Cross-sectional, descriptive study of Chagas disease among citizens of Bolivian origin living in Munich, Germany

Abstract

PurposeChagas disease (CD) has become a global health issue mainly due to migration. Germany lacks surveillance data and is home to a large Latin American immigrant population. Recognising that Bolivia is the country with the highest CD prevalence in Latin America, this cross-sectional, descriptive pilot study investigated CD and associated factors among citizens of Bolivian origin living in Munich, Germany.MethodsParticipants completed a questionnaire in order to collect socioeconomic and health-related data. In addition, serology was performed. In case of positive serological tests, PCR diagnostic and clinical staging together with disease management was initiated. Qualitative research was conducted to identify personal and community barriers as well as strategies to increase CD awareness among the population at risk.ResultsBetween June 2013 and June 2014, 43 people from Bolivia (or descendants) were enrolled. A total of 9.3% (4/43), of whom two women were of childbearing age, tested seropositive (ELISA and IFAT), and one also by PCR. For 2/4 positive participants, clinical evaluation was performed and the indeterminate form of CD was diagnosed. Knowledge about CD symptoms and ways of transmission were completely absent among 55.8% (24/43, 2/4 with CD) and 30.2% (13/43, 1/4 with CD) of participants, respectively. A total of 27.9% (12/43, 0/4 with CD) of participants had donated blood prior to the study, whereas 62.8% (27/43, 3/4 with CD) were motivated to donate blood in the future. The qualitative research identified lack of knowledge as well as stigma and fears related to CD.ConclusionsDespite the small number of participants, the prevalence of CD as well as the potential risk of non-vectorial transmission was alarming. Campaigns adapted for Latin American migrants as well as control strategies should be developed and put in place in order to prevent non-vectorial transmission and actively detect cases of CD in Germany.

Knowledge of Chagas disease in Latin American migrant population living in Japan and factors associated with knowledge level

“…Similar to the result of other studies about CD knowledge of LA migrants, the baseline knowledge of our participants was low [21–24]. Due to high representation of Bolivian population recruited, results of our study were more similar to Blasco-Hernandez et al study, conducted in Madrid in a group of Bolivian women [16].…”

“…Dissemination of the information about CD was considered one of the most important strategies for improving the seeking for care. It was remarked by other studies conducted in non-endemic countries [24]. As in other studies, religious meetings, social association and graphic materials was proposed for disseminate information.…”

Healthcare professionals and students’ awareness of Chagas disease: design and validation of ChaLKS (Chagas Level of Knowledge Scale)

“…Nevertheless, we drew conclusions based on results in convenience samples from selected populations with a special interest in global health, so our results are not generalizable [13]. Moreover, we speculate that general awareness among physicians of other European countries (where CD is not as prevalent as in Spain) may be even lower [5].…”

“…Under-diagnosis of CD in Europe has three main component causes, related to the population at risk (lack of knowledge and awareness about the disease, fear, stigma, barriers to access healthcare system); healthcare professionals (lack of training in tropical medicine, global health and cultural diversity in the consultation); and public health measures (so far, insufficient to address the challenge of detecting and controlling this emerging neglected tropical disease [NTD]) [1,5].…”

Chagas disease awareness and socioeconomic characteristics of Bolivian immigrants living in São Paulo, Brazil

“…(69.8%) indicated they had previously received information about CD, but the majority considered they had limited familiarity with transmission and symptoms, and >90% had not previously been tested [28].…”