TY - JOUR
T1 - Cross-sectional, descriptive study of Chagas disease among citizens of Bolivian origin living in Munich, Germany
AU - Navarro, Miriam
AU - Berens-Riha, Nicole
AU - Hohnerlein, Stefan
AU - Seiringer, Peter
AU - von Saldern, Charlotte
AU - Garcia, Sarah
AU - Blasco-Hernández, Teresa
AU - Navaza, Bárbara
AU - Shock, Jonathan
AU - Bretzel, Gisela
AU - Hoelscher, Michael
AU - Löscher, Thomas
AU - Albajar-Viñas, Pedro
AU - Pritsch, Michael
N1 - FTX; DOAJ; (CC BY-NC 4.0)
PY - 2017
Y1 - 2017
N2 - 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.
AB - 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.
KW - Adolescent
KW - Adult
KW - Aged
KW - Bolivia/ethnology
KW - Chagas Disease/blood
KW - Child
KW - Cross-Sectional Studies
KW - Emigrants and Immigrants/statistics & numerical data
KW - Enzyme-Linked Immunosorbent Assay
KW - Female
KW - Germany/epidemiology
KW - Humans
KW - Male
KW - Middle Aged
KW - Pilot Projects
KW - Polymerase Chain Reaction
KW - Prevalence
KW - Socioeconomic Factors
KW - Young Adult
U2 - 10.1136/bmjopen-2016-013960
DO - 10.1136/bmjopen-2016-013960
M3 - A1: Web of Science-article
C2 - 28093440
SN - 2044-6055
VL - 7
JO - BMJ Open
JF - BMJ Open
IS - 1
M1 - e013960
ER -