{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T10:23:17Z","timestamp":1762251797867},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"1035","license":[{"start":{"date-parts":[[2011,12,19]],"date-time":"2011-12-19T00:00:00Z","timestamp":1324252800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <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 (\u03c72=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\u00d7109\/l in those with helminths and 0.58\u00d7109\/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\/pgmj.2010.003392rep","type":"journal-article","created":{"date-parts":[[2011,12,20]],"date-time":"2011-12-20T06:20:34Z","timestamp":1324362034000},"page":"28-33","source":"Crossref","is-referenced-by-count":4,"title":["Republished research: Helminths: an unrecognised disease burden prevalent among migrants in the gastroenterology clinic"],"prefix":"10.1093","volume":"88","author":[{"given":"P J","family":"Smith","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, University College London Hospital , London, UK"},{"name":"Department of Medicine, University College London , London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"Theis","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University College London Hospital , London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"McCartney","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University College London Hospital , London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University College London Hospital , London, UK"},{"name":"Hospital for Tropical Diseases , London, UK"},{"name":"London School of Hygiene and Tropical Medicine , London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2011,12,19]]},"reference":[{"key":"2023041906262334000_bib1","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1172\/JCI34261","article-title":"Helminth infections: the great neglected tropical diseases","volume":"118","author":"Hotez","year":"2008","journal-title":"J Clin Invest"},{"key":"2023041906262334000_bib2","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1093\/qjmed\/hch133","article-title":"Chronic Strongyloides stercoralis infection in former British Far East prisoners of war","volume":"97","author":"Gill","year":"2004","journal-title":"QJM"},{"key":"2023041906262334000_bib3","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1053\/jinf.2002.1108","article-title":"Investigation of tropical eosinophilia; 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