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Intestinal parasites in Southeast Asian refugee children.

To determine the predictability of pediatric stool-parasite patterns among various Southeast Asian ethnic groups, I collected data from medical and microbiology laboratory records on all Southeast Asian refugee children who had a stool specimen examined for ova and parasites over a 21-month period. For most of the children, the specimen was examined as part of routine "health screening." The patterns of infection by ethnic group for those Vietnamese and Laotian children living in Seattle differ from the patterns seen in other geographic areas.

Adolescent↗

Parasite screening and treatment among Indochinese refugees. Cost-benefit/utility and the General Health Policy Model.

The General Health Policy Model and the Quality of Well-being scale are used to describe a "cost-benefit/utility" evaluation of a screening and treatment program for intestinal parasites among indochinese refugees in the United States. Cost-benefit/utility analysis subsumes conventional cost-effectiveness by explicitly adding social utility factors to the dollar dimension. Using actual data on parasite prevalence and program costs from one screening project and estimated figures for other factors, this article demonstrates calculation of the cost-benefit/utility outcome measure, dollars per well-year. Dollars per well-year for parasite screening are calculated for a number of examples. Further analysis and final conclusions on the worth of parasite screening and treatment programs await more reliable data for some terms of the developed model.

Asia, Southeastern↗

[A parasitologic survey conducted in Touraine (France) in a group of South East Asia refugees (author's transl)].

Forty refugees (23 from 5 lao families and 17 from 3 cambodian families) previously and routinely treated against intestinal parasites, underwent stools and serum controls: 77 p. 100 had still intestinal parasites but 61 p. 100 had a normal blood cells count without hypereosinophilia. The parasites so detected were: Clonorchis sinensis, Heterophyes heterophyes, Trichuris trichiura, Necator americanus, Strongyloides stercoralis, Giardia intestinals and Entamoeba coli.

Adolescent↗

[Priorities in health activities in refugee camps (author's transl)].

In times of natural or man-made disasters, settlements of refugees in temporary camps face the health authorities with new public health problems. The allocation of priorities and resources among Medical Care, Prevention and Sanitation, and Nutrition are usually not based on objective assessment of the situation. The potential role of epidemiological techniques and particularly of the surveillance is illustrated by the case studies of the Bengladesh civil war and the Niger drought. A rational priority order will usually rank nutrition at the top and individual medical care at the bottom.

Bangladesh↗

Observations on the infectivity of two strains of Plasmodium vivax from Vietnamese refugees to Aotus monkeys and anopheline mosquitoes.

Two strains of Plasmodium vivax (NAM and ONG) were isolated from Vietnamese refugees and established in splenectomized Aotus monkeys from Colombia and Bolivia. Mosquito infections were readily obtained from animals with no prior malarial experience or with a history of infection with P. falciparum only. Those animals with previous infections with P. vivax supported only low parasitemias, and the mosquito infections were minimal. Complete development of the sporogonic cycle was obtained with all species of mosquitoes tested. The most susceptible mosquito was An. dirus. Other mosquitoes readily infected with these strains were An. culicifacies, An. maculatus, An. gambiae, An. stephensi, and the two North American species, An. freeborni and An. quadrimaculatus. Transmission from one monkey to another was obtained via the bites of infected An. dirus, An. stephensi, and An. maculatus mosquitoes.

Animals↗

Protocol: health screening for Indochinese refugees.

Indochinese patients of all ages continue to present with multiple health problems. The most prevalent include incomplete immunizations, skin disease, dental disease, positive tuberculin skin tests, otitis media, anemia and intestinal parasites. Thorough health assessments for both adults and children include complete patient's age. If health problems can be diagnosed and treated soon after arrival in the United States, the refugees can then concentrate on the daily adaptation problems and complete the acculturation process.

Adolescent↗

An epidemiological investigation of pre-eclampsia and elevated blood pressure among Kampuchean refugee women at Sakaeo Holding Center, Thailand.

