Infectious, Environmental, and Chronic Disease Burden among 1,844 Newly Arrived Humanitarian Migrants in Oklahoma, 2019–2025

Global displacement has brought increasingly diverse migrant populations into health systems with limited experience managing large-scale humanitarian arrivals, yet contemporary data describing infectious, environmental, and noncommunicable disease burden across heterogeneous newcomer groups remain scarce. A cross-sectional analysis of 1,844 consecutively screened newly arrived individuals who completed the U.S. domestic medical examination at the University of Oklahoma Center for Travel and Immigrant Health between October 2019 and May 2025 was conducted. Screening was performed in accordance with Centers for Disease Control and Prevention Refugee Health Domestic Guidance, with programmatic adaptations. The cohort represented more than 25 countries of origin, with substantial variation across key indicators. Strongyloides stercoralis seropositivity was 14.6% overall, highest among arrivals from Vietnam (27.1%) and Cuba (25.0%). Eosinophilia exhibited low sensitivity (∼12%) for S. stercoralis seropositivity. Elevated blood lead levels (≥3.5 µg/dL) occurred in 19.2% of those tested, concentrated among young Afghan children. Latent tuberculosis infection was identified in 8.9% of patients, with marked country-level gradients. Predeparture antiparasitic therapy coverage was modest (albendazole: 42.2%; ivermectin: 34.2%). Only 6.8% of eligible women had ever undergone cervical cancer screening. Noncommunicable disease burdens varied widely by country of origin. The diverse infectious, environmental, and chronic disease profiles observed across countries of origin highlight the limitations of uniform post-arrival screening. These data support risk-stratified approaches that include targeted infectious disease testing based on country of origin and epidemiological exposures, universal predeparture hepatitis B triple-panel screening, strengthened pediatric lead surveillance, and cancer screening pathways.