Conners Erin E, Ordoñez Teresa López, Cordon-Rosales Celia, Casanueva Carmen Fernández, Miranda Sonia Morales, Brouwer Kimberly C
Graduate School of Public Health, San Diego State University, San Diego, California.
Department of Medicine, University of California, San Diego, La Jolla, California.
Am J Trop Med Hyg. 2017 Oct;97(4):1134-1140. doi: 10.4269/ajtmh.16-0777. Epub 2017 Oct 10.
Chagas disease results in the largest burden, in terms of disability-adjusted-life-years, of any parasitic disease in the Americas. Monitoring Chagas disease among migrants is critical to controlling its spread and to serving the needs of the migrant community. Therefore, we determined the prevalence and correlates of Chagas disease in regional and international migrant populations at the Mexico/Guatemala border. Data were collected as part of a larger study of human immunodeficiency virus (HIV) and migration. Participants were a sample of recent regional and international migrants who used an illicit substance or had recent problem drinking. infection was classified as testing positive on two different enzyme-linked immunosorbent assays (ELISAs). Interviewer-administered surveys captured sociodemographics, migration history, Chagas disease knowledge, and access to care. We enrolled 389 recent migrants, and the prevalence of Chagas disease was 3.1%. Only 19% of the participants reported having ever heard of the disease and less than 1% had been previously tested. -positive participants were more likely to have been born in a rural area or town than a city (92% yes versus 59% no, = 0.02) and have recently lived in a house with a makeshift roof (33% yes versus 8% no, < 0.01), walls (42% yes versus 13% no, < 0.01), or floor (50% yes versus 21% no, < 0.02), or cinderblock walls (92% yes versus 63% no, = 0.04). With migration rapidly changing the distribution of Chagas disease, more work needs to be done to create targeted surveillance programs and provide access to affordable treatment among Latin American migrants.
就伤残调整生命年而言,恰加斯病是美洲所有寄生虫病中造成负担最大的疾病。监测移民中的恰加斯病对于控制其传播以及满足移民群体的需求至关重要。因此,我们确定了墨西哥/危地马拉边境地区和国际移民人口中恰加斯病的患病率及其相关因素。数据收集是一项关于人类免疫缺陷病毒(HIV)与移民的更大规模研究的一部分。参与者是近期使用过非法药物或近期有酗酒问题的地区和国际移民样本。感染被定义为在两种不同的酶联免疫吸附测定(ELISA)中检测呈阳性。由访谈员进行的调查收集了社会人口统计学信息、移民历史、恰加斯病知识以及获得医疗服务的情况。我们招募了389名近期移民,恰加斯病的患病率为3.1%。只有19%的参与者报告曾听说过这种疾病,且不到1%的人之前接受过检测。呈阳性的参与者出生在农村地区或城镇而非城市的可能性更大(是:92%,否:59%,P = 0.02),并且近期居住在屋顶为临时搭建的房屋中的可能性更大(是:33%,否:8%,P < 0.01)、墙壁为临时搭建的房屋(是:42%,否:13%,P < 0.01)、地板为临时搭建的房屋(是:50%,否:21%,P < 0.02)或者煤渣砖墙壁房屋(是:92%,否:63%,P = 0.04)。随着移民迅速改变恰加斯病的分布情况,需要开展更多工作来制定有针对性的监测项目,并为拉丁美洲移民提供负担得起的治疗。