title: Evaluation of eosinophilia in immigrants in Southern Spain using tailored screening and treatment protocols: A prospective study.
abstract: OBJECTIVE
  To determine the etiology of eosinophilia in immigrant patients in Southern Spain.
  
  
  METHODS
  Prospective study of immigrant patients with eosinophilia (> 500 Eo/μL) attended in a reference Tropical Medicine Unit and evaluated through the implementation of a specific protocol structured in different levels meant to be accomplished depending on the findings of each previous level.
  
  
  RESULTS
  Out of the 549 patients included in the study (89.6% from sub-Saharan countries), a diagnosis of helminthiasis was reached in 417 (75.9%), mainly by Strongyloides stercoralis (n = 190), Schistosoma (n = 33) and Hookworms (n = 126). 30 patients (5.5%) had a non-parasitic disorder (asthma, allergic rhinoconjunctivitis, skin conditions and drug-related eosinophilia). Multiple helminthic infections were very common: in 107 patients (19.5%) 2 helminth species were identified, three in 21 patients (3.8%), and four or more in 6 patients (1.1%). Eosinophilia was resolved in 31 of the 33 patients (93.9%) who received empirical treatment with ivermectin, albendazole and praziquantel as an etiological diagnosis was not reached after applying the whole protocol.
  
  
  CONCLUSIONS
  Diagnosis of helminthic infections in immigrant patients with eosinophilia can be improved by using tailored protocols based on geographical exposure. The implementation of these protocols may also save costs by systematizing diagnostic explorations. Empirical treatment with ivermectin, albendazol and praziquantel in sub-Saharan population when an etiologic diagnosis of eosinophilia has not been attained is an effective measure.
authors.affiliation: Tropical Medicine Unit, Hospital de Poniente, Ctra. De Almerimar sn, 04700, El Ejido, Almería, Spain. Electronic address: joaquinsalascoronas@yahoo.es.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Salas-Coronas
authors.affiliation: Tropical Medicine Unit, Hospital de Poniente, Ctra. De Almerimar sn, 04700, El Ejido, Almería, Spain.
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Cabezas-Fernández
authors.affiliation: Tropical Medicine Unit, Distrito Poniente, El Ejido, Almería, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Vázquez-Villegas
authors.affiliation: Tropical Medicine Unit, Hospital de Poniente, Ctra. De Almerimar sn, 04700, El Ejido, Almería, Spain.
authors.forename: Manuel Jesús
authors.initials: MJ
authors.lastname: Soriano-Pérez
authors.affiliation: Tropical Medicine Unit, Hospital de Poniente, Ctra. De Almerimar sn, 04700, El Ejido, Almería, Spain.
authors.forename: Ana Belén
authors.initials: AB
authors.lastname: Lozano-Serrano
authors.affiliation: Tropical Medicine Unit, Hospital de Poniente, Ctra. De Almerimar sn, 04700, El Ejido, Almería, Spain.
authors.forename: Inés
authors.initials: I
authors.lastname: Pérez-Camacho
authors.affiliation: Tropical Medicine Unit, Hospital de Poniente, Ctra. De Almerimar sn, 04700, El Ejido, Almería, Spain.
authors.forename: María Isabel
authors.initials: MI
authors.lastname: Cabeza-Barrera
authors.affiliation: Tropical Medicine Unit, Hospital de Poniente, Ctra. De Almerimar sn, 04700, El Ejido, Almería, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Cobo
mesh_terms: D000328:Adult; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D004802:Eosinophilia / Q000453:epidemiology* / Q000469:parasitology*; D005260:Female; D006373:Helminthiasis / Q000453:epidemiology* / Q000469:parasitology*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
keywords: Eosinophilia; Helminths; Immigrants; Schistosoma; Strongyloides