Intestinal Parasitosis Research Articles

Immigrants living in an urban milieu with sanitation in Southern Italy: persistence and transmission of intestinal parasites

In the current era of globalization, the massive movement of populations to developed countries causes a greater attention to neglected tropical diseases in places where such diseases are considered unusual. The present study was planned to assess the persistence of intestinal parasitosis in immigrants stably living in the urban central area of Naples (Southern Italy) and the spread of infection within households with a lifestyle similar to that of the country of origin. A total of 2150 stool samples were analysed with the FLOTAC dual technique, and 415 subjects (19.3 %) tested positive for pathogenic intestinal parasites. One hundred ninety-six subjects were randomly selected and monitored again after 1 year in order to evaluate the persistence of intestinal parasites in immigrants having access to proper sanitation. No pathogenic parasites were found in these 196 samples. A total of 482 cohabitants of 151 positive subjects were recruited to evaluate the interfamilial spread of the identified parasites. Only in 18 households were there subjects infected with the same parasite. Monitoring of parasites in stool samples of immigrants showed a decrease of almost all pathogenic species over the years. From the analysis of households, it is not possible to assert that there is a familial transmission. Our study provides evidence that the prevalence of parasitic infections in immigrants is likely related to the poor sanitary habits of the country of origin and that acquisition of new sanitary regulations, together with the administration of pharmacological treatment, limits the transmission in the households and in the local population of their destination.

PREVALÊNCIA DE PARASITOSES INTESTINAIS DE ACORDO COM O GÊNERO EM UM HOSPITAL UNIVERSITÁRIO NO SUL DO BRASIL

Introdução: As parasitoses intestinais apresentam elevada morbimortalidade, especialmente em áreas endêmicas. O Brasil é um país de extrema heterogeneidade econômica e pouco se sabe sobre a prevalência de parasitoses intestinais na região Sul. O objetivo desse estudo é relatar a prevalência de parasitoses intestinais em exames de fezes, e avaliar se há diferenças em relação ao gênero. Métodos: Estudo de coorte histórico, analítico transversal, que avaliou exames parasitológicos de fezes (PPFs) realizados em laboratório de Hospital Universitário. Resultados: Foram incluídos 3.126 resultados de PPFs, onde 44,4% pertenciam a homens e 10,1% eram positivos. Protozoários comensais foram os mais frequentes (7,7%) e E. nana foi o mais prevalente (3,7%). Entre os patogênicos, o mais frequente foi G. lamblia (1,3%), seguido de S. stercoralis (0,7%). De uma forma geral, os homens apresentaram maior proporção de exames positivos (13,0% vs. 7,8%; P < 0,001), tanto para parasitos comensais (7,2% vs. 5,1%; P = 0,016), quanto para patogênicos (4,5% vs. 1,8%; P < 0,001); tanto para protozoários (10,7% vs. 6,4%; P < 0,001) quanto para nematodos (1,4% vs. 0,6%; P = 0,036). Igualmente, os homens apresentaram uma maior proporção de resultados positivos para E. nana (5,2% vs. 2,6%; P < 0,001), E. coli (3,5% vs. 1,6%; P < 0,001), G. lamblia (2,2% vs. 0,6%; P < 0,001) e S. stercoralis (1,1% vs. 0,3%; P = 0,013) quando comparados às mulheres. Conclusões: Parasitos foram encontrados em 10% dos exames, sendo os comensais mais prevalentes. Os homens exibiram maior proporção de enteroparasitoses que as mulheres.

Intestinal Parasitosis in Relation to Anti-Retroviral Therapy, CD4(+) T-cell Count and Diarrhea in HIV Patients.

Intestinal parasitic infections are one of the major causes of diarrhea in human immunodeficiency virus (HIV) seropositive individuals. Antiretroviral therapy has markedly reduced the incidence of many opportunistic infections, but parasite-related diarrhea still remains frequent and often underestimated especially in developing countries. The present hospital-based study was conducted to determine the spectrum of intestinal parasitosis in adult HIV/AIDS (acquired immunodeficiency syndrome) patients with or without diarrhea with the levels of CD4+ T-cell counts. A total of 400 individuals were enrolled and were screened for intestinal parasitosis. Of these study population, 200 were HIV seropositives, and the remaining 200 were HIV uninfected individuals with or without diarrhea. Intestinal parasites were identified by using microscopy as well as PCR assay. A total of 130 (32.5%) out of 400 patients were positive for any kinds of intestinal parasites. The cumulative number of parasite positive patients was 152 due to multiple infections. A significant association of Cryptosporidium (P<0.001) was detected among individuals with CD4+ T-cell counts less than 200 cells/μl.

