Laboratory of Cell Biology, Carlos Chagas Institute, Oswaldo Cruz Foundation, Curitiba, Paraná, Brazil.
Department of Veterinary Medicine, Federal University of Paraná State, Curitiba, Paraná, Brazil.
Front Public Health. 2023 Mar 3;11:1125028. doi: 10.3389/fpubh.2023.1125028. eCollection 2023.
Although Chagas disease, caused by , has been associated with social vulnerability worldwide, producing disability and mortality, no study to date has assessed this protozoal infection in persons experiencing homelessness. Accordingly, the present study aimed to assess anti- antibodies by Wiener Chagatest ELISA recombinant v.3.0 in serum samples of persons experiencing homelessness and related shelter workers in São Paulo, a city with reported vectors but no recent autochthonous case report. Overall, seropositivity to resulted in three of 203 (1.5%) persons experiencing homelessness and two of 87 (2.3%) shelter workers, with similar seroprevalence likely associated with their past social vulnerability. Although the seropositivity in persons experiencing homelessness and shelter workers was within 0 to 25.1% seroprevalence for chronic Chagas disease in the general Brazilian population, the disease has almost decreased 2-fold from the 1980s to 2000s, and such a wide range may not reflect the local disease status. In addition, the authors hypothesized that the similar seroprevalence and exposure between homeless persons and shelter workers herein may be more associated with shared past and present low-income social vulnerability than migratory movements, which may also include infection by sharing injecting drugs, vertical transmission, or blood transfusion. Thus, future studies are needed to confirm the active transmission of Chagas disease in São Paulo city. Moreover, Chagas disease should be considered as differential diagnosis in homeless persons and shelter workers, even in major disease-free Brazilian or other worldwide cities, mostly due to early exposure and vulnerable living conditions.
尽管由 引起的恰加斯病已与全球的社会脆弱性相关，导致残疾和死亡，但迄今为止尚无研究评估无家可归者中的这种原生动物感染。因此，本研究旨在评估圣保罗无家可归者和相关收容所工作人员血清样本中 Wiener Chagatest ELISA 重组 v.3.0 的抗- 抗体。圣保罗有报告的传播媒介，但没有最近的本地病例报告。总体而言，血清学阳性结果导致 203 名无家可归者中的 3 名（1.5%）和 87 名收容所工作人员中的 2 名（2.3%）感染了 ，其相似的血清流行率可能与其过去的社会脆弱性有关。尽管无家可归者和收容所工作人员的血清阳性率处于巴西普通人群慢性恰加斯病的 0 至 25.1%血清流行率范围内，但自 20 世纪 80 年代至 2000 年代，这种疾病的流行率已下降近 2 倍，如此广泛的范围可能无法反映当地的疾病状况。此外，作者假设，本文中无家可归者和收容所工作人员之间相似的血清流行率和暴露率可能更多地与过去和现在的低收入社会脆弱性有关，而不是与迁徙运动有关，这可能还包括通过共用注射毒品、垂直传播或输血感染。因此，需要进一步研究来确认恰加斯病在圣保罗市的传播。此外，即使在无恰加斯病的巴西或其他全球主要城市，也应将恰加斯病作为无家可归者和收容所工作人员的鉴别诊断，主要是因为他们早期暴露于该疾病且生活条件脆弱。
