Grupo de Parasitología, Instituto Nacional de Salud, Bogotá, D.C., Colombia.
Programme in Health Economics, Pontificia Universidad Javeriana, Bogotá, D.C., Colombia.
PLoS One. 2019 Jan 7;14(1):e0210156. doi: 10.1371/journal.pone.0210156. eCollection 2019.
Despite the adoption of campaigns to interrupt the main vector and to detect Trypanosoma cruzi in blood banks, millions of people are still chronically infected; however, the prevalence data are limited, and the epidemiology of Chagas disease has not been systematically evaluated. This study aimed to estimate the prevalence of Chagas disease in Colombia.
A systematic literature review and meta-analysis was conducted to select all observational studies reporting the prevalence of Chagas disease in Colombia, based on serological diagnosis in participants of any age and published between January 2007 and November 2017. Pooled estimates and 95% confidence intervals (95% CIs) were calculated using random-effects models. In addition, the I2 statistic was calculated.
The literature search yielded a total of 1,510 studies; sixteen articles with relevant prevalence data were included in the systematic review. Of these, only 12 articles were included for entry in the meta-analysis. The pooled prevalence of Chagas disease across studies was 2.0% (95% CI: 1.0-4.0). A high degree of heterogeneity was found among studies (I2 > 75%; p < 0.001). The publication bias was not statistically significant (Egger's test, p = 0.078). The highest pooled prevalences were found in the adult population (3.0%, 95% CI: 1.0-4.0), pregnant women (3.0%, 95% CI: 3.0-4.0) and the Orinoco region (7.0%, 95% CI: 2.2-12.6).
The results indicate that the T. cruzi-infected population is aging, the adult population, pregnant women and that the Orinoco region (department of Casanare) have the highest prevalences. These results highlight the need to maintain screening and surveillance programs to identify people with chronic T. cruzi infections.
尽管采取了阻断主要传播媒介和在血库中检测克氏锥虫的运动，但仍有数百万的人受到慢性感染；然而，流行数据有限，且尚未对恰加斯病的流行病学进行系统评估。本研究旨在估计哥伦比亚的恰加斯病的流行率。
我们进行了系统的文献综述和荟萃分析，以选择所有基于参与者的任何年龄的血清学诊断并在 2007 年 1 月至 2017 年 11 月间发表的报告哥伦比亚恰加斯病流行率的观察性研究。使用随机效应模型计算汇总估计值和 95%置信区间（95%CI）。此外，还计算了 I2 统计量。
文献检索共产生了 1510 项研究；系统综述纳入了 16 项具有相关流行率数据的文章。其中，只有 12 篇文章被纳入荟萃分析。研究间的恰加斯病总流行率为 2.0%（95%CI：1.0-4.0）。研究间存在高度异质性（I2＞75%；p＜0.001）。未发现发表偏倚有统计学意义（Egger 检验，p=0.078）。最高的汇总流行率见于成年人群（3.0%，95%CI：1.0-4.0）、孕妇（3.0%，95%CI：3.0-4.0）和奥里诺科地区（7.0%，95%CI：2.2-12.6）。
结果表明，感染 T. cruzi 的人群正在老龄化，成年人群、孕妇和奥里诺科地区（卡萨纳雷省）的流行率最高。这些结果强调需要维持筛查和监测计划，以发现慢性 T. cruzi 感染人群。
