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Travel-related schistosomiasis, strongyloidiasis, filariasis, and toxocariasis: the risk of infection and the diagnostic relevance of blood eosinophilia.
BMC Infect Dis 2011; 11:84BI

Abstract

BACKGROUND

This study prospectively assessed the occurrence of clinical and subclinical schistosomiasis, strongyloidiasis, filariasis, and toxocariasis, and the screening value of eosinophilia in adult short-term travelers to helminth-endemic countries.

METHODS

Visitors of a pre-travel health advice centre donated blood samples for serology and blood cell count before and after travel. Samples were tested for eosinophilia, and for antibodies against schistosomiasis, strongyloidiasis, filariasis, and toxocariasis. Previous infection was defined as seropositivity in pre- and post-travel samples. Recent infection was defined as a seroconversion. Symptoms of parasitic disease were recorded in a structured diary.

RESULTS

Previous infection was found in 112 of 1207 subjects: schistosomiasis in 2.7%, strongyloidiasis in 2.4%, filariasis in 3.4%, and toxocariasis in 1.8%. Recent schistosomiasis was found in 0.51% of susceptible subjects at risk, strongyloidiasis in 0.25%, filariasis in 0.09%, and toxocariasis in 0.08%. The incidence rate per 1000 person-months was 6.4, 3.2, 1.1, and 1.1, respectively. Recent infections were largely contracted in Asia. The positive predictive value of eosinophilia for diagnosis was 15% for previous infection and 0% for recent infection. None of the symptoms studied had any positive predictive value.

CONCLUSION

The chance of infection with schistosomiasis, strongyloidiasis, filariasis, and toxocariasis during one short-term journey to an endemic area is low. However, previous stay leads to a cumulative risk of infection. Testing for eosinophilia appeared to be of no value in routine screening of asymptomatic travelers for the four helminthic infections. Findings need to be replicated in larger prospective studies.

Authors+Show Affiliations

Department of Infectious Diseases, Public Health Service (GGD) Amsterdam, Nieuwe Achtergracht 100, PO Box 2200, 1000 CE Amsterdam, The Netherlands. gijsbaaten@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21466667

Citation

Baaten, Gijs G., et al. "Travel-related Schistosomiasis, Strongyloidiasis, Filariasis, and Toxocariasis: the Risk of Infection and the Diagnostic Relevance of Blood Eosinophilia." BMC Infectious Diseases, vol. 11, 2011, p. 84.
Baaten GG, Sonder GJ, van Gool T, et al. Travel-related schistosomiasis, strongyloidiasis, filariasis, and toxocariasis: the risk of infection and the diagnostic relevance of blood eosinophilia. BMC Infect Dis. 2011;11:84.
Baaten, G. G., Sonder, G. J., van Gool, T., Kint, J. A., & van den Hoek, A. (2011). Travel-related schistosomiasis, strongyloidiasis, filariasis, and toxocariasis: the risk of infection and the diagnostic relevance of blood eosinophilia. BMC Infectious Diseases, 11, p. 84. doi:10.1186/1471-2334-11-84.
Baaten GG, et al. Travel-related Schistosomiasis, Strongyloidiasis, Filariasis, and Toxocariasis: the Risk of Infection and the Diagnostic Relevance of Blood Eosinophilia. BMC Infect Dis. 2011 Apr 5;11:84. PubMed PMID: 21466667.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Travel-related schistosomiasis, strongyloidiasis, filariasis, and toxocariasis: the risk of infection and the diagnostic relevance of blood eosinophilia. AU - Baaten,Gijs G, AU - Sonder,Gerard J, AU - van Gool,Tom, AU - Kint,Joan A, AU - van den Hoek,Anneke, Y1 - 2011/04/05/ PY - 2010/11/14/received PY - 2011/04/05/accepted PY - 2011/4/7/entrez PY - 2011/4/7/pubmed PY - 2011/8/11/medline SP - 84 EP - 84 JF - BMC infectious diseases JO - BMC Infect. Dis. VL - 11 N2 - BACKGROUND: This study prospectively assessed the occurrence of clinical and subclinical schistosomiasis, strongyloidiasis, filariasis, and toxocariasis, and the screening value of eosinophilia in adult short-term travelers to helminth-endemic countries. METHODS: Visitors of a pre-travel health advice centre donated blood samples for serology and blood cell count before and after travel. Samples were tested for eosinophilia, and for antibodies against schistosomiasis, strongyloidiasis, filariasis, and toxocariasis. Previous infection was defined as seropositivity in pre- and post-travel samples. Recent infection was defined as a seroconversion. Symptoms of parasitic disease were recorded in a structured diary. RESULTS: Previous infection was found in 112 of 1207 subjects: schistosomiasis in 2.7%, strongyloidiasis in 2.4%, filariasis in 3.4%, and toxocariasis in 1.8%. Recent schistosomiasis was found in 0.51% of susceptible subjects at risk, strongyloidiasis in 0.25%, filariasis in 0.09%, and toxocariasis in 0.08%. The incidence rate per 1000 person-months was 6.4, 3.2, 1.1, and 1.1, respectively. Recent infections were largely contracted in Asia. The positive predictive value of eosinophilia for diagnosis was 15% for previous infection and 0% for recent infection. None of the symptoms studied had any positive predictive value. CONCLUSION: The chance of infection with schistosomiasis, strongyloidiasis, filariasis, and toxocariasis during one short-term journey to an endemic area is low. However, previous stay leads to a cumulative risk of infection. Testing for eosinophilia appeared to be of no value in routine screening of asymptomatic travelers for the four helminthic infections. Findings need to be replicated in larger prospective studies. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/21466667/full_citation L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-11-84 DB - PRIME DP - Unbound Medicine ER -