{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T06:16:58Z","timestamp":1668665818544},"reference-count":38,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,14]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Pretransplant recommendations advise risk-based screening for strongyloidiasis, schistosomiasis, and Chagas disease. We evaluated the implementation of a chronic parasite screening protocol at a health system in a nonendemic region serving a large foreign-born population. Candidates listed for kidney transplant at Hennepin Healthcare (Minneapolis, MN) between 2010 and 2020 were included. Country of birth and serologic screening for strongyloidiasis, schistosomiasis, and Chagas disease were retrospectively obtained from electronic medical records. Parasite screening frequency and seropositivity was assessed before and after implementation of a geographic risk factor\u2013based screening protocol in 2014. Cost-efficiency of presumptive treatment was modeled. Of 907 kidney transplant candidates, 312 (34%) were born in the United States and 232 (26%) outside the United States, with the remainder missing country of birth information. The 447 (49%) candidates evaluated after implementation of the screening protocol had fewer unidentified countries of birth (53%\u201327%, <jats:italic>P<\/jats:italic> &lt; 0.001) and were more frequently screened for strongyloidiasis, schistosomiasis, and Chagas disease (14%\u201344%, 8%\u201322%, and 1\u201314%, respectively, all <jats:italic>P<\/jats:italic>s &lt; 0.001). The number of identified seropositive candidates increased after protocol implementation from two to 14 for strongyloidiasis and from one to 11 for schistosomiasis, with none seropositive for Chagas disease. The cost-efficiency model favored presumptive ivermectin when strongyloidiasis prevalence reaches 30% of those screened. Implementing a geographic risk screening protocol before kidney transplant increases attention to infectious disease risk associated with country of birth and identification of chronic parasitic infections. In populations with higher strongyloidiasis prevalence or lower ivermectin costs, presumptive treatment may be cost-efficient.<\/jats:p>","DOI":"10.4269\/ajtmh.22-0413","type":"journal-article","created":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T17:08:03Z","timestamp":1668618483000},"page":"1041-1046","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of a Geographic Screening Protocol for Chronic Parasitic Infections Before Kidney Transplant: An Institutional Experience in Minnesota"],"prefix":"10.4269","volume":"107","author":[{"given":"Christine M.","family":"Thomas","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Butts","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Czachura","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Altair","family":"Alonso","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Minnesota, Minneapolis, Minnesota;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Reininger","sequence":"additional","affiliation":[{"name":"Banner University Medical Center, Phoenix, Arizona;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan K.","family":"Shaughnessy","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota;"},{"name":"Division of Infectious Diseases, Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Pathogens","first-page":"65","article-title":"Solid organ transplant and parasitic diseases: a review of the clinical cases in the last two decades","volume":"7","year":"2018"},{"key":"b2","series-title":"Clin Transplant","first-page":"e13618","article-title":"Intestinal parasites including Cryptosporidium, Cyclospora, Giardia, and Microsporidia, Entamoeba histolytica, Strongyloides, Schistosomiasis, and Echinococcus: guidelines from the American Society of Transplantation Infectious Diseases Community of Practice","volume":"33","year":"2019"},{"key":"b3","series-title":"PLoS Negl Trop Dis","first-page":"e0007998","article-title":"Severe Strongyloides stercoralis infection in kidney transplant recipients: a multicenter case\u2013control study","volume":"14","year":"2020"},{"key":"b4","series-title":"Infect 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