Prevalence and factors associated with intestinal parasitic infections among food handlers of Southern Ethiopia: cross sectional study.

BackgroundGlobally about one third of the total population is estimated to be infected with intestinal parasites, of which, the majority are people living in tropical and sub-tropical parts of the world. Cases of intestinal parasitosis are also highly abundant in Ethiopia and hence the aim of present study was to assess prevalence and predictors of intestinal parasitic infections among food handlers working in Arba Minch University students’ cafeteria, South Ethiopia.MethodA cross sectional study was conducted among food handlers working in Arba Minch University from April to June, 2015. A pretested structured questionnaire was used for collecting data about socio-demographic characteristics and possible risk factors. Stool specimens were collected and examined microscopically for the presence of eggs, cysts and trophozoites of intestinal parasites. Data entry and analysis were done using SPSS version 20 software.ResultsA total of 376 food handlers were enrolled in the study of which thirty one of them were not willing to participate for a stool examination. The majority of study participants were females 273 (72.6 %). About 123 (36 %) of food handlers were found to be positive for different intestinal parasites with the most abundant parasite of Entamoeba histolytica/dispar 48 (14 %) followed by Ascaris lumbricoides 32 (9.27 %). Finger nail status (AOR: 2.2, 95 % CI: 1.29–3.72), hand washing practice after toilet (AOR: 1.71, 95 % CI: 1.06–2.77), hand washing practice before food handling (AOR: 1.69, 95 % CI: 1.04–2.75), preparing food when suffering from diseases (AOR: 3.08, 95 % CI: 1.17–8.13), and using common knife for cutting raw flesh food and other food (AOR: 1.72, 95 % CI: 1.01–2.92) were independent predictors of intestinal parasitic infection among the food handlers.ConclusionThis study revealed a high prevalence of intestinal parasites among food handlers. Since most of the intestinal parasites are transmitted by the feco-oral route, food handlers could be an important source of infection to the students and general population. Therefore, constant epidemiological surveillance through biannual routine parasitological tests and treatment of the infected cases along with the improvement of personal hygiene and environmental sanitation are recommended to control the parasitic infection in food handlers.

Clinical and epidemiological features of leishmaniasis in northwestern-Argentina through a retrospective analysis of recent cases

Leishmaniasis is a parasitic disease caused by hemoflagellates of the genus Leishmania and is transmitted to humans by the bite of infected phlebotomine sandflies. Depending on the Leishmania species, the disease has different clinical forms including cutaneous, mucocutaneous, and visceral manifestations. Previous studies performed in endemic zones of northwestern-Argentina, during epidemic outbreaks, have been important for detecting patients suffering from the acute phase of the disease, but have not given a complete representation of the clinical and epidemiological features in the region. Furthermore, due to the resurgence of leishmaniasis worldwide and in particular the large increase of international tourism to the region, it seems pertinent to update the current epidemiological and clinical profile of leishmaniasis in northwestern-Argentina. Here we present a retrospective analysis of 95 Leishmania positive cases, presenting between 2000 and 2014. Patients were derived from hospitals and diagnosed in our lab at the University of Salta, located in a non-endemic area in Salta, Argentina. We detected numerous extensive mucocutaneous cases (34/95, 35.8%) distinct from mucosal affected patients, some instances originating in locations with no previously reported human cases. Additionally patients suffering from concomitant diseases, besides leishmaniasis, were assessed. These included Chagas disease, syphilis, deep mycoses, tuberculosis, toxoplasmosis and intestinal parasitosis. This study updates the clinical and epidemiological features of leishmaniasis in northwestern-Argentina, and discusses the implications and management strategy for patients who acquire the disease in this region.

Immunohistochemical detection and gene expression of TNFα in turbot (Scophthalmus maximus) enteromyxosis.

