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非流行国家的恰加斯病:一项多学科研究,意大利博洛尼亚

Chagas Disease in a Non-endemic Country: A Multidisciplinary Research, Bologna, Italy.

作者信息

Di Girolamo Chiara, Martelli Giulia, Ciannameo Anna, Vocale Caterina, Fini Marco, Stefanini Angelo, Landini Maria Paola, Viale Pierluigi, Verucchi Gabriella

机构信息

Centre for International Health, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.

Infectious Diseases Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy.

出版信息

J Immigr Minor Health. 2016 Jun;18(3):616-623. doi: 10.1007/s10903-015-0214-0.

Abstract

Global processes have brought about a substantial change in the epidemiological landscape of Chagas disease, spreading it to non-endemic areas. Italy is the second country in Europe in terms of Latin American migrants and expected infection rate. Given that scenario, the Bologna University Teaching Hospital undertaken a study aimed at providing preliminary data on the prevalence and investigating the knowledge and the subjective perceptions of Chagas disease, migration pathways and other relevant ill-health experiences. A cross-sectional study was undertaken in association with an ethnographic research. Between November 2010 and May 2013 Chagas disease testing was offered to people who attended the hospital and data were collected to investigate the broader socio-demographic and cultural factors. 151 individuals were screened for anti T. cruzi antibodies; 12 of them, 10 Bolivians and 2 Argentinians, were seroreactive, resulting in an overall prevalence of 7.94 %. Both the quantitative and the qualitative analysis revealed a degree of heterogeneity in terms of knowledge and perceptions of the disease as well as of migration pathways. The results are comparable with those reported by previous studies with similar characteristics and highlight the relevance of such public health issue in a non-endemic context. Moreover, the interdisciplinary approach has greatly helped to unveil the complex social and cultural implications of Chagas disease, to explain the subjective ill-health experiences, and to understand the ways in which the broader socio-economic and cultural context affects an intervention and its potential for success or failure.

摘要

全球进程已使恰加斯病的流行病学格局发生了重大变化,将其传播到了非流行地区。就拉丁美洲移民数量和预期感染率而言,意大利是欧洲第二个国家。鉴于这种情况,博洛尼亚大学教学医院开展了一项研究,旨在提供关于恰加斯病患病率的初步数据,并调查对恰加斯病的了解、主观认知、移民途径及其他相关的健康不佳经历。一项横断面研究与一项人种志研究联合开展。在2010年11月至2013年5月期间,对到该医院就诊的人员进行了恰加斯病检测,并收集数据以调查更广泛的社会人口学和文化因素。对151人进行了抗克鲁斯锥虫抗体筛查;其中12人呈血清反应阳性,包括10名玻利维亚人和2名阿根廷人,总体患病率为7.94%。定量和定性分析均显示,在对该疾病的了解和认知以及移民途径方面存在一定程度的异质性。研究结果与之前具有类似特征的研究所报告的结果相当,突出了这一公共卫生问题在非流行背景下的相关性。此外,跨学科方法极大地有助于揭示恰加斯病复杂的社会和文化影响、解释主观的健康不佳经历,并理解更广泛的社会经济和文化背景如何影响一项干预措施及其成败可能性。

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