An investigation was undertaken at Sakaeo Holding Center in Thailand to determine the cause for an increase in the frequency of pre-eclampsia and elevated blood pressure among Kampuchean refugee women. A review of the admission and delivery logs revealed an incidence rate of 12.6 per 100 deliveries from March to August 1982. A study based on review of antenatal records indicated that haematocrit levels were significantly lower in the second and third trimesters among cases. When other Kampuchean holding centres were visited, pre-eclampsia and elevated blood pressure cases were few, and haematocrit levels were substantially higher than at Sakaeo. After an iron therapy programme was instituted at Sakaeo, there was a decrease in the number of pre-eclampsia cases.

Adolescent↗

Parasitic diseases with emphasis on schistosomiasis in Cambodian refugees, in Prachinburi Province Thailand.

Epidemiologic surveys were carried on 24,619 Cambodian refugees in Khao-I-Dang holding center, employing a skin test as a screening device to determine the prevalence of schistosomiasis. The diagnosis of Schistosoma mekongi was confirmed in 62 by positive stool examination. The majority of the positive cases came from Battambang province which is probably a new endemic area of schistosomiasis in Cambodia.

Adolescent↗

Active tuberculosis in Indochinese refugees in British Columbia.

The incidence of active tuberculosis in 8692 Indochinese refugees admitted to British Columbia between 1979 and 1981 was reviewed. In the first 3 months after entry into the province the rate was extremely high--estimated at 1890/100 000 (126 times the provincial average). A large proportion of these cases were of primary or minimal pulmonary tuberculosis. However, although the proportion of cases of minimal pulmonary tuberculosis was twice the provincial average, the proportion of these cases that were confirmed by culture was only one third the provincial average; this suggests some overdiagnosis in this period. In the subsequent 21 months of residence the incidence of active tuberculosis was also high, at 353/100 000, which was more than 20 times the provincial average. The distribution of cases by severity was closer to the provincial distribution in this period, but advanced disease accounted for a far smaller proportion of cases in both periods than it did in 1980 in the entire province.

Adolescent↗

Paragonimus westermani: a cause of cavitary lung disease in an Indochinese refugee.

A Laotian immigrant with persistent cough and hemoptysis was found to have multiple small cavities on chest roentgenogram. Ova of the lung fluke Paragonimus westermani were found in the sputum, and the patient responded to bithionol therapy. Pulmonary paragonimiasis should be considered in the differential diagnosis of cavitary lung disease in Indochinese refugees entering the United States.

Adult↗

[Coprological investigation into a group of 268 South East Asia refugees (author's transl)].

A coprological investigation has been carried out on 268 refugees from the South Eastern Asiatic region. They were separated in two groups, one having received no treatment and the other having received a systematic treatment by diphetarsone, 1.-tetramisole and thiabendazole. In the first group, the infestation rate by protozoa (E. histolytica: 3,68 p. 100, G. lamblia: 9,2 p. 100, T. intestinalis: 9,81 p. 100) was lower than by helminths (A. lumbricoides: 17,44 p. 100, Ancylostomidae: 44,17 p. 100 and S. stercoralis: 25,58 p. 100) which were more frequently found. After a systematic treatment, effects on intestinal protozoa remained nearly inexistent. Indeed, the same percentages were found in the second group, whereas antihelmintic drugs were more active particularly on A. lumbricoides (4,94 p. 100) and S. stercolaris (5,49 p. 100). The compiled data have shown a high percentage of ancylostomidae infection which lead the authors to propose the systematic application of the described nematocide therapy.

Adolescent↗

Infectious diseases of Indochinese refugees.

The recent Mayo Clinic experience in the diagnosis and treatment of infectious diseases in Indochinese refugees is discussed. One hundred patients from whom stool and blood specimens were submitted for parasitic examination showed a high percentage of parasitic infection, often with multiple agents. An outline for the initial medical examination and treatment of the parasitic agents found is presented.

Adolescent↗

[The Bremen primary examination program for refugees (I)].

In April 1993, the Bremen State Office of Public Health initiated a programme based on the requirements of political asylum legislation while answering the need of medical care for refugees in the first phase of their stay. Newly arriving asylum seekers channelled into legally obligatory "initial accommodation" are offered to avail themselves of a regular medical consultation in their accommodation facility. Thus, they have the opportunity to resort to medical examination, a doctor's advice, and, if need be, initial treatment.

