对居住在德国慕尼黑的玻利维亚裔公民中恰加斯病的横断面描述性研究。
Cross-sectional, descriptive study of Chagas disease among citizens of Bolivian origin living in Munich, Germany.
作者信息
Navarro Miriam, Berens-Riha Nicole, Hohnerlein Stefan, Seiringer Peter, von Saldern Charlotte, Garcia Sarah, Blasco-Hernández Teresa, Navaza Bárbara, Shock Jonathan, Bretzel Gisela, Hoelscher Michael, Löscher Thomas, Albajar-Viñas Pedro, Pritsch Michael
机构信息
Fundación Mundo Sano, Madrid, Spain.
Department of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), Munich, Germany.
出版信息
BMJ Open. 2017 Jan 16;7(1):e013960. doi: 10.1136/bmjopen-2016-013960.
PURPOSE
Chagas disease (CD) has become a global health issue mainly due to migration. Germany lacks surveillance data and is home to a large Latin American immigrant population. Recognising that Bolivia is the country with the highest CD prevalence in Latin America, this cross-sectional, descriptive pilot study investigated CD and associated factors among citizens of Bolivian origin living in Munich, Germany.
METHODS
Participants completed a questionnaire in order to collect socioeconomic and health-related data. In addition, serology was performed. In case of positive serological tests, PCR diagnostic and clinical staging together with disease management was initiated. Qualitative research was conducted to identify personal and community barriers as well as strategies to increase CD awareness among the population at risk.
RESULTS
Between June 2013 and June 2014, 43 people from Bolivia (or descendants) were enrolled. A total of 9.3% (4/43), of whom two women were of childbearing age, tested seropositive (ELISA and IFAT), and one also by PCR. For 2/4 positive participants, clinical evaluation was performed and the indeterminate form of CD was diagnosed. Knowledge about CD symptoms and ways of transmission were completely absent among 55.8% (24/43, 2/4 with CD) and 30.2% (13/43, 1/4 with CD) of participants, respectively. A total of 27.9% (12/43, 0/4 with CD) of participants had donated blood prior to the study, whereas 62.8% (27/43, 3/4 with CD) were motivated to donate blood in the future. The qualitative research identified lack of knowledge as well as stigma and fears related to CD.
CONCLUSIONS
Despite the small number of participants, the prevalence of CD as well as the potential risk of non-vectorial transmission was alarming. Campaigns adapted for Latin American migrants as well as control strategies should be developed and put in place in order to prevent non-vectorial transmission and actively detect cases of CD in Germany.
目的
恰加斯病（CD）主要因移民问题已成为一个全球健康问题。德国缺乏监测数据，且有大量拉丁美洲移民人口。鉴于玻利维亚是拉丁美洲恰加斯病患病率最高的国家，这项横断面描述性试点研究调查了居住在德国慕尼黑的玻利维亚裔公民中的恰加斯病及相关因素。
方法
参与者填写问卷以收集社会经济和健康相关数据。此外，进行了血清学检测。血清学检测呈阳性的情况下，启动PCR诊断、临床分期以及疾病管理。开展定性研究以确定个人和社区障碍以及提高高危人群对恰加斯病认识的策略。
结果
2013年6月至2014年6月期间，招募了43名来自玻利维亚（或其后代）的人。共有9.3%（4/43）的人血清学检测呈阳性（酶联免疫吸附测定和间接荧光抗体试验），其中两名育龄妇女呈阳性，还有一人PCR检测也呈阳性。对2/4名阳性参与者进行了临床评估，诊断为恰加斯病的不确定形式。分别有55.8%（24/43，2/4患有恰加斯病）和30.2%（13/43，1/4患有恰加斯病）的参与者完全不了解恰加斯病症状和传播途径。共有27.9%（12/43，0/4患有恰加斯病）的参与者在研究前献过血，而62.8%（27/43，3/4患有恰加斯病）的参与者未来有献血意愿。定性研究确定了对恰加斯病缺乏了解以及与该病相关的污名化和恐惧。
结论
尽管参与者数量较少，但恰加斯病的患病率以及非媒介传播的潜在风险令人担忧。应制定并实施针对拉丁美洲移民的宣传活动以及控制策略，以防止非媒介传播并在德国积极检测恰加斯病病例。
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