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Title: Screening for Trypanosoma cruzi infection in immigrants and refugees: Systematic review and recommendations from the Spanish Society of Infectious Diseases and Clinical Microbiology
Authors: Velasco, Maria
Andres Gimeno-Feliu, Luis
Molina, Israel
Salas-Coronas, Joaquin
Sola, Ivan
Monge-Maillo, Begona
Torrus-Tendero, Diego
Cayla, Joan
Nino de Guzman, Ena
Pérez Arellano, José Luis 
Perez-Molina, Jose A.
UNESCO Clasification: 3202 Epidemologia
Keywords: Latin-American Migrants
Risk Blood-Donors
Congenital Transmission, et al
Issue Date: 2020
Journal: Eurosurveillance 
Abstract: Background: Chagas disease has spread beyond its original borders on the American continent with migration. It can be transmitted from mother to child, through organ transplantation and transfusion of blood and blood products. It is necessary to determine when to screen for this infection. Aim: Our objective was to evaluate the appropriateness of screening for Trypanosoma cruzi infection in Latin American migrants and their descendants. Methods: We reviewed the literature using rigorous criteria. The quality of evidence was ranked according to the GRADE classification. An evidence to decision framework was adopted to provide information on the most relevant aspects necessary to formulate recommendations. Results: The 33 studies evaluated revealed a prevalence of T. cruzi infection among Latin American migrants in Europe of 6.08% (95% confidence interval (CI): 3.24-9.69; 28 studies). Vertical transmission occurred in three of 100 live births (95% CI: 1-6; 13 studies). The prevalence of cardiovascular disease was 19% (95% CI: 13-27; nine studies), including only 1% severe cardiac events (95% CI: 0-2; 11 studies). The overall quality of evidence was low because of risk of bias in the studies and considerable heterogeneity of the evaluated populations. The recommendations took into account economic studies on the value of screening strategies and studies on acceptability of screening and knowledge of the disease in the affected population. Conclusions: We identified five situations in which screening for T. cruzi infection is indicated. We recommend screening persons from endemic areas and children of mothers from these areas.
ISSN: 1560-7917
DOI: 10.2807/1560-7917.ES.2020.25.8.1900393
Source: Eurosurveillance [ISSN 1560-7917], v. 25 (8), p. 11-23, (Febrero 2020)
Appears in Collections:Reseña
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