Immigration from east Africa (mainly Eritrea) to Israel peaked during 2011-2013. Little is known about the prevalence of chronic parasitic diseases in this population.
We performed a survey of Schistosomiasis and Strongyloidiasis among immigrants, both are pararsites that can cause chronic infections, and can lead to significant morbidity and complications.
A prospective survey of adults (>18 years) from Eritrea was performed at a primary care clinic for immigrants in Tel Aviv, Israel. Participants provided written informed consent. Stool and blood samples were collected, and participants filled epidemiological and clinical questionnaires. Stool was tested by real time PCR for Strongyloides stercoralis and Schistosoma species, serum was tested for IgG antibodies against these pathogens using comercial kits (WB, LDBio Diagnostic for schistosoma, ELISA, SciMedx for Strongyloides ).
106 patients were included in the survey; 85% were males and 15% females, median age was 34 (IQR30-39) years, and median duration living in Israel was 7 years (IQR 6-9). Serology was positive in 55/106 (52%) for Schistosoma spp. and in 1/106 (1%) for Strongyloides. Stool PCR for Schistosoma was positive in 34 of 106 (32%), and uniformly negative for Strongyloides. Risk factors for positive schistosoma serology and PCR were male gender and younger age. Other factors such as duration of residence in Israel, staying in other countries along the way to Israel, self-reported swimming in fresh water reservoirs and symptoms such as diarrhea, abdominal pain, and blood in stool were not significantly associated with Schistosoma infection.
We found high rate of Schistosomiasis (both by serology and PCR in stool) among Eritrean immigrants in Israel. While serology can remain positive for many years after there are no longer living parasites, high rates of positive stool PCR suggest current active infection. In contrary, chronic Strongyloidiasis was rarely detected.
Empirical treatment of schistosomiasis with praziquantel should be considered for immigrants from Eritrea.
R. Ben Ami, None
D. Shasha, None
T. Grossman, None