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. 2017 May 1;64(9):1182-1188.
doi: 10.1093/cid/cix064.

Prevalence of Chagas Disease in the Latin American-born Population of Los Angeles

Sheba K Meymandi  1 , Colin J Forsyth  1 , Jonathan Soverow  1 , Salvador Hernandez  1 , Daniel Sanchez  1 , Susan P Montgomery  2 , Mahmoud Traina  1
Affiliations

Prevalence of Chagas Disease in the Latin American-born Population of Los Angeles

Sheba K Meymandi et al. Clin Infect Dis. .

Abstract

Background: According to an estimate from the Centers for Disease Control and Prevention (CDC), Chagas disease (CD) may affect 1.31% of Latin American immigrants in the United States, with >300 000 cases. However, there is a lack of real-world data to support this estimate. Little is known about the actual prevalence of this neglected tropical disease in the United States, and the bulk of those infected are undiagnosed.

Methods: From April 2008 to May 2014, we screened 4,755 Latin American-born residents of Los Angeles County. Blood samples were tested for serologic evidence of CD. We collected demographic data and assessed the impact of established risk factors on CD diagnosis, including sex, country of origin, housing materials, family history of CD, and awareness of CD.

Results: There were 59 cases of CD, for an overall prevalence of 1.24%. Prevalence was highest among Salvadorans (3.45%). Of the 3,182 Mexican respondents, those from Oaxaca (4.65%) and Zacatecas (2.2%) had the highest CD prevalence. Salvadoran origin (aOR = 6.2; 95% CI = 2.8-13.5; P < .001), prior knowledge of CD (aOR = 2.4; 95% CI = 1.0-5.8; P = .047), and exposure to all 3 at-risk housing types (adobe, mud, and thatched roof) (aOR = 2.5; 95% CI = 1.0-6.4; P = .048) were associated with positive diagnosis.

Conclusions: In the largest screening of CD in the United States to date outside of blood banks, we found a CD prevalence of 1.24%. This implies >30 000 people infected in Los Angeles County alone, making CD an important public health concern. Efficient, targeted surveillance of CD may accelerate diagnosis and identify candidates for early treatment.

Keywords: Chagas disease; Trypanosmoa cruzi; neglected tropical diseases; prevalence; screening.

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Figures

Figure 1.
Figure 1.
Chagas disease positive cases in Los Angeles county and proximity to the CECD, April 2008 to May 2014. ● = positive case,★ = CECD. Abbreviation: CECD, Center of Excellence for Chagas Disease.
Figure 2.
Figure 2.
Countries of origin of Trypanosmoa cruzi positive cases in Los Angeles, 2008–2014*. * One case from Argentina is not shown.
See this image and copyright information in PMC

Comment in

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