The Sero-Prevalence of Antibodies to Trypanosoma cruzi in Latin American Refugees and Immigrants to Canada

Steele, Leah S.; MacPherson, Douglas W.; Kim, J.; Keystone, Jay S.; Gushulak, B. D.

doi:10.1007/s10903-006-9014-x

Cited by 40 publications

(25 citation statements)

References 15 publications

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“…This figure is much higher than previously reported in Canada (1%) and Germany (2%), but lower than the very high (41%) prevalence found at a referral centre in Spain [5],[22],[23]. Our finding is mostly explained by the high proportion (48%) of Bolivian migrants in the study cohort, of whom 26.2% were diagnosed with Chagas disease.…”

Section: Discussioncontrasting

confidence: 78%

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

et al. 2010

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BackgroundMigration 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 FindingsThis 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 (Biomérieux 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.ConclusionsChagas 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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Section: Discussioncontrasting

confidence: 78%

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

et al. 2010

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“…Three out of 4 of these studies were based on samples of blood donors (Custer et al, 2012; El Ghouzzi et al, 2010; O’Brien et al, 2013) and one was a sample of pregnant women from Latin America (Edwards et al, 2013). One other study in Canada (Steele et al, 2007) used a sample of community clinics and had a prevalence similar to the PAHO based estimate. One study in France (Lescure et al, 2008) based on study volunteers from South American communities was above PAHO estimates.…”

Section: Resultsmentioning

confidence: 99%

A global systematic review of Chagas disease prevalence among migrants

et al. 2016

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Human migration has been identified as a potential factor for increased Chagas disease risk and has transformed the disease from a Latin American problem to a global one. We conducted a systematic review of the scientific literature between 2004–2014 in order to: summarize current seroprevalence estimates of Chagas disease among Latin American migrants, in both endemic and non-endemic settings; compare seroprevalence estimates in migrants to countrywide prevalence estimates; and identify risk factors for Chagas disease among migrants. A total of 320 studies were screened and 23 studies were included. We found evidence that the prevalence of Chagas disease is higher than expected in some migrant groups and that reliance on blood donor screening prevalence underestimates the burden of disease. Overall there is a dearth of high quality epidemiologic studies on the prevalence of Chagas in migrants, especially among intra-regional migrants within Latin America. Given that the disease cannot likely be eradicated, improved surveillance and reporting is vital to continuing control efforts. More accurate health surveillance of both Latin American migrants and the Chagas disease burden will help countries appropriately scale up their response to this chronic disease. Overall, improved estimates of Chagas disease among migrants would likely serve to highlight the real need for better screening, diagnostics, and treatment of individuals living with the disease.

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“…Among 205 Central American immigrants living in Washington DC, 4.5% had positive T. cruzi serology (12). A study of Latin American refugees and immigrants to Canada found that 1% of 102 participants had antibodies to T. cruzi (13).…”

Section: Recommendations Of the Working Groupmentioning

confidence: 99%

Screening and Treatment of Chagas Disease in Organ Transplant Recipients in the United States: Recommendations from the Chagas in Transplant Working Group

Chin‐Hong

Schwartz

Bern

et al. 2011

American Journal of Transplantation

175

151

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Donor-derived transmission of Trypanosoma cruzi, the etiologic agent of Chagas disease, has emerged as an issue in the United States over the past 10 years. Acute T. cruzi infection causes substantial morbidity and mortality in the posttransplant setting if not recognized and treated early. We assembled a working group of transplant infectious disease specialists, laboratory medicine specialists, organ procurement organization representatives and epidemiologists with expertise in Chagas disease. Based on review of published and unpublished data, the working group prepared evidence-based recommendations for donor screening, and follow-up testing and treatment of recipients of organs from infected donors. We advise targeted T. cruzi screening of potential donors born in Mexico, Central America and South America. Programs can consider transplantation of kidneys and livers from T. cruzi -infected donors with informed consent from recipients. However, we recommend against heart transplantation from infected donors. For other organs, we recommend caution based on the anticipated degree of immunosuppression. Our recommendations stress the need for systematic monitoring of recipients by polymerase chain reaction, and microscopy of buffy coat and advance planning for immediate antitrypanosomal treatment if recipient infection is detected. Data on management and outcomes of all cases should be collected to inform future guidelines and to assist in coordination with public health authorities.

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The Sero-Prevalence of Antibodies to Trypanosoma cruzi in Latin American Refugees and Immigrants to Canada

Abstract: We found a low sero-prevalence of Chagas' disease in a community sample of Latin American immigrants and refugees. Physicians who treat Latin American immigrants should consider the risk profile and clinical status of the individual in their decision to screen for Chagas' disease.

Cited by 40 publications

References 15 publications

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

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

A global systematic review of Chagas disease prevalence among migrants

Screening and Treatment of Chagas Disease in Organ Transplant Recipients in the United States: Recommendations from the Chagas in Transplant Working Group

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