Community-based screening of Chagas disease among Latin American migrants in a non-endemic country: an observational study.
Adult
Chagas Disease
/ diagnosis
Community Health Services
Community-Based Participatory Research
Cross-Sectional Studies
Early Diagnosis
Humans
Latin America
/ ethnology
Mass Screening
Middle Aged
Neglected Diseases
/ epidemiology
Prevalence
Spain
/ epidemiology
Transients and Migrants
/ statistics & numerical data
Trypanosoma cruzi
/ isolation & purification
Chagas disease
Community-based intervention
Early diagnosis
Knowledge
Migrant
Screening
Trypanosoma cruzi
Journal
Infectious diseases of poverty
ISSN: 2049-9957
Titre abrégé: Infect Dis Poverty
Pays: England
ID NLM: 101606645
Informations de publication
Date de publication:
15 Sep 2021
15 Sep 2021
Historique:
received:
25
06
2021
accepted:
24
08
2021
entrez:
16
9
2021
pubmed:
17
9
2021
medline:
1
10
2021
Statut:
epublish
Résumé
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. 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. 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. 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.
Sections du résumé
BACKGROUND
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
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
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
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.
Identifiants
pubmed: 34526137
doi: 10.1186/s40249-021-00897-2
pii: 10.1186/s40249-021-00897-2
pmc: PMC8441044
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
117Subventions
Organisme : institute of health and biomedical research of alicante (isabial)/fisabio foundation
ID : 16-158
Investigateurs
María García-López
(M)
Cristina Bernal-Alcaraz
(C)
Pedro B Guevara-Hernández
(PB)
Jara Llenas-García
(J)
Joan Gregori-Colome
(J)
Ana Lucas-Dato
(A)
Esther Martínez-Birlanga
(E)
Estefanía García-Rodríguez
(E)
José-Manuel Ramos-Rincón
(JM)
Diego Torrús-Tendero
(D)
M Paz Ventero-Martín
(MP)
Adelin Gimeno-Gascón
(A)
Ares Sánchez-Sánchez
(A)
Roser Muñoz-Pérez
(R)
Carmen Almoedo-Albero
(C)
Concepción Gil-Anguita
(C)
Concepción Amador Prous
(CA)
Ana-Isabel Pujades-Tárraga
(AI)
Antonio Santonja
(A)
María Sánchez-Valera
(M)
Rosa Sánchez-García
(R)
Miriam Navarro-Beltrá
(M)
Informations de copyright
© 2021. The Author(s).
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