{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T12:09:34Z","timestamp":1764936574457,"version":"3.44.0"},"reference-count":34,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Frontline Gastroenterol"],"accepted":{"date-parts":[[2010,11,23]]},"published-print":{"date-parts":[[2011,4]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To estimate the prevalence of, and implement a diagnostic strategy for, imported helminth infection in the gastroenterology clinic.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>A retrospective study of eosinophil count and probable tropical exposure (phase I) followed by a prospective study of parasitological investigation (phase II).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Gastroenterology service of an inner London hospital.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients<\/jats:title>\n                  <jats:p>Adult patients newly attending general gastroenterology and inflammatory bowel disease clinics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interventions<\/jats:title>\n                  <jats:p>In phase I, evidence of undiagnosed helminth infection was sought by analysing patient records for associations between eosinophil count and ethnicity. In phase II, a UK guideline for investigation of eosinophilia in migrants was implemented and diagnostic yield determined.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measures<\/jats:title>\n                  <jats:p>In phase I, prevalence of eosinophilia was determined; in phase II, helminth prevalence and degree of eosinophilia before and after treatment were reported. Information on symptomatic response to treatment was recorded. Ethnicity was used as a proxy measure for tropical exposure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>426 new patients attended in a 12 month period. Eosinophilia was present in 27 (6.3%). 10\/27 (37.0%) patients with eosinophilia were of African or Asian ethnicity whereas only 20% (85\/426) of patients overall were from these ethnic groups (\u03c7<jats:sup>2<\/jats:sup>=5.27, p=0.02). Following implementation of the protocol, 25\/36 migrants with eosinophilia attended for parasitological investigations. Helminth infection was diagnosed in 10\/25 (40%). Strongyloidiasis (six patients) and schistosomiasis (three patients) were the most common diagnoses. Median eosinophil count was 1.06\u00d710<jats:sup>9<\/jats:sup>\/l in those with helminths and 0.58\u00d710<jats:sup>9<\/jats:sup>\/l in those without (p=0.004). Eosinophil counts normalised in, and symptomatic improvement was reported by, most patients after treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Eosinophilia is associated with African or Asian ethnicity in an inner city gastroenterology service. This association is probably explained by imported helminths, which are prevalent in this setting, may be a cause of gastrointestinal symptoms and is easily diagnosed and treated by standard protocols.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/fg.2010.003392","type":"journal-article","created":{"date-parts":[[2010,12,23]],"date-time":"2010-12-23T23:02:34Z","timestamp":1293145354000},"page":"124-129","source":"Crossref","is-referenced-by-count":6,"title":["Helminths: an unrecognised disease burden prevalent among migrants in the gastroenterology clinic"],"prefix":"10.1136","volume":"2","author":[{"given":"P J","family":"Smith","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"Theis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"McCartney","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Brown","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2010,12,23]]},"reference":[{"key":"2025090708445783000_2.2.124.1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI34261"},{"key":"2025090708445783000_2.2.124.2","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hch133"},{"key":"2025090708445783000_2.2.124.3","doi-asserted-by":"publisher","DOI":"10.1053\/jinf.2002.1108"},{"key":"2025090708445783000_2.2.124.4","doi-asserted-by":"publisher","DOI":"10.1309\/PK0RDQWB764C3WQ2"},{"key":"2025090708445783000_2.2.124.5","doi-asserted-by":"crossref","first-page":"9","DOI":"10.2310\/7060.2005.00003","article-title":"Presentation and diagnosis of imported schistosomiasis: relevance of eosinophilia, microscopy for ova, and serology","volume":"12","author":"Bierman","year":"2005","journal-title":"J Travel Med"},{"key":"2025090708445783000_2.2.124.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1708-8305.2006.00045.x"},{"key":"2025090708445783000_2.2.124.7","doi-asserted-by":"publisher","DOI":"10.1097\/01.mcg.0000152779.68900.33"},{"key":"2025090708445783000_2.2.124.8","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1093\/oxfordjournals.aje.a115655","article-title":"Seroepidemiology of Strongyloides infection in the Southeast Asian refugee population in Canada","volume":"132","author":"Gyorkos","year":"1990","journal-title":"Am J Epidemiol"},{"key":"2025090708445783000_2.2.124.9","doi-asserted-by":"publisher","DOI":"10.1086\/338026"},{"key":"2025090708445783000_2.2.124.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2008.01.020"},{"key":"2025090708445783000_2.2.124.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2006.01.016"},{"key":"2025090708445783000_2.2.124.12","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.14.4413"},{"key":"2025090708445783000_2.2.124.13","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1016\/0016-5085(81)90261-4","article-title":"Clinical features of Strongyloides stercoralis infection in an endemic area of the United States","volume":"80","author":"Milder","year":"1981","journal-title":"Gastroenterology"},{"key":"2025090708445783000_2.2.124.14","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1987.00370070071011"},{"key":"2025090708445783000_2.2.124.15","unstructured":"Grove DI . 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