1642. Seroprevalence of Strongyloidiasis and Schistosomiasis among Immigrants and Refugees in Montreal, Canada
Session: Poster Abstract Session: Global Health
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • 2015 ID week Poster AA #1642 .pdf (392.8 kB)
  • Background: Strongyloides and Schistosoma can persist for decades asymptomatically.  Strongyloides can rapidly evolve into life-threatening disseminated disease after immunosuppression and chronic untreated schistosomiasis can result in end stage liver disease and bladder cancer. Current US and Canadian guidelines only recommend screening refugee populations for these parasites even though they make up a small proportion (<10%) of all potentially at risk migrants. The objective of this study was to measure and compare the seroprevalence of Strongyloides and Schistosoma in both immigrants and refugees.

    Methods: 1297 foreign-born adults (≥18 years), living ≤5 years in Canada, were recruited between October 2002 and December 2004. Socio-demographic information was collected via a questionnaire. Antibodies to recombinant Strongyloides stercoralis NIE antigen [Optical density (OD) <0.30=negative, ≥ 0.30=positive] and Schistosoma mansoni [OD <0.40=negative, ≥ 0.40=positive] were detected by ELISA on stored, banked sera. 

    Results: The mean age was 32.4 ± 8.8 years, 66% were female, and 44% were refugees. Overall 31.3% [95% CI: 29-34%] had antibodies to strongyloides and ranged from 22-45% in 6 different geographic regions.  In multivariate analysis, after adjusting for age, sex, region of origin, and several socioeconomic factors, positive strongyloides serology was more common in men [OR 1.4, 95% CI: 1.1-1.8] and in refugees compared to immigrants [OR 1.4, 95% CI: 1.01-2.0].  Although refugees were more likely to be seropositive for strongyloides [36.7%, 95% CI: 33-40%], a total of 26% (95% CI: 23-29%) of immigrants also had positive serology.   Overall 7.4% had schistosoma antibodies and those from Sub-Saharan Africa were the most likely to be seropositive [19.9%, 95% CI 4-26%].  In multivariate analysis, the only significant predictor of positive schistosoma serology was originating from Sub-Saharan Africa [OR 6.1, 95%CI: 2.9-12.7]. 

    Conclusion: A large proportion of both immigrants and refugees from all world regions are infected with strongyloides. Migrants from Sub-Saharan Africa are at greatest risk for schistosoma. Both immigrants and refugees are at risk for these diseases and may benefit from targeted screening programs and or empiric treatment.

    Archana Asundi, MDCM, Internal Medicine, McGill University, Montreal, QC, Canada, Momar Ndao, Ph.D, Division of Infectious Diseases, Montreal General Hospital, Montreal, QC, Canada, Brian Ward, MD, Infectious Diseases, McGill University, Montreal, QC, Canada, Sonya Cnossen, MSc, SMBD Jewish General Hospital, Montreal, QC, Canada, Michael Libman, MD, McGill University, Montreal, QC, Canada and Christina Greenaway, MD, MSc, Department of Microbiology and Infectious Diseases, SMBD Jewish General Hospital, Montreal, QC, Canada

    Disclosures:

    A. Asundi, None

    M. Ndao, None

    B. Ward, None

    S. Cnossen, None

    M. Libman, None

    C. Greenaway, None

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