Enteromyxum scophthalmi (Myxozoa) constitutes one of the most devastating pathogens for turbot (Scophthalmus maximus, L.) aquaculture. This parasite causes a severe intestinal parasitosis that leads to a cachectic syndrome with high morbidity and mortality rates for which no therapeutic options are available. Presence of inflammatory infiltrates, increased apoptotic rates and epithelial detaching have been described at intestinal level, as well as leukocyte depletion in lymphohaematopoietic organs. Previous investigations on enteromyxosis in turbot showed the high susceptibility of this species to the parasite and reported the existence of a dysregulated immune response against the parasite. The pleiotropic cytokine tumour necrosis factor alpha (TNFα) plays a major role in immune response and is involved in a wide range of biological activities. In teleost, the gene expression of this cytokine has been found regulated under several pathological conditions. Teleost TNFα shows some analogous functions with its mammalian counterparts, but the extent of its activities is still poorly understood. Cytokines are generally considered as a double-edge sword and TNFα has been implicated in the pathogenesis of different inflammatory diseases as well as in wasting syndromes described in mammals. The aim of this work was to analyse the expression of TNFα during enteromyxosis with molecular (Q-PCR) and morphological (immunohistochemistry) tools. Kidney, spleen and pyloric caeca from turbot with moderate and severe infections were analysed and compared to healthy naïve fish. TNFα expression was increased in both spleen and kidney in the earlier stages of the disease, whereas in severely infected fish, the expression decreased, especially in kidney. At the intestinal level, an increase in the number of TNFα-positive cells was noticed, which was proportional to the infiltration of inflammatory cells. The results demonstrate the involvement of TNFα in the immune response to E. scophthalmi in turbot, which could be related to the development of the clinic signs and lesions.

Ebola Virus Disease Outbreak in Isiro, Democratic Republic of the Congo, 2012: Signs and Symptoms, Management and Outcomes.

Data collected during the 2012 Ebola virus disease (EVD) epidemic in the Democratic Republic of the Congo were analysed for clinical signs, symptoms and case fatality of EVD caused by Bundibugyo virus (BDBV), establishment of differential diagnoses, description of medical treatment and evaluation of the quality of clinical documentation. In a quantitative observational prospective study, global epidemiological data from 52 patients (34 patients within the community, 18 patients treated in the Ebola Treatment Centre) were entered anonymously into a database, subsequently matched and analysed. Relevant findings include an over-representation of females among community EVD cases (85.3%) and of community EVD cases in the age group of 15-54 years (82.4%). All ETC patients had fever (55.6% of all 18 ETC patients during their hospital stay) or self-reported fever (88.2% upon admission) at some point of time during their illness. Major symptoms of ETC patients during hospital stay included asthenia (82.4%), anorexia (82.4%), myalgia (70.6%), sore throat/difficulty swallowing (70.6%), arthralgia (76.5%) and nausea (70.6%). Gastrointestinal signs and symptoms (nausea, diarrhoea, vomiting) (76.4%) as well as general pain (94.1%) were frequent in ETC patients. The median duration of EVD was 18 days, while the mean incubation period was 11.3 days. Differential diagnosis of EVD included malaria (28.3%), intestinal parasitosis (10.9%), and infectious syndrome (10.9%). There was also an important variation in clinical evolvement. Quality of documentation was adversely affected by the way patient file contents were transferred from inside to outside the high-risk zone, entailing a mean mismatch value of 27.3% between patient file contents inside vs. outside the high-risk zone. This study adds further description of EVD (frequently non-specific signs and symptoms, non frequent bleeding, a long incubation period, long duration of disease) and emphasizes the need for improving clinical monitoring and documentation in EVD outbreak settings.

Progression of the load of waterborne and intestinal parasitic diseases in the State of Amazonas.

In the State of Amazonas, Brazil, urban expansion together with precarious basic sanitation conditions and human settlement on river banks has contributed to the persistence of waterborne and intestinal parasitic diseases. Time series of the recorded cases of cholera, typhoid fever, hepatitis A and leptospirosis are described, using data from different levels of the surveillance systems. The sources for intestinal parasitosis prevalence data (non-compulsory reporting in Brazil) were Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latino-Americana (LILACS) and the annals of major scientific meetings. Relevant papers and abstracts in all languages were accessed by two independent reviewers. The references cited by each relevant paper were scrutinized to locate additional papers. Despite its initial dissemination across the entire State of Amazonas, cholera was controlled in 1998. The magnitude of typhoid fever has decreased; however, a pattern characterized by eventual outbreaks still remains. Leptospirosis is an increasing cause of concern in association with the annual floods. The overall prevalence of intestinal parasites is high regardless of the municipality and the characteristics of areas and populations. The incidence of hepatitis A has decreased over the past decade. A comparison of older and recent surveys shows that the prevalence of intestinal parasitic diseases has remained constant. The load of waterborne and intestinal parasitic diseases ranks high among the health problems present in the State of Amazonas. Interventions aiming at basic sanitation and vaccination for hepatitis A were formulated and implemented, but assessment of their effectiveness in the targeted populations is still needed.

