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Community‑based screening of Chagas disease among Latin American migrants in a non‑endemic country: an observational study

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摘要 Background:Chagas disease is a parasitic disease endemic to Latin America,but it has become a disease of global concern due to migration fows.Asymptomatic carriers may host the parasite for years,without knowing they are infected.The aim of this study is to assess prevalence of Chagas disease and evaluate the participants’level of knowl‑edge between Latin American migrants attending a community-based screening campaign.Methods:Three community-based campaigns were performed in Alicante(Spain)in 2016,2017 and 2018,including educational chats and blood tests for Trypanosoma cruzi serology.Participants completed a questionnaire assessing knowledge about the mechanisms of transmission,disease presentation,diagnosis,and treatment.People seroposi‑tive for T.cruzi underwent diagnostic confrmation by two diferent tests.Results were analyzed by multivariable logistic regression and expressed as adjusted odds ratios(aORs),adjusting for age,sex,and time in Spain.Results:A total of 596 participants were included in the study;17%were aged under 18 years.Prevalence in adults was 11%[54/496;95%confdence interval(CI):8.3–14.5%]versus 0%among children.All but one case were in Bolivians.Diagnosis was independently associated with having been born in Bolivia(aOR:102,95%CI:13–781)and a primary school-level education(aOR:2.40,95%CI:1.14–5.06).Of 54 people diagnosed with Chagas disease(most of whom were asymptomatic),42(77.7%)returned to the clinic at least once,and 24(44.4%)received treatment.Multivariable analysis showed that coming from Argentina(aOR:13,95%CI:1.61–1188)or Bolivia(aOR:1.90,95%CI:1.19–3.39)and having received information about Chagas disease in Spain(aOR:4.63,95%CI:2.54–8.97)were associ‑ated with a good level of knowledge on the disease.Having primary level studies(aOR:0.59,95%CI:0.34–0.98)and coming from Ecuador(aOR:4.63,95%CI:2.52–847)were independently associated with a lower level of knowledge.Conclusions:Community-based interventions are a good strategy for diagnosing neglected diseases such as Chagas disease in non-endemic countries and for identifying and treating infected,asymptomatic individuals.
出处 《Infectious Diseases of Poverty》 SCIE 2021年第5期14-27,共14页 贫困所致传染病(英文)
基金 partially supported by the third call for research grants(J-M.R.R.)from the Institute of Health and Biomedical Research of Alicante(ISABIAL)/FISABIO Foundation(Ⅲ convocatoria de ayudas a proyectos de investigación del Instituto de Investigación Sanitaria y Biomédica de Alicante(ISABIAL)–Fundación FISABIO)(UGP-16-158) by the collaborative agreement between ISABIAL/Fundación FISABIO and Fundación Mundo Sano-Spain,in accordance with the Sponsorship Law.
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