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Am. J. Trop. Med. Hyg., 77(4), 2007, pp. 633-635
Copyright © 2007 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT


Persistent and Untreated Tropical Infectious Diseases Among Sudanese Refugees in the United States

Carlos Franco-Paredes*, Roberta Dismukes, Deborah Nicolls, Alicia Hidron, Kimberly Workowski, Alfonso Rodriguez-Morales, Marianna Wilson, Danielle Jones, Peter Manyang, AND Phyllis Kozarsky
Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Crawford Long Hospital, Atlanta, Georgia; Instituto Experimental José Witremundo Torrealba (Center for Parasitological Research, José Witremundo Torrealba), Universidad de Los Andes, Trujillo, Venezuela; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; University of the South, Sewanee, Tennessee

 

ABSTRACT

A comprehensive medical evaluation to identify persistent and untreated tropical infections among members of the Sudanese group "Lost Boys of Sudan" living in Atlanta, GA, was initiated. Medical examinations and laboratory testing including blood cell counts, liver function tests, stool studies for parasites, hepatitis B serologies, and serologic testing for Schistosoma spp., Strongyloides, and filariae were performed. Preliminary results showed a high prevalence of untreated active schistosomiasis and strongyloidiasis infections in this group, 5 years after their resettlement in the United States. In addition, we found that many of them were infected with onchocerciasis and hepatitis B. We suggest that based on these preliminary results, pre-departure presumptive treatment and/or testing algorithms need to address some of these persistent tropical infections.

Received March 20, 2007. Accepted for publication June 18, 2007.

Acknowledgments: The authors thank Susan Gordon and Janice Sandquist for dedication to the care of the Lost Boys and for assuring the medical evaluation of the Lost Boys after Gabriel’s death; Dr. Thomas Nutman (Laboratory of Parasitic Diseases, National Institutes of Health, Bethesda, Maryland) for support with filaria serologic testing; Kimberly Won and Kolby Sanders-Lewis (Division of Parasitic Diseases, CDC, Atlanta, GA) for performance of the Schistosoma and Strongyloides serology tests; and Dr. Drew Posey and Dr. Michelle Weinberg (Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA) for valuable comments and advice.

Disclaimer: All authors have no conflicts of interest to disclose.

* Address correspondence to Carlos Franco-Paredes, Division of Infectious Diseases, 550 Peachtree Street, Medical Office Tower, 7th Floor, Atlanta, GA 30308. E-mail: cfranco{at}sph.emory.edu; carlos_franco{at}emoryhealthcare.org

Authors’ addresses: Carlos Franco-Paredes, Roberta Dismukes, Deborah Nicolls, Alicia Hidron, Kimberly Workowski, Danielle Jones, and Phyllis Kozarsky, 550 Peachtree Street, Atlanta, GA 30308, E-mails: cfranco{at}sph.emory.edu, Roberta_dismukes{at}emoryhealthcare.org, dnicoll{at}emory.edu, ahidron{at}emory.edu, and kworkow{at}emory.edu. Alfonso Rodriguez-Morales, Instituto Experimental José Witremundo Torrealba (Center for Parasitological Research José Witremundo Torrealba), Universidad de Los Andes, Trujillo, Venezuela, E-mail: ajrm_msds{at}yahoo.es. Marianna Wilson, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, E-mail: ruddyducks1{at}comcast.net, djone22{at}emory.edu. Peter Manyang, University of the South, Sewanee, TN, E-mail: pmanyang{at}sewanee.edu. Phyllis_kozarsky{at}emoryhealthcare.org.

Presented in part at the 55th Annual Meeting of the American Society of Tropical Medicine and Hygiene, Washington, DC, December 11–15, 2005.






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