Anguillulose digestive révélée par un abdomen aigu

Strongyloidiasis is an intestinal parasitosis generally considered minor, it can progress to a severe form, very serious and fatal multiorgan by larval dispersal in immunocompromised patients. in immunocompetents patients, digestive signs are less noisy. We report a clinical case of digestive strongyloidiasis revealed by an acute abdomen in a patient 41 years at the University Hospital of Brazzaville. The diagnosis was established by examination of gastric and rectal biopsies. The outcome was favorable after treatment with albendazole.

TF-Test Modified: New Diagnostic Tool for Human Enteroparasitosis.

Intestinal parasitosis is highly prevalent worldwide, being among the main causes of illness and death in humans. Currently, laboratory diagnosis of the intestinal parasites is accomplished through manual technical procedures, mostly developed decades ago, which justifies the development of more sensitive and practical techniques. Therefore, the main objective of this study was to develop, evaluate, and validate a new parasitological technique referred to as TF-Test Modified, in comparison to three conventional parasitological techniques: TF-Test Conventional; Rugai, Mattos & Brisola; and Helm Test/Kato-Katz. For this realization, we collected stool samples from 457 volunteers located in endemic areas of Campinas, São Paulo, Brazil, and statistically compared the techniques. Intestinal protozoa and helminths were detected qualitatively in 42.23% (193/457) of the volunteers by TF-Test Modified technique, against 36.76% (168/457) by TF-Test Conventional, 5.03% (23/457) by Helm Test/Kato-Katz, and 4.16% (19/457) by Rugai, Mattos & Brisola. Furthermore, the new technique presented "almost perfect kappa" agreement in all evaluated parameters with 95% (P < 0.05) of estimation. The current study showed that the TF-Test Modified technique can be comprehensively used in the diagnosis of intestinal protozoa and helminths, and its greater diagnostic sensitivity should help improving the quality of laboratory diagnosis, population surveys, and control of intestinal parasites.

Transición parasitaria: experiencia en un hospital pediátrico de tercer nivel (1990-2010)

BackgroundIn recent years, the main reason for parasitological diagnosis was suspicion of a parasitic etiology. Currently, diagnosis and consultation are associated with co-morbidity with a hemato-oncological, autoimmune, immunodeficiency or post-transplant condition. MethodsResults collected from the Parasitology Laboratory of the Hospital Infantil de Mexico Federico Gómez from January 1990 to December 2010 were analyzed to determine the frequency and distribution of parasites and commensals per year and decade. ResultsThere were 211,600 samples analyzed with a statistical media of 10,100 and a standard deviation of 3,500 samples. Percentage of observations for parasitic structures as well as commensals was 37.73% according to Pearson Chi square with a significant difference among percentages between decades (p<0.0001). ConclusionsBehavioral tendency of intestinal parasitosis during the last two decades shows a change in frequency and genera from the agents that were reported at this pediatric health care level. The processing of epidemiologic information is important in order to determine the response of the parasitosis and its variations over time.

Performance evaluation of direct saline stool microscopy, Formol ether concentration and Kato Katz diagnostic methods for intestinal parasitosis in the absence of gold standard methods

The parasite load within the sample and the amount of sample taken during examination greatly compromise the sensitivity of direct saline stool microscopy. A cross-sectional study was conducted in March 2011 in Bahir Dar city among 778 fresh single stool samples to evaluate the performance of direct saline (DS), Kato Katz (KK) and Formol ether concentration (FEC) methods against the 'Gold' standard. Among 778 stool samples from school age children, the highest prevalence of intestinal parasites was recorded by FEC (55.1%). The sensitivity of DS, FEC and KK were 61.1%, 92.3% and 58.7%, respectively. FEC is more sensitive than DS and KK. Hence, use of the latter is preferred.

Intestinal parasitosis in patients treated with corticoids

Se presenta el reporte del examen coproparasitologico de 23 pacientes de con enfermedades reumatologicas y tratamiento inmunosupresor del Servicio de Reumatologia del Hospital de Clinicas (Asuncion, Paraguay) en el ano 2013. Se detectaron 16 pacientes parasitados, siendo en orden de frecuencia: Entamoeba coli (41%), Giardia lambia (23%), Strongyloides stercoralis (14%), el resto 1 caso de Hymenolepis nana y Ascaris lumbricoides.

