☆ 4.5 Article

Prevalence, Clinical Staging and Risk for Blood-Borne Transmission of Chagas Disease among Latin American Migrants in Geneva, Switzerland

PLOS NEGLECTED TROPICAL DISEASES (2010)

Journal

PLOS NEGLECTED TROPICAL DISEASES

Volume 4, Issue 2, Pages -

Publisher

PUBLIC LIBRARY SCIENCE

DOI: 10.1371/journal.pntd.0000592

Keywords

Funding

Foundation Simon I. Patino, Geneva, Switzerland
WHO
Geneva University Hospitals
Department of Health and Community medicine, Faculty of Medicine, University of Geneva

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Community support

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Abstract

Background: Migration of Latin Americans to the USA, Canada and Europe has modified Chagas disease distribution, but data on imported cases and on risks of local transmission remain scarce. We assessed the prevalence and risk factors for Chagas disease, staged the disease and evaluated attitudes towards blood transfusion and organ transplant among Latin American migrants in Geneva, Switzerland. Methodology/Principal Findings: This cross-sectional study included all consecutive Latin American migrants seeking medical care at a primary care facility or attending two Latino churches. After completing a questionnaire, they were screened for Chagas disease with two serological tests (Biomerieux ELISA cruzi; Biokit Bioelisa Chagas). Infected subjects underwent a complete medical work-up. Predictive factors for infection were assessed by univariate and multivariate logistic regression analysis. 1012 persons (females: 83%; mean age: 37.2 [SD 11.3] years, Bolivians: 48% [n = 485]) were recruited. 96% had no residency permit. Chagas disease was diagnosed with two positive serological tests in 130 patients (12.8%; 95% CI 10.8%-14.9%), including 127 Bolivians (26.2%; 95% CI 22.3%-30.1%). All patients were in the chronic phase, including 11.3% with cardiac and 0.8% with digestive complications. Predictive factors for infection were Bolivian origin (OR 33.2; 95% CI 7.5-147.5), reported maternal infection with T. cruzi (OR 6.9; 95% CI 1.9-24.3), and age older than 35 years (OR 6.7; 95% CI 2.4-18.8). While 22 (16.9%) infected subjects had already donated blood, 24 (18.5%) and 34 (26.2%) considered donating blood and organs outside Latin America, respectively. Conclusions: Chagas disease is highly prevalent among Bolivian migrants in Switzerland. Chronic cardiac and digestive complications were substantial. Screening of individuals at risk should be implemented in nonendemic countries and must include undocumented migrants.

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

Violeta Ramos-Sesma, Miriam Navarro, Jara Llenas-Garcia, Concepcion Gil-Anguita, Diego Torrus-Tendero, Philip Wikman-Jorgensen, Maria Garcia-Lopez, Concepcion Amador-Prous, Maria-Paz Ventero-Martin, Pedro Guevara-Hernandez, Ana Garijo-Saiz, Ares Sanchez-Sanchez, Cristina Bernal-Alcaraz, Ana-Isabel Pujades-Tarraga, Roser Munoz-Perez, Maria Flores-Chavez, Jose-Manuel Ramos-Rincon

Summary: The study assessed Chagas disease prevalence and knowledge levels among Latin American migrants participating in community-based screening campaigns. Most diagnosed cases were asymptomatic, with community interventions proving effective for diagnosing and treating this neglected disease in non-endemic countries.

INFECTIOUS DISEASES OF POVERTY (2021)