Prevalence of tuberculosis, hepatitis B virus, and intestinal parasitic infections among refugees to Minnesota

Objective. The purpose of this study was to define the prevalence of infection with Mycobacterium tuberculosis, hepatitis B virus, and various intestinal parasites among different groups of primary refugees immigrating to Minnesota. Methods. 2,545 refugees arriving in Minnesota during 1999 received a domestic health examination that included tuberculin skin testing, hepatitis B virus serologic testing, and stool ova and parasite examinations. The Refugee Health Assessment form asked specifically about screening results for amebiasis, ascariasis, clonorchiasis, giardiasis, hookworm, schistosomiasis, strongyloidiasis, and trichuriasis. Results. Forty-nine percent of refugees had a reactive tuberculin test of greater than or equal to10 mm induration, with a higher prevalence in males (54%) and refugees greater than or equal to18 years of age (63%) (p<0.001). Seven percent had a positive hepatitis B surface antigen, with the highest prevalence in those people from sub-Saharan Africa (8%) (p=0.002) and those refugees greater than or equal to18 years of age (9%) (p=0.006). Twenty-two percent had one or more intestinal parasites asked about, including 30% of those refugees <18 years of age (p<0.001). The most commonly reported parasitic infections were trichuriasis (8%) and giardiasis (7%). Conclusions. Evidence of infection with M. tuberculosis, hepatitis B virus, or one of eight intestinal parasites was present in a substantial proportion of refugees receiving the domestic health assessment. Screening for such infections gives new immigrants the opportunity to receive important medical evaluation and treatment, provides valuable surveillance data, and allows appropriate public health measures to be taken.