Prevalence, clinical staging and risk for blood-borne transmission of Chagas disease among Latin American migrants in Geneva, Switzerland
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2010-02
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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.
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Migration of Latin Americans, Chagas disease, Risk factors, Trypanosoma cruzi infection
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.