Intestinal parasites in stool testing among refugees at a primary care clinic in Toronto, Canada

Abstract

Background Enteric parasites are endemic in many of the countries from which refugees originate. Clinical guidelines vary in approaches to screening for and treating intestinal parasites in refugee receiving countries. This study aims to investigate the prevalence and species of intestinal parasites identified in stool ova and parasite (O&P) specimens in a sample of newly arrived refugees in Toronto, Canada. Methods We conducted a retrospective chart review of 1042 refugee patients rostered at a specialized primary care clinic in Toronto from December 2011 to September 2016. Patients who completed recommended stool O&P analyses were included. Basic sociodemographic and clinical variables and results of stool O&P were examined. Results 419 patients (40.2%) had a stool O&P positive for any protozoan or helminth species. Sixty-nine patients (6.6%) had clinically significant parasite species (excluding B hominis, D fragilis, and E dispar, given their lower risk for causing symptoms/complications): 2.3% had clinically significant protozoans and 4.2% had helminths on stool analysis. Conclusion Given the relatively low prevalence of clinically significant parasites identified, our findings do not support universal screening for enteric parasites with stool O&P among refugee claimants/asylum seekers. However, stool analysis should be considered in certain clinical situations, as part of a more tailored approach.

Improving Diagnosis of Intestinal Parasites Towards a Migrant-Friendly Health System

“…Among protozoa, E. coli (25.3%), E. nana (14.9%), and G. duodenalis (8.0%) showed a higher prevalence than in other studies [7,30].…”

Intestinal parasitic infections in officers of the Border Guard in East Poland

“…According to Ceccarelli et al [8], the decreased rates of parasitic infections among refugees may be the effect of mass de-worming campaigns conducted under the auspices of World Health Organization and the improvement in sanitation in most developing countries over the last few decades. A study of over 1000 refugees carried out between 2011 and 2016 in Canada demonstrated that although the rate of parasitic infections in the study group reached 40%, most of the infestations were clinically insignificant [9]. All the identified infections were found to have been caused by Blastocystis spp.…”