Table 3.
Comorbid conditions among Congolese refugees diagnosed with splenomegaly and their matched controls, measured at the initial post–U.S. arrival screening visit or the first available result
| Condition* | Controls | Splenomegaly, all case patients | Crude RR (95% CI) | Adj RR (95% CI) | ||
|---|---|---|---|---|---|---|
| N/Total | Proportion | N/Total | Proportion | |||
| A Hematologic abnormality | 35/80 | 0.44 | 78/129 | 0.60 | 1.33 (1.00–1.77) | 1.28 (0.97–1.68) |
| Leukopenia | 6/70 | 0.09 | 22/114 | 0.19 | 2.24 (0.97–5.14) | 1.99 (0.84–4.70) |
| Anemia | 30/79 | 0.38 | 65/128 | 0.51 | 1.32 (0.96–1.82) | 1.30 (0.96–1.77) |
| Thrombocytopenia | 2/21 | 0.10 | 30/101 | 0.30 | 3.07 (0.92–10.29) | 2.98 (0.84–10.61) |
| Elevated transaminases | 4/40 | 0.10 | 18/81 | 0.22 | 2.22 (0.86–5.74) | 2.10 (0.77–5.68) |
| Elevated AST | 0/40 | 0 | 15/81 | 0.19 | – | – |
| Elevated ALT | 4/40 | 0.10 | 11/81 | 0.14 | 1.39 (0.50–3.85) | 1.24 (0.45–3.43) |
| Other | ||||||
| Elevated ALP | 20/39 | 0.51 | 47/82 | 0.57 | 1.07 (0.71–1.60) | 1.17 (0.94–1.47) |
| Condition | Controls | Case patients with splenomegaly at intake | Crude RR (95% CI) | Adj RR (95% CI) | ||
|---|---|---|---|---|---|---|
| N/Total | Proportion | N/Total | Proportion | |||
| B Hematologic abnormality | 35/80 | 0.44 | 61/94 | 0.65 | 1.44 (1.07–1.93) | 1.39 (1.04–1.85) |
| Leukopenia | 6/70 | 0.09 | 19/88 | 0.22 | 2.53 (1.10–5.84) | 2.11 (0.86–5.21) |
| Anemia | 30/79 | 0.38 | 50/93 | 0.54 | 1.41 (1.01–1.96) | 1.43 (1.04–1.97) |
| Thrombocytopenia | 2/21 | 0.10 | 24/74 | 0.32 | 3.41 (1.08–10.80) | 3.18 (0.96–10.55) |
| Elevated transaminases | 4/40 | 0.10 | 16/65 | 0.25 | 2.46 (0.95–6.36) | 2.24 (0.82–6.14) |
| Elevated AST | 0/40 | 0 | 14/65 | 0.22 | – | – |
| Elevated ALT | 4/40 | 0.10 | 9/65 | 0.14 | 1.41 (0.49–4.06) | 1.22 (0.43–3.41) |
| Other | ||||||
| Elevated ALP | 20/39 | 0.51 | 36/65 | 0.55 | 1.02 (0.66–1.58) | 1.21 (0.95–1.54) |
| Condition | Controls | Case patients with persistent splenomegaly (≥ 6 months) | Crude RR (95% CI) | Adj RR (95% CI) | ||
|---|---|---|---|---|---|---|
| N/Total | Proportion | N/Total | Proportion | |||
| C Hematologic abnormality | 35/80 | 0.44 | 33/44 | 0.75 | 1.68 (1.28–2.20) | 1.60 (1.15–2.24) |
| Leukopenia | 6/70 | 0.09 | 13/41 | 0.32 | 3.72 (1.53–9.06) | 2.00 (0.78–5.16) |
| Anemia | 30/79 | 0.38 | 23/44 | 0.52 | 1.37 (0.96–1.95) | 1.41 (0.93–2.16) |
| Thrombocytopenia | 2/21 | 0.10 | 17/35 | 0.49 | 4.97 (1.39–17.83) | 5.53 (1.73–17.62) |
| Elevated transaminases | 4/40 | 0 | 8/35 | 0.23 | 2.40 (0.81–7.08) | 2.98 (0.66–13.52) |
| Elevated AST | 0/40 | 0.10 | 6/35 | 0.17 | – | – |
| Elevated ALT | 4/40 | 4/35 | 0.11 | 1.09 (0.27–4.44) | 1.37 (0.35–5.37) | |
| Other | 0.51 | |||||
| Elevated ALP | 20/39 | 0.44 | 17/35 | 0.49 | 0.93 (0.54–1.60) | 1.57 (1.03–2.40) |
ALP = alkaline phosphatase; ALT = alanine aminotransferase. Relative risk of selected hematologic and hepatic abnormalities among Congolese refugees diagnosed with splenomegaly compared with their matched controls, measured at (A) any point during screening or follow-up, (B) at their initial post-arrival U.S. screening visit, and (C) 6 months or more after U.S. arrival.
Cutoff vales: leukopenia (< 4.0 103 cells/µL); anemia (males: < 14 g/dL; females: < 12.0 g/dL); thrombocytopenia (< 150 103 PLT/µL); AST (≥ 40 U/L); ALT (≥ 40 U/L); ALP (≥ 147 U/L). In the absence of laboratory reference ranges from all domestic laboratories, the highest cutoff value reported was used, which might have sacrificed sensitivity.