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Tipo do documento: Artigo
Título: Prevalence, clinical staging and risk for blood-borne transmission of Chagas disease among Latin American migrants in Geneva, Switzerland
Autor: Jackson, Yves
Gétaz, Laurent
Wolff, Hans
Holst, Marylise
Mauris, Anne
Tardin, Aglaé
Sztajzel, Juan
Besse, Valérie
Loutan, Louis
Gaspoz, Jean-Michel
Jannin, Jean
Vinas, Pedro Albajar
Ostermayer, Alejandro Luquetti
Chappuis, François
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 (Biome´rieux 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.
Palavras-chave: Migration of Latin Americans
Chagas disease
Risk factors
Trypanosoma cruzi infection
País: Estados unidos
Unidade acadêmica: Instituto de Patologia Tropical e Saúde Pública - IPTSP (RG)
Citação: JACKSON, Yves; GÉTAZ, Laurent; WOLFF, Hans; HOLST, Marylise; MAURIS, Anne; TARDIN, Aglaé; SZTAJZEL, Juan; BESSE, Valérie; LOUTAN, Louis; GASPOZ, Jean-Michel; JANNIN, Jean; VINÃS, Pedro Albajar; LUQUETTI, Alejandro; CHAPPUIS, François. Prevalence, clinical staging and risk for blood-borne transmission of Chagas disease among Latin American migrants in Geneva, Switzerland. Plos Neglected Tropical Diseases, San Francisco, v. 4, n. 2, e592, Feb. 2010.
Tipo de acesso: Acesso Aberto
Identificador do documento: 10.1371/journal.pntd.0000592
Identificador do documento: 10.1371/journal.pntd.0000592
Data de publicação: Fev-2010
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