{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:43:45Z","timestamp":1788176625727,"version":"build-2803163510"},"reference-count":0,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","license":[{"start":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T00:00:00Z","timestamp":1651622400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,4]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>The most common causes of eosinophilia globally are helminth parasites. Refugees from high endemic areas are at increased risk of infection compared with the general U.S. population. It is widely accepted that eosinophilia is a good marker for helminth infection in this population, yet its absence has little predictive value for excluding infection. During an enhanced premigration health program, the CDC offered voluntary testing and management of intestinal parasites, among other conditions, to U.S.-bound refugees in Thailand. Stool specimens were tested for <jats:italic>Ascaris lumbricoides<\/jats:italic>, <jats:italic>Strongyloides stercoralis<\/jats:italic>, <jats:italic>Trichuris trichiura<\/jats:italic>, hookworms, <jats:italic>Giardia lamblia<\/jats:italic>, <jats:italic>Cryptosporidium<\/jats:italic> spp., and <jats:italic>Entamoeba histolytica<\/jats:italic> using quantitative polymerase chain reaction. Complete blood counts were performed to identify eosinophilia. Predictive values of eosinophilia for parasitic infections were calculated within nematode groups. Between July 9, 2012 and November 29, 2013, 2,004 participants were enrolled. About 73% were infected with at least one parasite. The overall median eosinophil count was 483 cells\/\u03bcL (interquartile range [IQR]\u2009=\u2009235\u2013876 cells\/\u03bcL). Compared with participants who did not test positive for any infection, higher eosinophil counts were observed in those infected with <jats:italic>A. lumbricoides<\/jats:italic> (RR\u2009=\u20091.3, 95% CI\u2009=\u20091.1\u20131.4), <jats:italic>S. stercoralis<\/jats:italic> (RR\u2009=\u20091.8, 95% CI\u2009=\u20091.4\u20132.4), <jats:italic>Necator americanus<\/jats:italic> (RR\u2009=\u20091.2, 95% CI\u2009=\u20091.1\u20131.4), and <jats:italic>Ancylostoma ceylanicum<\/jats:italic> (RR\u2009=\u20091.8, 95% CI\u2009=\u20091.5\u20132.2). Eosinophil counts were higher in younger participants (2\u20134 years versus 65+ years: RR\u2009=\u20094.2, 95% CI\u2009=\u20092.5\u20136.9), and lower in female participants (RR\u2009=\u20090.9, 95% CI\u2009=\u20090.8\u20130.9). Sensitivities ranged from 51% to 73%, specificities from 48% to 65%, and predictive values from 4% to 98%. The predictive value of eosinophilia is poor for the most common parasitic infections, and it should not be used alone for screening refugees.<\/jats:p>","DOI":"10.4269\/ajtmh.21-0853","type":"journal-article","created":{"date-parts":[[2022,3,7]],"date-time":"2022-03-07T14:25:36Z","timestamp":1646663136000},"page":"1552-1559","source":"Crossref","is-referenced-by-count":17,"title":["Cross-Sectional Assessment of the Association of Eosinophilia with Intestinal Parasitic Infection in U.S.-Bound Refugees in Thailand: Prevalent, Age Dependent, but of Limited Clinical Utility"],"prefix":"10.4269","volume":"106","author":[{"given":"Jessica L.","family":"Webster","sequence":"first","affiliation":[{"name":"1Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia;"},{"name":"2Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William M.","family":"Stauffer","sequence":"additional","affiliation":[{"name":"1Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia;"},{"name":"3Department of Medicine, Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarissa","family":"Mitchell","sequence":"additional","affiliation":[{"name":"1Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Lee","sequence":"additional","affiliation":[{"name":"1Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise M.","family":"O\u2019Connell","sequence":"additional","affiliation":[{"name":"4Laboratory of Parasitic Diseases, National Institutes of Health, Bethesda, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Weinberg","sequence":"additional","affiliation":[{"name":"1Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas B.","family":"Nutman","sequence":"additional","affiliation":[{"name":"4Laboratory of Parasitic Diseases, National Institutes of Health, Bethesda, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Potsawin","family":"Sakulrak","sequence":"additional","affiliation":[{"name":"5International Organization for Migration, Mae Sot, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilok","family":"Tongsukh","sequence":"additional","affiliation":[{"name":"5International Organization for Migration, Mae Sot, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina R.","family":"Phares","sequence":"additional","affiliation":[{"name":"1Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/106\/5\/article-p1552.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/106\/5\/article-p1552.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T11:39:40Z","timestamp":1651664380000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/106\/5\/article-p1552.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,4]]},"references-count":0,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.21-0853","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,4]]}}}