Chagas disease among pregnant Latin American women in the United Kingdom: time for action

Turienzo, Cristina Fernandez; Brasa, Carmen Cabeza; Newsholme, William; Sandall, Jane; Chiodini, Peter L.; Moore, David

doi:10.1136/bmjgh-2017-000478

Cited by 6 publications

(9 citation statements)

References 15 publications

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“… 43 Another study from the same centre showed a low uptake of antenatal screening in pregnant women despite the increased risk of vertical transmission and congenital disease. 12 One potential contributor of this low uptake may be that the Latinx in the United Kingdom are often undocumented, may be living in precarious conditions, and could be marginalised due to a limited command of the English language. 44 These factors can lead to additional barriers to the access of healthcare services in the United Kingdom.…”

Section: Discussionmentioning

confidence: 99%

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Screening for neglected tropical diseases and other infections in refugee and asylum-seeker populations in the United Kingdom

Cinardo

Farrant

Gunn

et al. 2022

Therapeutic Advances in Infection

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Asylum-seekers and refugees have an increased burden of infections compared with the general population. This has been widely recognised by countries welcoming those fleeing conflict and persecution; however, there are no screening standardised guidelines and regulatory processes. Identification of certain neglected tropical diseases (NTDs) and other infections is important for the health and well-being of the individual in addition to public health and biosecurity. In the United Kingdom, screening for infections at port of entry or after arrival is not mandatory. Those on refugee resettlement programmes will have infection screening as part of their pre-entry health assessment, but no such system exists for those claiming asylum in the United Kingdom. In this article, we have reviewed published, peer-reviewed articles looking at the approaches to screening for NTDs and infectious diseases in the United Kingdom. In addition to this, we have reviewed the literature looking at the acceptability, barriers and facilitators of these screening practices. We found that there is a heterogeneous approach to screening practices in the United Kingdom and a paucity of data to support a single ‘best practice’ approach. Based on our findings, we have made recommendations and consideration for NTD screening strategies and highlighted important areas for future research.

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Section: Discussionmentioning

confidence: 99%

“…Previous studies have demonstrated that asylum-seekers and refugees are more likely to be affected by NTDs such as Chagas disease, schistosomiasis, and filariasis. 11 , 12 …”

Section: Introductionmentioning

confidence: 99%

Screening for neglected tropical diseases and other infections in refugee and asylum-seeker populations in the United Kingdom

Cinardo

Farrant

Gunn

et al. 2022

Therapeutic Advances in Infection

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“…The alternative is to apply a permanent deferral to people born in South America, estimated at over 95 000 in London (Requena‐Méndez et al, ). It is thought that there is huge under‐ascertainment of Chagas disease in the Latin American (LA) community in the UK, with calls to launch antenatal T. cruzi testing for women at risk (Fernandez‐Turienzo et al, ). Extending previously published NHSBT T. cruzi testing data (Kitchen et al, ), this study shows that, between 2012 and 2016, T. cruzi testing by NHSBT allowed a total of 8146 donations to be made with minimal confirmatory testing required and zero confirmed positive donors, which is within the expected range for NHSBT, with just 3 of 38 585 donations (0·01%, range 0·00–0·02%) confirmed positive between 1998 and 2011.…”

Section: Discussionmentioning

confidence: 99%

Who do we gain? Enhancement of blood supplies by additional testing for donors who travel

Reynolds

Cieply

Sell

et al. 2019

Transfusion Medicine

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SUMMARY Aims/Objectives To describe the impact of additional testing on the England blood supply. Background The blood service for England, NHS Blood and Transplant, applies a system of deferral and testing to donors with potential exposure to Chagas disease, malaria and West Nile virus; however, testing costs must be justified. Here, we describe the donations and donors gained by testing. Methods Donation testing results and demographic data on donors in England where additional testing was applied were analysed in 2012–2016. The total number and proportion of donations tested, reactive and confirmed positive were calculated. Proportions of donors requiring additional tests were calculated by ethnic group for first‐time and repeat donors. Results Additional testing for travel was applied to 3·5% of NHSBT blood donations between 2012 and 2016. Over 98% of these tests were non‐reactive. Only malaria tests were confirmed positive, in 1·7% of donations tested. In first‐time donors, 45 and 40% of Asian and Black donors required an additional test, respectively, mainly for malaria. Testing for West Nile virus increased from 1·5% in 2012 to 2·2% of donations in 2016. Conclusion The majority of additional tests were screened negative, allowing approximately 64 000 donations to be released for issue annually. Donors most affected by malaria testing were more likely to have rare blood groups and be targeted for recruitment, whereas those given West Nile virus testing were mainly regular donors required for continuity of supply. These data show differences in the characteristics of donors by test and can be used to inform decisions about additional testing and deferrals.

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“…A study performed on London health system during the period of 2001‐2014 showed a prevalence of 0.043% among immigrants from Latin America . However, another study based on epidemiological data and demographic predictions estimated that the prevalence among Latin American immigrants exceeds 1.3% . These discrepancies show the need to better characterize the actual epidemiological status through deeper analysis and better diagnostic tools, not only on immigrants but also on native population.…”

Section: Introductionmentioning

confidence: 99%

High sensitivity and reproducibility of in‐house ELISAs using different genotypes of Trypanosoma cruzi

Caballero

Corrêa

Nascimento

et al. 2019

Parasite Immunology

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Summary The adequate choice of Trypanosoma cruzi strains as antigen source for the diagnosis of Chagas disease is still controversial due to differences in terms of accuracy reported between different diagnostic tests. In this study was determined if the genetic variability between different genotypes of T. cruzi (TcI, TcII and TcIV) affect the final diagnosis of Chagas disease. The sensitivity and specificity index of in‐house ELISA tests prepared with different T. cruzi strains were evaluated with chagasic and non‐chagasic control sera and using the TESA‐blot as a reference test. The results of this study revealed that the sensitivity index did not vary, with percentages of 100% for all strains in both tests. However, the specificity index for ELISA tests showed differences between 92% and 98%, but were reduced to 78%‐89% when Leishmania‐positive sera were included. All ELISAs and TESA‐blot prepared with different antigens and the recombinant Wiener test were challenged in an endemic community for Chagas disease in Panama. Both ELISAs and TESA‐blot recognized the same positive sera, corroborating the sensitivity indexes (100%) found with the control sera. The TESA‐blot maintained the specificity index of 100% and did not display false positives. However, the recombinant Wiener test decreased its sensitivity to 81.25%.

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Chagas disease among pregnant Latin American women in the United Kingdom: time for action

Cited by 6 publications

References 15 publications

Screening for neglected tropical diseases and other infections in refugee and asylum-seeker populations in the United Kingdom

Screening for neglected tropical diseases and other infections in refugee and asylum-seeker populations in the United Kingdom

Who do we gain? Enhancement of blood supplies by additional testing for donors who travel

High sensitivity and reproducibility of in‐house ELISAs using different genotypes of Trypanosoma cruzi

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