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Observational Study
. 2021 Sep 15;10(1):117.
doi: 10.1186/s40249-021-00897-2.

Community-based screening of Chagas disease among Latin American migrants in a non-endemic country: an observational study

Violeta Ramos-Sesma #  1 , Miriam Navarro #  2   3 , Jara Llenas-García  4   5 , Concepción Gil-Anguita  6 , Diego Torrus-Tendero  7   8 , Philip Wikman-Jorgensen  9 , María García-López  4 , Concepción Amador-Prous  6 , María-Paz Ventero-Martín  10 , Pedro Guevara-Hernández  4 , Ana Garijo-Saiz  6 , Ares Sanchez-Sanchez  11 , Cristina Bernal-Alcaraz  4 , Ana-Isabel Pujades-Tarraga  6 , Roser Muñoz-Perez  12 , María Flores-Chávez  13 , José-Manuel Ramos-Rincón  14   15 ; #CorazonesSinChagas Platform
Collaborators, Affiliations
Observational Study

Community-based screening of Chagas disease among Latin American migrants in a non-endemic country: an observational study

Violeta Ramos-Sesma et al. Infect Dis Poverty. .

Abstract

Background: Chagas disease is a parasitic disease endemic to Latin America, but it has become a disease of global concern due to migration flows. Asymptomatic carriers may host the parasite for years, without knowing they are infected. The aim of this study is to assess prevalence of Chagas disease and evaluate the participants' level of knowledge between Latin American migrants attending a community-based screening campaign.

Methods: Three community-based campaigns were performed in Alicante (Spain) in 2016, 2017 and 2018, including educational chats and blood tests for Trypanosoma cruzi serology. Participants completed a questionnaire assessing knowledge about the mechanisms of transmission, disease presentation, diagnosis, and treatment. People seropositive for T. cruzi underwent diagnostic confirmation by two different tests. Results were analyzed by multivariable logistic regression and expressed as adjusted odds ratios (aORs), adjusting for age, sex, and time in Spain.

Results: A total of 596 participants were included in the study; 17% were aged under 18 years. Prevalence in adults was 11% [54/496; 95% confidence interval (CI): 8.3-14.5%] versus 0% among children. All but one case were in Bolivians. Diagnosis was independently associated with having been born in Bolivia (aOR: 102, 95% CI: 13-781) and a primary school-level education (aOR: 2.40, 95% CI: 1.14-5.06). Of 54 people diagnosed with Chagas disease (most of whom were asymptomatic), 42 (77.7%) returned to the clinic at least once, and 24 (44.4%) received treatment. Multivariable analysis showed that coming from Argentina (aOR: 13, 95% CI: 1.61-1188) or Bolivia (aOR: 1.90, 95% CI: 1.19-3.39) and having received information about Chagas disease in Spain (aOR: 4.63, 95% CI: 2.54-8.97) were associated with a good level of knowledge on the disease. Having primary level studies (aOR: 0.59, 95% CI: 0.34-0.98) and coming from Ecuador (aOR: 4.63, 95% CI: 2.52-847) were independently associated with a lower level of knowledge.

Conclusions: Community-based interventions are a good strategy for diagnosing neglected diseases such as Chagas disease in non-endemic countries and for identifying and treating infected, asymptomatic individuals.

Keywords: Chagas disease; Community-based intervention; Early diagnosis; Knowledge; Migrant; Screening; Trypanosoma cruzi.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Three years campaigns’ follow chart of the clinical evaluation and management of participants with positive Trypanosoma cruzi serology
Fig. 2
Fig. 2
Results of the three campaigns and comparison of two different strategies
See this image and copyright information in PMC

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