Screening for Trypanosoma cruzi infection in immigrants and refugees: Systematic review and recommendations from the Spanish Society of Infectious Diseases and Clinical Microbiology.
Euro Surveill
; 25(8)2020 02.
Article
em En
| MEDLINE
| ID: mdl-32127121
ABSTRACT
BackgroundChagas 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.AimOur objective was to evaluate the appropriateness of screening for Trypanosoma cruzi infection in Latin American migrants and their descendants.MethodsWe 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.ResultsThe 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.ConclusionsWe 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.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Refugiados
/
Trypanosoma cruzi
/
Programas de Rastreamento
/
Doença de Chagas
/
Guias de Prática Clínica como Assunto
/
Emigrantes e Imigrantes
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
/
Systematic_reviews
Limite:
Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
Euro Surveill
Assunto da revista:
DOENCAS TRANSMISSIVEIS
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Espanha