections are likely under-recognized among immigrant populations in the USA. We conducted a cross-sectional study to evaluate if such infections have health impacts among recent immigrants in Chicago and to identify predictive factors for parasitic infections. A total of 133 recent immigrants were enrolled, filling out a standardized medical questionnaire and providing blood and stool samples. Appriximately 12% of subjects (15/125) who provided a blood or stool sample for testing were found to have evidence of current or prior infection with a pathogenic parasite, of which Toxocara spp. (8 subjects, 6.4%) and Strongyloides stercoralis (5 subjects, 4%) were most commonly identified. Parasitic infection was more likely among subjects who had immigrated within the previous 2 years and those with a self-reported history of worms in the stool. The most useful surrogate markers identified for parasitic infections were an elevated immunoglobulin E level (seen in 46.7% (7/15) of subjects with parasitic infections and 20% (22/110) of uninfected individuals, p = 0.04) and the presence of Blastocystis hominis cysts on Ova & Parasite exam (detected in 38.5% (5/13) of subjects with parasitic infections who provided a stool sample and 5.1% (5/98) of uninfected subjects, p = 0.002). Our study found that parasitic infections may be common in recent US immigrants, which highlights an important health disparity among a vulnerable population that merits further study. Additionally, clinical risk factors, symptoms, and laboratory findings traditionally thought to be associated with parasites were commonly found but not predictive of infection in this study population.
寄生虫感染在美国移民人群中可能未被充分认识。我们进行了一项横断面研究，以评估此类感染是否对芝加哥的近期移民有健康影响，并确定寄生虫感染的预测因素。共纳入 133 名近期移民，填写标准化医学问卷并提供血液和粪便样本。约有 12%（15/125）提供血液或粪便样本进行检测的受试者有当前或既往感染致病性寄生虫的证据，其中以 Toxocara spp.（8 例，6.4%）和 Strongyloides stercoralis（5 例，4%）最为常见。寄生虫感染更可能发生在最近 2 年内移民的受试者和自述粪便中有虫的受试者中。确定的寄生虫感染最有用的替代标志物是免疫球蛋白 E 水平升高（在 15 例寄生虫感染者中有 46.7%（7/15），在 110 例未感染者中有 20%（22/110），p=0.04）和粪便 Ova & Parasite 检查中发现的 Blastocystis hominis 包囊（在提供粪便样本的 13 例寄生虫感染者中有 38.5%（5/13），在 98 例未感染者中有 5.1%（5/98），p=0.002）。我们的研究发现，寄生虫感染在近期美国移民中可能很常见，这突出了一个重要的健康差距，值得进一步研究。此外，在本研究人群中，传统上认为与寄生虫相关的临床危险因素、症状和实验室发现虽然常见，但不能预测感染。
