Valerio-Sallent L, Roure S, Basile L, Ballesteros L A, Sabrià M, Rodrigo C
Unitat de Salut Internacional Metropolitana Nord, Universitat Autònoma de Barcelona, Barcelona, España.
Rev Clin Esp. 2012 Jul;212(7):329-36. doi: 10.1016/j.rce.2012.03.017. Epub 2012 May 18.
As an inevitable consequence of Latin American immigration to Europe, Spain and other European countries, it is necessary to confront the approach to cases of Chagas infection/disease for which, epidemiologically, there are more questions than answers. This study has aimed to describe all the Chagas-infected population in the north metropolitan area of Barcelona (406,000 inhabitants).
A prospective and multicentric study was performed in 3 hospitals and 1 International Health Unit. It included all patients with Trypanosoma cruzi positive serology, regardless of the requesting reason.Results The 139 diagnosed cases represent an annual incidence of: a) 0.68/10,000 inhabitants and, b) 73.2/10,000 immigrants coming from endemic zones. Of the patients, 80 (57.6%) had alterations in some complementary tests: cardiologic 62 (44.6%), digestive 38 (27.3%) and 20 (14.4%) both. According to the Brazilian Consensus of Chagas cardiomyopathy, they were classified as: 0=84 (60.4%); a=40 (28.7%); b1=4 (2.9%), b2=10 (7.2%) and c/d=1 (0.7%). Treatment with benznidazole (5mg/kg/24h for 60 days) was prescribed in 116 (83.4%) patients, 89 (76.7%) of whom completed it. Secondary effects were recorded in 56 (50.9%), which made it necessary to withdraw it in 21 (19.1%).
Fewer cases of Chagas infection/disease than expected have been diagnosed in the North Metropolitan area of Barcelona. The series contains a high number of patients and there may be an elevated number of immigrants from endemic zones who have the asymptomatic chronic stages of the infection and who were unaware of their condition.
作为拉丁美洲人移民到欧洲、西班牙及其他欧洲国家的必然结果，有必要应对恰加斯感染/疾病病例的处理问题，从流行病学角度来看，关于这些病例存在诸多疑问。本研究旨在描述巴塞罗那北部大都市区（40.6万居民）所有恰加斯感染人群的情况。
在3家医院和1个国际卫生单位开展了一项前瞻性多中心研究。研究纳入了所有血清学检测克氏锥虫呈阳性的患者，无论其就诊原因如何。
确诊的139例病例的年发病率为：a）0.68/10000居民；b）73.2/10000来自流行区的移民。在这些患者中，80例（57.6%）在某些辅助检查中有异常：心脏方面62例（44.6%），消化方面38例（27.3%），两者均有异常的20例（14.4%）。根据巴西恰加斯心肌病共识，将他们分类为：0级=84例（60.4%）；a级=40例（28.7%）；b1级=4例（2.9%），b2级=10例（7.2%），c/d级=1例（0.7%）。116例（83.4%）患者接受了苯硝唑治疗（5mg/kg/24小时，共60天），其中89例（76.7%）完成了治疗。记录到56例（50.9%）出现了副作用，其中21例（19.1%）因此停药。
在巴塞罗那北部大都市区确诊的恰加斯感染/疾病病例比预期的少。该系列研究包含大量患者，可能有大量来自流行区的移民处于感染的无症状慢性阶段且未意识到自己的病情。
