Assessing enteric helminths in refugees, asylum seekers and new migrants

Abstract

Currently there are 59.5million people forcibly displaced worldwide as a result of conflict, human rights violations, generalised violence or persecution. Of these, 19.5million are refugees and 1.8million are asylum seekers. Each year Australia accepts 13750 refugees through the offshore Humanitarian program, and in 2016 that number will almost double with the addition of 12000 refugees from Syria and Iraq. Many refugees have complex medical needs and have reached Australia after a difficult journey, often involving time in refugee camps and exposure to traumatic events including physical hardship and illness. Refugees often come from parts of the world where parasitic and tropical infectious diseases are prevalent and untreated. This article provides a review of enteric helminth infections in refugees, including asylum seekers and those from a refugee-like background.

The health status of newly arrived Syrian refugees at the Refugee Health Service, South Australia, 2016

“…18 There is scant data available regarding parasite prevalence, including strongyloides, schistosomiasis and soil-transmitted helminths in Syria. 21 Cutaneous leishmaniasis is reported to affect the Syrian refugee population in parts of Syria and is spreading to Lebanon. 7,22 There is little data regarding the prevalence of sexually transmitted infections in the Middle East or in Syrian refugee populations.…”

Soil-Transmitted Helminths in Tropical Australia and Asia

“…Stool-based microscopy remains the most common diagnostic method for STH, including in Australia, with the formol ethyl acetate sedimentation technique most commonly employed [ 133 , 134 ]. For S. stercoralis, serology is recommended, due to low and irregular numbers of larvae excreted in the stool even in heavy infections, with stool microscopy used to rule out other infections [ 133 , 135 ]. Diagnosis of STH in Australia is largely done on a case-by-case basis rather than by case detection.…”

“…As indicated, serology is often used in Australia for diagnosis of S. stercoralis [ 133 ], with microscopy employed for the other STH. In general, this holds true for Asia as well.…”

Neglected tropical diseases in Australia: a narrative review

“…Strongyloidiasis is endemic in parts of Australia, predominantly occurring in remote Aboriginal and Torres Strait Islander communities in tropical areas of WA, the NT, Queensland, northern South Australia, and northern NSW (Box 2). 27,41‐48 A limited number of epidemiological surveys, both retrospective and prospective, have been undertaken in Australia, reporting highly variable prevalence (0–60%) 42,48‐50 . The true prevalence and burden of strongyloidiasis in Australia is unclear, due to the large number of asymptomatic cases, underdiagnosis, and limited surveillance data 51 .…”