We prospectively evaluated 201 Southeast Asian refugees in a primary care clinic for intestinal parasites and their association with gastrointestinal symptoms. Patients completed a standardized screening questionnaire which elicited information on demographic factors and eight gastrointestinal symptoms, and stools were collected for ova and parasite examination. Although 89% had been living in the U.S.A. for more than 1 year, intestinal parasites were found in 37 (18%) patients and pathogenic parasites in 23 (11%). Among these 37 patients with intestinal parasites, seven (19%) had multiple parasites. Seven pathogenic and four nonpathogenic species were identified. Hookworm was most prevalent (4.5%), followed by Strongyloides stercoralis (2.5%) and Clonorchis sinensis (2%). Cambodians had the highest prevalence (11%) and Vietnamese and highland Laotians the lowest (0%). Intestinal parasitosis was not associated with gender or duration of residence in the U.S.A. Individual symptoms had a low positive predictive value for the presence of pathogenic parasites. This suggests that even years after immigration a substantial number of Southeast Asian refugees may benefit from screening and treatment for intestinal parasites.
Psychiatric disorders were frequent in this clinical population of Eastern Europeans presenting for outpatient mental health care and may be associated with previous mental health problems. Our findings emphasize the need for sensitivity to the special risks of emigration.
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