Swiss Medical Weekly
Volume 149, Issue 13-14, 2019

Screening strategy for Chagas disease in a non-endemic country (Switzerland): A prospective evaluation (Article) (Open Access)

Da Costa-Demaurex C. , Cárdenas M.T. , Aparicio H. , Bodenmann P. , Genton B. , D'Acremont V.*
  • a Faculty of Biology and Medicine, University of Lausanne, Switzerland
  • b Department of Ambulatory Care and Community Medicine, University Hospital of Lausanne, Switzerland
  • c Clinique Bois-Bougy, Nyon, Switzerland
  • d Department of Ambulatory Care and Community Medicine, University Hospital of Lausanne, Switzerland
  • e Department of Ambulatory Care and Community Medicine, University Hospital of Lausanne, Switzerland, Swiss Tropical and Public Health Institute, University of Basel, Switzerland
  • f Department of Ambulatory Care and Community Medicine, University Hospital of Lausanne, Switzerland, Swiss Tropical and Public Health Institute, University of Basel, Switzerland, Tropical and Travel Clinic, Policlinique Médicale Universitaire, Bugnon 44, Lausanne, CH-1011, Switzerland

Abstract

The WHO recommends screening of Latin American migrants for Chagas disease to reduce morbidity and mortality and increase the likelihood of eradicating the disease. The objective was to assess the feasibility and acceptability of a screening strategy in one Swiss canton. From February 2011 to September 2012, people attending six healthcare centres of different types were offered a rapid diagnostic test if they or their mother were of Latin American origin (or, at the blood donation centre, if they had travelled for ≥1 year in Latin America). In addition, testing was offered during events where Latin Americans gathered. In total, 1,010 people were tested, mainly originating from Brazil (24%), Ecuador (13%) and Chile (10%). 54% were born in Latin America, 15% had a Latin American mother, and 29% were travellers. The prevalence of Chagas disease was 2.3% among migrants (15.5% in the community testing) and 0% among travellers. The prevalence was 18.0%, 0.8%, 0.5% and 0% among Bolivians, Ecuadorians, Brazilians and other countries respectively. Predictors for Chagas disease were: born in Latin America (OR = infinite, p <0.001), Bolivian origin (OR = 95, 95% CI: 19.482, p <0.001), being tested in the community (OR = 56, 95% CI: 14.218, p <0.001), and age >35 years OR = 3.4, 95% CI: 1.1.10.5, p = 0.03). The prevalence of Chagas disease was much higher in people attending social events than healthcare centres, suggesting that observations based only on health facility data underestimate the real prevalence of Chagas disease. Screening in the community was well accepted and should be promoted to reach the population at highest risk. © 2019 EMH Swiss Medical Publishers Ltd.. All rights reserved.

Author Keywords

Primary care Screening blood donors Migrants Non-endemic country Chagas disease Rapid diagnostic test Community

Index Keywords

prospective study South and Central America Ecuador human middle aged travel Brazilian screening test Bolivian blood donor Young Adult migrant Hispanic male female prediction prevalence Article feasibility study major clinical study adult age Chile Brazil Chagas Disease health care facility Switzerland social behavior
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85064239799&doi=10.4414%2fsmw.2019.20050&partnerID=40&md5=1934162f0a461670d766c3f3698f0e20
DOI: 10.4414/smw.2019.20050
ISSN: 14247860
Original Language: English