PLoS Neglected Tropical Diseases
Volume 4, Issue 2, 2010

Prevalence, clinical staging and risk for blood-borne transmission of chagas disease among latin American migrants in Geneva, Switzerland (Article) (Open Access)

Jackson Y.* , Gétaz L. , Wolff H. , Holst M. , Mauris A. , Tardin A. , Sztajzel J. , Besse V. , Loutan L. , Gaspoz J.-M. , Jannin J. , Vinas P.A. , Luquetti A. , Chappuis F.
  • a Division of Primary Care Medicine, University Hospitals of Geneva, Geneva University, Geneva, Switzerland
  • b Division of Primary Care Medicine, University Hospitals of Geneva, Geneva University, Geneva, Switzerland
  • c Division of Primary Care Medicine, University Hospitals of Geneva, Geneva University, Geneva, Switzerland
  • d Division of Primary Care Medicine, University Hospitals of Geneva, Geneva University, Geneva, Switzerland
  • e Division of Humanitarian and International Medicine, University Hospitals of Geneva, Geneva University, Geneva, Switzerland
  • f Department of Genetics and Laboratory, University Hospitals of Geneva, Geneva University, Geneva, Switzerland
  • g Division of Cardiology, University Hospitals of Geneva, Geneva University, Geneva, Switzerland
  • h Department of Radiology, University Hospitals of Geneva, Geneva University, Geneva, Switzerland
  • i Department of Genetics and Laboratory, University Hospitals of Geneva, Geneva University, Geneva, Switzerland
  • j Division of Primary Care Medicine, University Hospitals of Geneva, Geneva University, Geneva, Switzerland
  • k Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
  • l Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
  • m Laboratorio de Chagas, Hospital Das Clinicas, Universidade Federal de Goiás, Goiania, Brazil
  • n Department of Genetics and Laboratory, University Hospitals of Geneva, Geneva University, Geneva, Switzerland

Abstract

Background: Migration 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 Findings: This 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. Conclusions: Chagas 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. © 2010 Jackson et al.

Author Keywords

[No Keywords available]

Index Keywords

organ transplantation immigrant South and Central America primary medical care Latin America human middle aged statistics pathology Tissue and Organ Procurement Cross-Sectional Studies Blood Donors blood donor transplantation cross-sectional study Humans male Emigrants and Immigrants female risk factor enzyme linked immunosorbent assay Risk Factors questionnaire prevalence Article disease transmission major clinical study adult migration serology Chagas Disease Bolivia Switzerland blood transfusion
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-77649218807&doi=10.1371%2fjournal.pntd.0000592&partnerID=40&md5=192ac4e464094098ed1a7ebc0b2ca92a
DOI: 10.1371/journal.pntd.0000592
Cited by: 82
Original Language: English