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Prevalence of Chagas disease among Latin American immigrants in non-endemic countries: an updated systematic review and meta-analysis.
Nepomuceno de Andrade, Gisele; Bosch-Nicolau, Pau; Nascimento, Bruno R; Martins-Melo, Francisco Rogerlândio; Perel, Pablo; Geissbühler, Yvonne; Demacq, Caroline; Quijano, Monica; Mosser, Jonathan F; Cousin, Ewerton; Machado, Ísis Eloah; Rodrigues, Matheus Lucca A C; Ribeiro, Antonio Luiz P; Molina, Israel.
Afiliação
  • Nepomuceno de Andrade G; Department of Maternal and Child Nursing and Public Health, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
  • Bosch-Nicolau P; International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Spain.
  • Nascimento BR; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
  • Martins-Melo FR; Department of Internal Medicine, Faculdade de Medicina, and Telehealth Center and Cardiology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
  • Perel P; Serviço de Hemodinâmica, Hospital Madre Teresa, Belo Horizonte, MG, Brazil.
  • Geissbühler Y; Federal Institute of Education, Science and Technology of Ceará, Fortaleza, Brazil.
  • Demacq C; World Heart Federation, Geneva, Switzerland.
  • Quijano M; Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom.
  • Mosser JF; Evidence Generation, Novartis Pharma AG, Basel, Switzerland.
  • Cousin E; Global Health, Novartis Pharma AG, Basel, Switzerland.
  • Machado ÍE; Global Health, Novartis Pharma AG, Basel, Switzerland.
  • Rodrigues MLAC; Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, United States of America.
  • Ribeiro ALP; Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, United States of America.
  • Molina I; Department of Family Medicine, Mental and Collective Health, Escola de Medicina, Universidade Federal de Ouro Preto, Ouro Preto, MG, Brazil.
Lancet Reg Health Eur ; 46: 101040, 2024 Nov.
Article em En | MEDLINE | ID: mdl-39290806
ABSTRACT

Background:

Chagas disease (CD), endemic in 21 Latin American countries, has gradually spread beyond its traditional borders due to migratory movements and emerging as a global health concern. We conducted a systematic review and meta-analysis of available data to establish updated prevalence estimates of CD in Latin American migrants residing in non-endemic countries.

Methods:

A systematic search was conducted in MEDLINE/PubMed, Embase, Cochrane Library, Scopus, Web of Science, and LILACS via Virtual Health Library (Biblioteca Virtual em Saúde - BVS), including references published until November 1st, 2023. Pooled prevalence estimates and 95% confidence intervals (CI) were calculated using random effect models. Heterogeneity was assessed by the chi-square test and the I2 statistic. Subgroup analyses were performed to explore potential sources of heterogeneity among studies. The study was registered in the PROSPERO database (CRD42022354237).

Findings:

From a total of 1474 articles screened, 51 studies were included. Studies were conducted in eight non-endemic countries (most in Spain), between 2006 and 2023, and involving 82,369 screened individuals. The estimated pooled prevalence of CD in Latin American migrants living in non-endemic countries was 3.5% (95% CI 2.5-4.7; I2 97.7%), considering studies in which screening was indicated simply because the person was Latin American. Per subgroups, the pooled CD prevalence was 11.0% (95% CI 7.7-15.5) in non-targeted screening (unselected population in reference centers) (27 studies); in blood donors (4 studies), the pooled prevalence was 0.8% (95% CI 0.2-3.4); among people living with HIV Latin American immigrants (4 studies) 2.4% (95% CI 1.4-4.3) and for Latin American pregnant and postpartum women (14 studies) 3.7% (95 CI 2.4-5.6). The pooled proportion of congenital transmission was 4.4% (95% CI 3.3-5.8). Regarding the participants' country of origin, 7964 were from Bolivia, of which 1715 (21,5%) were diagnosed with CD, and 21,304 were from other Latin American countries of which 154 (0,72%) were affected.

Interpretation:

CD poses a significant burden of disease in Latin American immigrants in non-endemic countries, suggesting that CD is no longer a problem limited to the American continent and must be considered as a global health challenge.

Funding:

This study was funded by the World Heart Federation, through a research collaboration with Novartis Pharma AG.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Lancet Reg Health Eur Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Lancet Reg Health Eur Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido