Background/AimsThe epidemiology of Chagas disease, until recently confined to areas of
continental Latin America, has undergone considerable changes in recent
decades due to migration to other parts of the world, including Spain. We
studied the prevalence of Chagas disease in Latin American patients treated
at a health center in Barcelona and evaluated its clinical phase. We make
some recommendations for screening for the disease.Methodology/Principal FindingsWe performed an observational, cross-sectional prevalence study by means of
an immunochromatographic test screening of all continental Latin American
patients over the age of 14 years visiting the health centre from October
2007 to October 2009. The diagnosis was confirmed by serological methods:
conventional in-house ELISA (cELISA), a commercial kit (rELISA) and ELISA
using T cruzi lysate (Ortho-Clinical Diagnostics) (oELISA).
Of 766 patients studied, 22 were diagnosed with T. cruzi
infection, showing a prevalence of 2.87% (95% CI,
1.6–4.12%). Of the infected patients, 45.45% men and
54.55% women, 21 were from Bolivia, showing a prevalence in the
Bolivian subgroup (n = 127) of 16.53%
(95% CI, 9.6–23.39%).All the infected patients were in a chronic phase of Chagas disease:
81% with the indeterminate form, 9.5% with the cardiac form
and 9.5% with the cardiodigestive form. All patients infected with
T. cruzi had heard of Chagas disease in their country
of origin, 82% knew someone affected, and 77% had a
significant history of living in adobe houses in rural areas.ConclusionsWe found a high prevalence of T. cruzi infection in
immigrants from Bolivia. Detection of T.
cruzi–infected persons by screening programs in non-endemic
countries would control non-vectorial transmission and would benefit the
persons affected, public health and national health systems.
The study presented here aimed to contrast the marked clinical differences in the presentation of Schistosoma mansoni-induced infection between immigrants and travellers entering Spain from endemic regions, and to elucidate the therapeutic implications of these infections. A total of 200 African immigrants and 80 travellers with schistosomiasis were included in the study. Among the immigrants, 25 patients were diagnosed with Schistosoma mansoni infection; 15 presented with nonspecific symptoms, and 10 were asymptomatic. Hepatosplenomegaly was observed in nine. Among the travellers, 14 were diagnosed with Schistosoma mansoni infection; four were asymptomatic, four had Katayama syndrome, four had diarrhoea, and two had prostatitis. All of the patients were treated with praziquantel. Patients diagnosed with Katayama syndrome received praziquantel and dexamethasone for 3 days, with the praziquantel treatment being repeated at 3-4 weeks. The significant differences observed in the clinical presentation of Schistosoma mansoni-induced infection, indicate that a well-differentiated therapeutic strategy is required when this infection is diagnosed in a non-immune (traveller) or a semi-immune (immigrant) patient.
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