Prevalence of Chagas disease in the Latin American immigrant population in a primary health centre in Barcelona (Spain)

Soriano‐Arandes, Antoni; Gutierrez, José Muñoz; Navarro, Mireia; Doménech, Clara Castells; Vinyeta, Montserrat Portús; Gascón, Joaquim

doi:10.1016/j.actatropica.2009.07.014

Cited by 31 publications

(15 citation statements)

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“…The highest prevalence was found among Bolivian patients, in agreement with other studies performed in Spain [9], [16] and other non-endemic countries [12], [32]. No cases were diagnosed among the Peruvian or Ecuadorian patients, who formed 45% of the sample, probably due to the heterogeneous distribution of CD in endemic countries and the lower seroprevalence of T. cruzi estimated in Peru (0.69%) and Ecuador (1.74%) [33].…”

Section: Discussionsupporting

confidence: 89%

“…In recent years several studies of CD in non-endemic countries [6]–[9] have focused in particular on non-vectorial transmission mechanisms such as pregnancy and childbirth [10], [11], blood transfusion [12], [13] and organ transplantation [14], [15]. However, when reviewing the literature we found little information on imported CD in non-endemic countries at the primary care level [16], which is ideal for screening the general population [17].…”

Section: Introductionmentioning

confidence: 99%

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Chagas Disease among the Latin American Adult Population Attending in a Primary Care Center in Barcelona, Spain

et al. 2011

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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.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Chagas Disease among the Latin American Adult Population Attending in a Primary Care Center in Barcelona, Spain

et al. 2011

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“…Within Spain, 7 of the 12 studies with prevalence estimates of Chagas disease in migrants were similar to the highest countrywide estimate (Del Pino and Coll, 2006; Giménez-Martí et al, 2006; Munoz-Vilches et al, 2012; Paricio-Talayero et al, 2008; Roca et al, 2011; Santiago et al, 2012; Soriano Arandes et al, 2009), two were lower(Piron et al, 2008; Ramos et al, 2012a), and three(Avila Arzanegui et al, 2013; Barona-Vilar et al, 2012; Lucas and Barba, 2009) were higher (Figure 2). One additional study was conducted in Spain, but its results are not summarized here because it was a non-representative sample of only Bolivian and Paraguayan participants (Ramos et al, 2012b).…”

Section: Resultssupporting

confidence: 57%

A global systematic review of Chagas disease prevalence among migrants

et al. 2016

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Human migration has been identified as a potential factor for increased Chagas disease risk and has transformed the disease from a Latin American problem to a global one. We conducted a systematic review of the scientific literature between 2004–2014 in order to: summarize current seroprevalence estimates of Chagas disease among Latin American migrants, in both endemic and non-endemic settings; compare seroprevalence estimates in migrants to countrywide prevalence estimates; and identify risk factors for Chagas disease among migrants. A total of 320 studies were screened and 23 studies were included. We found evidence that the prevalence of Chagas disease is higher than expected in some migrant groups and that reliance on blood donor screening prevalence underestimates the burden of disease. Overall there is a dearth of high quality epidemiologic studies on the prevalence of Chagas in migrants, especially among intra-regional migrants within Latin America. Given that the disease cannot likely be eradicated, improved surveillance and reporting is vital to continuing control efforts. More accurate health surveillance of both Latin American migrants and the Chagas disease burden will help countries appropriately scale up their response to this chronic disease. Overall, improved estimates of Chagas disease among migrants would likely serve to highlight the real need for better screening, diagnostics, and treatment of individuals living with the disease.

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“…Regarding the child-bearing age women (10–49 years) analyzed in the present study, the described prevalence of 6.1% [27] was higher than that described by Munhoz et al [13] but lower than those registered in Europe (Tables 1 and 2) [10,11,12,14,17,23,24]. Moreover, in recent and previous publications, a higher prevalence was registered for general Bolivian immigrants in European countries [5,12, Table 1] compared with São Paulo [27].…”

Section: Discussioncontrasting

confidence: 63%

Interdisciplinary approach at the primary healthcare level for Bolivian immigrants with Chagas disease in the city of São Paulo

et al. 2017

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Background/MethodsIn a pioneering cross-sectional study among Bolivian immigrants in the city of São Paulo, Brazil, the epidemiological profile, clinical manifestations and morbidity of Chagas disease were described. The feasibility of the management of Chagas disease at primary healthcare clinics using a biomedical and psychosocial interdisciplinary approach was also tested. Previously, a Trypanosoma cruzi (T. cruzi) infection rate of 4.4% among 633 immigrants was reported. The samples were screened using two commercial enzyme-linked immunoassay (ELISA) tests generated with epimastigote antigens, and those with discrepant or seropositive results were analyzed by confirmatory tests: indirect immunofluorescence (IFI), TESA-blot and a commercial recombinant ELISA. PCR and blood cultures were performed in seropositive patients.ResultsThe majority of the 28 seropositive patients were women, of whom 88.89% were of child-bearing age. The predominant clinical forms of Chagas disease were the indeterminate and atypical cardiac forms. Less than 50% received the recommended antiparasitic treatment of benznidazole. An interdisciplinary team was centered on primary healthcare physicians who applied guidelines for the management of patients. Infectologists, cardiologists, pediatricians and other specialists acted as reference professionals. Confirmatory serology and molecular biology tests, as well as echocardiography, Holter and other tests, were performed for the assessment of affected organs in secondary healthcare centers. The published high performance of two commercial ELISA tests was not confirmed.ConclusionAn interdisciplinary approach including antiparasitic treatment is feasible at the primary healthcare level for the management of Chagas disease in Bolivian immigrants. The itinerant feature of immigration was associated with a lack of adherence to antiparasitic treatment and was considered a main challenge for the clinical management of this population. This approach is recommended for management of the infected population in endemic and nonendemic areas, although different strategies are needed depending on the severity of the disease and the structure of the healthcare system.

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Prevalence of Chagas disease in the Latin American immigrant population in a primary health centre in Barcelona (Spain)

Cited by 31 publications

References 14 publications

Chagas Disease among the Latin American Adult Population Attending in a Primary Care Center in Barcelona, Spain

Chagas Disease among the Latin American Adult Population Attending in a Primary Care Center in Barcelona, Spain

A global systematic review of Chagas disease prevalence among migrants

Interdisciplinary approach at the primary healthcare level for Bolivian immigrants with Chagas disease in the city of São Paulo

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