Intestinal Parasitosis among Primary School Pupils in Coastal Areas of the Cape Coast Metropolis, Ghana

Intestinal Parasitosis among Primary School Pupils in Coastal Areas of the Cape Coast Metropolis, Ghana

Intestinal Parasitoses in HIV Infected Children in a Nigerian Tertiary Hospital.

Intestinal parasitoses are common amongst people living in developing countries. They may impact negatively on the growth and health of immune competent children. There is paucity of information on the association between HIV and intestinal parasitoses in African children. To identify the intestinal infections responsible for infections in HIV infected children and document characteristics of HIV infected children at a Nigerian teaching hospital. Consecutive children attending a Paediatric anti-retroviral clinic were studied. Information such as socio-demographics and clinical characteristics elicited from clinical examination were recorded in the proforma. Stool samples of the children were obtained and examined for intestinal parasites. Data was analysed with the SPSS 18 software. A total 52 children were studied and their age ranged between 6 months and 14 years, with a mean of 6.5 years ± 3.93. The 52 were made up of 27 boys and 25 girls, giving a male: female ratio of 1.1:1. 10 (19.2%) of the 52 children were infected with cryptosporidium spp, while 1(1.9%) had Ascaris lumbricoides infestation. Anti-helminthics had previously been administered to 86.5% of children studied. Those who previously received anti-helminthics had lower prevalence estimates of cryptosporidium infections. (p<0.01, RR = 0.42, 95%CI = 0.20 - 0.90). Children on co-trimoxazole prophylaxis had lower prevalence estimates of cryptosporidium infections. (P<0.01, RR = 0.35, 95%CI = 0.14 - 0.91). Use of highly active antiretroviral drugs was also associated with lower prevalence estimates of intestinal cryptosporidium. (p=0.04, RR = 0.58, 95%CI = 0.31 - 1.10). Eight of the 10 children infected with cryptosporidium had recurrent abdominal pain in comparison with the six with recurrent abdominal pain amongst the 42 without cryptosporidial infections. (p<0.01, RR=5.6, 95%CI= 2.51 - 12.1). Cryptosporidial infection is the most common intestinal parasitoses among HIV infected children in this study, while intestinal helminthiasis are not so common. Anti-helminthics, Co-trimoxazole prophylaxis and highly active anti-retroviral therapy have a protective effect against intestinal cryptosporidium. Screening for intestinal cryptosporidium is suggested in HIV infected children with recurrent abdominal pain, because of the statistically association.

Prevalence of Intestinal Parasitic Infections among Patients with Diarrhea at Wonago Health Center, Southern Ethiopia: A Retrospective Study

Background: Intestinal parasitic infections are among the most common infections worldwide. High prevalence is found in people with low socio-economic status, poor living condition, overcrowded areas, poor environmental sanitation, improper garbage disposal, unsafe water supply and unhygienic personal habits. Thus, the objective of this retrospective study was to determine the prevalence of intestinal parasitosis among patients with diarrhea who visited Wonago health center Southern Ethiopia. Methodology: Institution based retrospective study design was employed. Stool examination records of all patients with diarrhea who visited Wonago health center from September 2010 to September 2012 were included. A total of 10694 stool examination results of those diarrheic patients were analyzed for this study. Samples were examined using direct saline wet mount technique. Statistical analysis was done by SPSS version 16 and results were shown in percent and prevalence rates. Results: The overall prevalence of intestinal parasite for at least one parasite in this retrospective study was 1776/10694(16.6%). Furthermore, 5.7% of those positive patients were infected by two species of parasites and 4.6%of patients had triple infections. The most prevalent parasites were E. histolytica/dispar 956/1776(53.8%) followed by G. lamblia 420/1776(23.7%) and Taenia species 140/1776(7.9%) respectively. Conclusion: Intestinal parasitosis is highly prevalent in varying magnitude among diarrheic patients who visited Wonago health Center, Southern Ethiopia. E. histolytica/dispar was the most prevalent parasite infecting patients followed by, G. lamblia, Taenia species and H. nana. Because of absence of molecular diagnosis for E. histolytica, over diagnosis might be possible for the high prevalence of amoebiasis.

Quadruple burden of HIV/AIDS, tuberculosis, chronic intestinal parasitoses, and multiple micronutrient deficiency in ethiopia: a summary of available findings.

