Intestinal parasites in refugees and asylum seekers entering the Stockholm area, 1987-88: evaluation of routine stool screening.

In order to evaluate the results of routine screening for intestinal parasites, the medical records of 4592 refugees and asylum seekers arriving in the Stockholm area from January 1987 to December 1988 were reviewed. 3938/4592 (86%) delivered stool specimens for examination and intestinal parasites were demonstrated in 651/3938 (17%). Protozoa, mainly Giardia intestinalis, were found in 403/3938 (10%) and helminths, mainly nematodes, in 277/3938 (7%). Intestinal parasites were most frequently recovered in subjects coming from the Indian subcontinent/Southeast Asia and Africa (infection rates 39% and 25%, respectively). Extensive variations in the prevalence of intestinal parasite infection in various ethnic groups (range 4%-39%) were largely attributable to variations in prevalence of helminthic infections (range 2%-34%). Origin from the tropics or subtropics as well as low age, male sex, rural region of domicile before/during exile and short length of stay in Sweden were related to intestinal parasitic infection. Lack of data on morbidity in untreated asymptomatic carriers, limited risks for transmission of the recovered parasites in Sweden as well as the expenses for screening indicate a need for reconsideration of the present praxis of mass screening in favour of a selective screening of high-risk groups based on country of origin and age.