Targeted screening and health education for Chagas disease tailored to at-risk migrants in Spain, 2007 to 2010

Navarro, Miriam; Pérez‐Ayala, Ana; Guionnet, Anne; Pérez‐Molina, José A.; Navaza, Bárbara; Estévez, L; Norman, Francesca; Flóres-Chávez, María; López‐Vélez, Rogelio

doi:10.2807/ese.16.38.19973-en

Cited by 59 publications

(79 citation statements)

References 10 publications

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“…Our study found a high prevalence of Chagas disease. However, this could be overestimated because of the specific programs carried out by personnel at the Tropical Medicine Unit, which encouraged immigrants from endemic areas to undergo screening for T. cruzi infection 44 and so screening was probably performed in high-risk populations. We did not observe significant changes in prevalence with respect to the pre-consultation period, probably because of the prolonged asymptomatic phase of the disease.…”

Section: Discussionmentioning

confidence: 99%

Screening of Imported Infectious Diseases Among Asymptomatic Sub-Saharan African and Latin American Immigrants: A Public Health Challenge

Monge‐Maíllo¹,

López‐Vélez²,

Norman³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. Migrants from developing countries are usually young and healthy but several studies report they may harbor asymptomatic infections for prolonged periods. Prevalence of infections were determined for asymptomatic immigrants from Latin America and sub-Saharan Africa who ettended to a European Tropical Medicine Referral Center from 2000 to 2009. A systematic screening protocol for selected infections was used. Data from 317 sub-Saharan Africans and 383 Latin Americans were analyzed. Patients were mostly young (mean age 29 years); there were significantly more males among sub-Saharan Africans (83% versus 31.6%) and pre-consultation period was longer for Latin Americans (5 versus 42 months). Diagnoses of human immunodeficiency virus (HIV), chronic hepatitis B and C virus infection, and latent tuberculosis were significantly more frequent in sub-Saharan Africans (2.3% versus 0.3%; 14% versus 1.6%; 1.3 versus 0%; 71% versus 32.1%). There were no significant differences in prevalence for syphilis and intestinal parasites. Malaria and schistosomiasis prevalence in sub-Saharan Africans was 4.6% and 5.9%, respectively, and prevalence of Chagas disease in Latin Americans was 48.5%. Identifying and treating asymptomatic imported infectious diseases may have an impact both for the individual concerned and for public health. Based on these results, a systematic screening protocol for asymptomatic immigrants is proposed.

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Section: Discussionmentioning

confidence: 99%

Screening of Imported Infectious Diseases Among Asymptomatic Sub-Saharan African and Latin American Immigrants: A Public Health Challenge

Monge‐Maíllo¹,

López‐Vélez²,

Norman³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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“…Individuals with positive or indeterminate results were recalled for collection of a further blood sample to detect anti-T. cruzi antibodies by conventional serum testing. This study was performed within a public health and surveillance program on Chagas' disease conducted by the Tropical Medicine Unit at the Ramón y Cajal Teaching Hospital (TMU-RCH) (26). To define the state of compromise and decide on further treatment, TMU-RCH conducted a thorough clinical assessment not described in this paper.…”

Section: Methodsmentioning

confidence: 99%

Sensitivity and Specificity of an Operon Immunochromatographic Test in Serum and Whole-Blood Samples for the Diagnosis of Trypanosoma cruzi Infection in Spain, an Area of Nonendemicity

Flóres-Chávez

Cruz

Nieto

et al. 2012

Clin Vaccine Immunol

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bTrypanosoma cruzi infection is an imported parasitic disease in Spain, and the majority of infected individuals are in the chronic phase of the disease. This study evaluated the sensitivity and specificity of the Operon immunochromatographic test (ICT-Operon; Simple Stick Chagas and Simple Chagas WB [whole blood]; Operon S.A., Spain) for different biological samples. Well-characterized serum samples were obtained from chagasic patients (n ‫؍‬ 63), nonchagasic individuals (n ‫؍‬ 95), visceral leishmaniasis patients (n ‫؍‬ 38), and malaria patients (n ‫؍‬ 55). Noncharacterized specimens were obtained from Latin American immigrants and individuals at risk with a clinical and/or epidemiological background: these specimens were recovered serum or plasma samples (n ‫؍‬ 450), whole peripheral blood (n ‫؍‬ 94), and capillary blood (n ‫؍‬ 282). The concordance of the results by enzyme-linked immunosorbent assay and indirect immunofluorescence test was considered to be the "gold standard" for diagnosis. Serum and plasma samples were analyzed by Stick Chagas, and whole blood was analyzed by Simple Chagas WB. The sensitivity and specificity of the ICT-Operon in well-characterized samples were 100% and 97.9%, respectively. No cross-reactivity was found with samples obtained from visceral leishmaniasis patients. In contrast, a false-positive result was obtained in 27.3% of samples from malaria patients. The sensitivities of the rapid test in noncharacterized serum or plasma, peripheral blood, and capillary blood samples were 100%, 92.1%, and 86.4%, respectively, while the specificities were 91.6%, 93.6%, and 95% in each case. ICT-Operon showed variable sensitivity, depending on the kind of sample, performing better when serum or plasma samples were used. It could therefore be used for serological screening combined with any other conventional test.

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“…This figure would be even greater if we consider the tablets needed to treat infected newborn children and adolescents, immunosuppressed patients, and non-Bolivian Chagas disease patients (the latter account for around 25% of the total number of infected patients [6][7][8][9][10][11] ). With this letter we would like to highlight that the shortage of benznidazole could become a public health problem even in non-endemic countries, as has occurred with other antiinfective drug shortages.…”

mentioning

confidence: 99%

“…These recommendations exclude patients with advanced chagasic cardiomyopathy. 4 To calculate the amount of benznidazole needed to treat adult Chagas disease patients in Spain different factors were considered (Table 1) Trypanosoma cruzi infection prevalence rates in adult migrants from Bolivia, calculated from studies performed in non-clinical settings (such as migrant associations), blooddonation centers, and maternity hospitals [6][7][8][9][10][11] : 15.5%. Around 5% of infected patients have severe disease, 20% have early visceral involvement, and 75% are asymptomatic.…”

mentioning

confidence: 99%

Benznidazole Shortage Makes Chagas Disease a Neglected Tropical Disease in Developed Countries: Data from Spain

Navarro

Norman

Pérez‐Molina

et al. 2012

The American Society of Tropical Medicine and Hygiene

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Targeted screening and health education for Chagas disease tailored to at-risk migrants in Spain, 2007 to 2010

Abstract: Binary file ES_Abstracts_Final_ECDC.txt matches

Cited by 59 publications

References 10 publications

Screening of Imported Infectious Diseases Among Asymptomatic Sub-Saharan African and Latin American Immigrants: A Public Health Challenge

Screening of Imported Infectious Diseases Among Asymptomatic Sub-Saharan African and Latin American Immigrants: A Public Health Challenge

Sensitivity and Specificity of an Operon Immunochromatographic Test in Serum and Whole-Blood Samples for the Diagnosis of Trypanosoma cruzi Infection in Spain, an Area of Nonendemicity

Benznidazole Shortage Makes Chagas Disease a Neglected Tropical Disease in Developed Countries: Data from Spain

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