Human immunodeficiency virus (HIV), tuberculosis (TB), and helminthic infections are among the commonest public health problems in the sub-Saharan African countries like Ethiopia. Multiple micronutrient deficiencies also known as the “hidden hunger” are common in people living in these countries either playing a role in their pathogenesis or as consequences. This results in a vicious cycle of multiple micronutrient deficiencies and infection/disease progression. As infection is profoundly associated with nutritional status resulting from decreased nutrient intake, decreased nutrient absorption, and nutrient losses, micronutrient deficiencies affect immune system and impact infection and diseases progression. As a result, micronutrients, immunity, and infection are interrelated. The goal of this review is therefore to provide a summary of available findings regarding the “quadruple burden trouble” of HIV, TB, intestinal parasitic infections, and multiple micronutrient deficiencies to describe immune-modulating effects related to disorders.

The current spectrum and prevalence of intestinal parasitosis in Campania (region of southern Italy) and their relationship with migration from endemic countries

In Italy, the current clinical-epidemiological features of intestinal parasitosis and the impact of recent massive migration flows from endemic areas on their distribution are not very well known. An analysis was carried out involving 1766 patients (720 natives and 1046 immigrants) observed during the period 2009-2010 (the 'current group') and 771 native patients observed during the period 1996-1997 (the 'historical group'), a time at which immigration in the area was minimal. Patients were analyzed for intestinal parasitosis at four healthcare centres in Campania. A wide variety of intestinal parasites was detected in the study subjects. Immigrants had a significantly higher prevalence of parasitosis and multiple simultaneous infections than natives in both groups. In both study groups of natives, the detection of at least one parasite was significantly associated with a history of travel to endemic areas. Among immigrants, we found an inverse correlation between the frequency of parasite detection and the amount of time spent in Italy. No circulation of parasites was found among contacts of parasitized patients. Intestinal parasites are still a cause of intestinal infection in Campania. Although immigrants have a significantly higher prevalence of parasitosis than natives, this does not increase the risk of infection for that population. This is likely due to the lack of suitable biological conditions in our area.

Clinical aspects of paediatric visceral leishmaniasis in North-west Ethiopia.

Visceral leishmaniasis (VL) in north-west Ethiopia is causing an overwhelming case load among adult migrant workers that masked the disease burden in children. This study describes the clinical profile and explores comorbidities in paediatric VL patients. A prospective study at two hospitals in this region (Gondar and Humera) was conducted in a year period, 2011-2012. The clinical manifestations and comorbidities such as malnutrition, intestinal parasitosis and vitamin D deficiency and HIV infection were assessed, and treatment outcomes noted. A total of 122 children with VL were detected during the study period with median age of 8.5years (IQR 5-12years); 23% were under 5years. Eighty-five (69.7%) cases were male. The clinical manifestations were similar to the adult patients. High rates of malnutrition, intestinal parasitosis (47.5%) and hypovitaminosis D (56.4%) were detected. The proportion of stunting and wasting was 63% and 22.2% in children aged under five years, and 50.5% and 75.9% in 5-year and older children, respectively, using WHO standard growth curves. Only one child had HIV infection. In 95% of the cases, sodium stibogluconate (20mg/kg/day for 30days) was used for treatment. The treatment success rate at end of therapy was 98.3%, but the definitive outcome at 6months could not be determined because of a high loss to follow-up (80.2%). While HIV co-infection was rare, malnutrition, intestinal parasitosis and vitamin D deficiency were frequent indicating the need for further research on their role in the pathophysiology. Meanwhile, systematic assessment and management of malnutrition and intestinal parasitosis in VL programmes is recommended.

Screening for imported diseases in an immigrant population: experience from a teaching hospital in Barcelona, Spain.

The objective of this study was to describe the screening for imported diseases among an immigrant population. This retrospective observational study was of all adult immigrants attended at the Tropical Medicine Unit of the Vall d'Hebron Teaching Hospital from September of 2007 to March of 2010. The screening strategy was adjusted by symptoms, country of origin, and length of residence in Europe. Overall, 927 patients were included. The median age was 34.5 years, and 42.1% of patients were male. A diagnosis was made in 419 (45.2%) patients. The most frequent diagnoses were Chagas disease, anemia, latent tuberculosis infection, intestinal parasitosis, hepatitis B virus (HBV) infection, and human immunodeficiency virus (HIV) infection. After screening, more diseases were identified in immigrants from sub-Saharan Africa (new diagnoses in 56.6% of patients) than patients from other geographic areas. The geographic origin and length of residence in a developed country determine the prevalence of diseases; hence, screening protocols must be based on this information.