Communicable Disease Control↗

[Collective food poisoning in a camp for unaccompanied refugee children in the city of Goma, Zaire, September 1994].

We report a retrospective study of a group of 440 children following an outbreak of infectious food poisoning in Goma in 1994. The study was part of the epidemiological surveillance in a non-accompanied child refugee reception centre. There were 11 cases (rate 2.5%). We evidence a problem of hygiene in the food preparation chain. Despite the numerous epidemics in the region (cholera, dysentery) this study demonstrated that they were not responsible. Similarly, the findings removed any existing doubts about the quality of the food supplied as part of the international aid.

Child, Preschool↗

[Study of an HIV positive, tropical origin population in a refugee center in France].

The study describes HIV positive refugee patients, who were seen over a 3 years period at COMEDE, a dispensary for foreign nationals. COMEDE offered a HIV test to every patient, and it followed up on the disease and its prevention. Out of 5,234 tests, 328 were positive (6.3%). Less than 5% of the patients refused the test. All the patients returned for the result; 88.4% were African and 11.3% Haitian. The mean age was 31.5 years. The male/female sex ratio was 1.28. In this study, 94.5% of the HIV patients were HIV1, 3% HIV2 and 2.5% carried both strains; 78% were asymptomatic, 7% had ARC and 12.5% had AIDS. The prevalence of tuberculosis was high (10.6%), especially for AIDS patients (65%); Treponematosis prevalence was 13% and toxoplasmosis was 62.8%; 40% had intestinal parasites. 36.4% of the women became pregnant during the study; 41% of the pregnancies were terminated, while 27% went full term. The proportion of missing patients after 6 months was high (57%) because of numerous factors which prevented them from returning. This study shows the importance of proposing a HIV test to this immigrant population, although follow-up is difficult, due to social and economic factors.

AIDS-Related Complex↗

Sero-prevalence to hepatitis B and C virus infection in refugees from Mozambique in southern Africa.

Serological markers for evidence of past exposure to hepatitis B virus (HBV) and hepatitis C virus (HCV) were investigated in a cohort of refugees from Mozambique. Serological markers for past exposure to HBV were detected in 56% of the population and, in addition, 13.2% carried the HBV surface antigen. Anti-HCV antibodies could be confirmed in 3.2% of the population and occurred mostly in the older individuals. Only one anti-HCV antibody positive individual was positive for HBsAg. Immunity to rubellavirus had reached 85% by 11 years of age.

Adolescent↗

[Endemic mercury burden caused by a bleaching ointment in Balken refugees].

In two camps in Ibbenbüren occupied by refugees from Balkan countries we found in 121 inhabitants, among them 56 children, high mercury concentrations in urine and blood. The median of the urinary concentrations was 12 micrograms/l (range: 0.15-770 micrograms/l) or 11.4 micrograms/g creatinin (range: 0.2-446 micrograms/g). 12 adults and 15 children had values above 50 micrograms/l. As source, a mercury-containing bleaching ointment, sold by foreign vendors, was identified. Mercury concentrations in several samples of this ointment ranged from 708 to 17,200 micrograms/g. Similar exposure to mercury may occur elsewhere. Hence, chronic mercury poisoning should by taken into differential diagnostic consideration.

Adolescent↗

[The search for historical truth: psychotherapeutic work with Bosnian refugees].

The trauma haunting refugees from ex-Yugoslavia is inextricably bound up with complex processes of historical change. In order to be able to understand and treat their severe psychic problems, psychotherapists have to go in search of the historical truth, which is frequently masked by myths and obsolete notions. Only when a psychotherapist who has received the relevant interdisciplinary schooling acknowledges the existence of completely new historical experiences can s/he provide effective support for Bosnian Muslims fleeing "ethnic cleansing" and attempting to achieve self-healing, learning and growth after such an extreme form of collective and individual destruction. In this way the psychotherapist becomes an initiated listener and a unique witness of a form of historical truth that for the traumatized patients themselves is at first entirely or largely beyond recall and comprehension.

Bosnia and Herzegovina↗