03280nas a2200529   4500000000100000008004100001653000900042653001900051653001500070653001000085653000900095653001200104653001300116653001300129653001000142653001400152653001100166653001100177653001100188653000900199653001600208653001300224653002800237653002400265653002000289653003000309653001200339653002100351653001000372653001800382100001300400700001700413700001500430700001300445700001300458700001300471700001300484700002000497700001000517700001400527245011000541856003100651300001100682490000700693520203600700022001402736       2007                            d10aNTDs10aAbdominal pain10aAdolescent10aAdult10aAged10aAnimals10aAntigens10ahelminth10aChild10aPreschool10aFemale10aHumans10aInfant10aMale10aMiddle Aged10aRefugees10aSchistosoma haematobium10aSchistosoma mansoni10aschistosomiasis10aSeroepidemiologic Studies10aSomalia10aStrongyloidiasis10aSudan10aUnited States1 aPosey DL1 aBlackburn BG1 aWeinberg M1 aFlagg EW1 aOrtega L1 aWilson M1 aSecor EW1 aSanders-Lewis K1 aWon K1 aMaguire J00aHigh prevalence and presumptive treatment of schistosomiasis and strongyloidiasis among African refugees.  uhttp://tinyurl.com/mrxgyaj  a1310-50 v453 a<p><strong>BACKGROUND: </strong>Schistosomiasis and strongyloidiasis cause substantial morbidity and mortality among hundreds of millions of infected persons worldwide. In the United States, these infections are most commonly found among international travelers, immigrants, and refugees from areas of endemicity. Refugees resettled to the United States since 2000 include &gt;3800 "Lost Boys and Girls" of Sudan and 8000 Somali Bantu. Many Lost Boys and Girls of Sudan reported chronic abdominal pain only since arrival, and some received diagnoses of schistosomiasis or strongyloidiasis. We assessed seroprevalence of these infections among these refugees and hypothesized an association between infection and abdominal pain.</p>

<p><strong>METHODS: </strong>We offered a survey assessing chronic abdominal pain and serologic testing for schistosomiasis and strongyloidiasis to all 800 attendees of a Lost Boys and Girls of Sudan reunion in the United States. Serologic testing was performed on preimmigration specimens obtained from 100 United States-bound Somali Bantu refugees.</p>

<p><strong>RESULTS: </strong>Of the 462 Sudanese refugees (58%) tested, 44% and 46% were seropositive for schistosomiasis (primarily due to Schistosoma mansoni) and strongyloidiasis, respectively; 24% of those who tested positive for schistosomiasis had S. mansoni antigenemia. Forty-six percent reported chronic abdominal pain, which was not associated with either infection. Among 100 Somali Bantu, 73% and 23% tested seropositive for schistosomiasis (primarily due to Schistosoma haematobium) and strongyloidiasis, respectively.</p>

<p><strong>CONCLUSIONS: </strong>The high seroprevalence of schistosomiasis and strongyloidiasis among Sudanese Lost Boys and Girls and Somali Bantu refugees supports presumptive treatment for these refugees. Current refugee resettlement policies inadequately address these diseases; our data support consideration of predeparture presumptive therapy for all refugees from areas of endemicity.</p>
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