Epidemiology and clinical description of Chagas disease in Valencia, Spain, from 2010 to 2020

Abstract

Chagas disease (CD), caused by the flagellate protozoan parasite Trypanosoma cruzi, is endemic in 21 American countries. It is estimated that about 6-8 million people are infected. Nevertheless, CD should be now considered a worldwide-distributed disease due to migratory movements from endemic to non-endemic regions where the infection risk is related to transplacental transmission to newborns from infected mothers or through blood or organ donations from infected individuals. Spain is the non-endemic country with the highest burden of CD in Europe. This study aims to assess the prevalence and perform a descriptive analysis of patients with CD at Hospital Universitari i Politécnic (HUiP) in Valencia, Spain, from 2010 to 2020, to raise awareness about the importance of the disease.We compared data collected from official sources (National Institute of Statistics and Microbiological Surveillance Network of the Comunitat Valenciana) as well as data from the Health Department-Valencia La Fe, Valencia (Spain). A total of 3713 subjects were analyzed, 3159 women and 554 men, of which 433 were positive, prevalence of 11.7 %. Pediatric population accounted for 106 (24.5 %) while adult population for 327 (75.5 %). Most migrants were from Bolivia (298, 91.1 %). Regarding women, 200 (64 %) were of childbearing age and 90 (45 %) of these were pregnant. DNA detection by PCR was positive only in 4 newborns (3.8 %). Treatment with benznidazole was implemented in 204 patients and 107 developed adverse drug reactions (ADRs). In conclusion, the prevalence of CD in our health department is not negligible and poses a challenge for the health system; worrisomely, many patients remain undiagnosed and untreated.

Keywords: Benznidazole; Bolivian migrants; Chagas disease; Endemic; Trypanosoma cruzi; Undiagnosed.