Skip to main content

Advertisement

SpringerLink
Log in

Chagas disease screening among HIV-positive Latin American immigrants: an emerging problem

  • Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Chagas disease (CD) is an emergent disease in Europe that can behave as an opportunistic infection in HIV positive patients. The objective of this study was to evaluate the implementation of a CD screening programme in an HIV unit. An immunochromatography (ICT) of Trypanosoma cruzi was performed as a screening tool in HIV-positive patients born in CD endemic countries. ELISA and IFAT were used to confirm the diagnosis. A total of 155 patients, 116 males and 38 females, were included. Mean age was 36.9 years (±8.4) and mean length of stay in Spain at the screening was 7.1 years (±4.7). T. cruzi ICT was positive in four cases (2.6%), being confirmed (by ELISA and IFAT) in three of those (1.9%). Factors associated with confirmed positive T.cruzi serology were: Bolivia origin (p = 0.016), Bolivia or Argentina origin (p = 0.002), Southern Cone origin (p = 0.015), rural origin (p = 0.023), previously living in an adobe-made (p = 0.001) or thatch-roofed house (p < 0.0001), having a previous CD test (p = 0.015), previous knowledge about CD (p = 0.019), about vector (p = 0.009) or recorded seeing vectors at home (p = 0.012). Units dealing with HIV patients from endemic areas of American trypanosomiasis should implement CD screening protocols. Interviews of patients coming from endemic areas should include CD epidemiological questions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Pan American Health Organization (2006) Quantitative estimation of Chags disease in the Americas. Montevideo, Uruguay, pp 1–28. http://www.bvsops.org.uy/pdf/chagas19.pdf. Accessed 11 July 2011

  2. Schmunis GA, Yadon ZE (2010) Chagas disease: a Latin American health problem becoming a world health problem. Acta Trop 115:14–21

    Article  PubMed  Google Scholar 

  3. Bern C, Montgomery SP (2009) An estimate of the burden of Chagas disease in the United States. Clin Infect Dis 49:e52–e54

    Article  PubMed  Google Scholar 

  4. WHO (2010) Control and prevention of Chagas disease in Europe. Report of a WHO informal consultation (jointly organized by WHO headquarters and the WHO Regional Office for Europe). World Health Organization, Geneva, Switzerland, 17–18 December 2009

  5. Kirchhoff L (2006) American Trypanosomiasis (Chagas’ disease). In: Guerrant R, Walker D, Weller P (eds) Tropical infectious diseases: principles, pathogens, & practice. Elsevier, Philadelphia, pp 1082–1094

    Google Scholar 

  6. No authors listed (2006) Recommendations for diagnosis, treatment and follow-up of the Trypanosoma cruzi: human immunodeficiency virus co-infection. Rev Soc Bras Med Trop 39:392–415 [Article in Portuguese]

    Google Scholar 

  7. Sartori AM, Ibrahim KY, Nunes Westphalen EV, Braz LM, Oliveira OC Jr, Gakiya E et al (2007) Manifestations of Chagas disease (American trypanosomiasis) in patients with HIV/AIDS. Ann Trop Med Parasitol 101:31–50

    Article  PubMed  CAS  Google Scholar 

  8. Albrecht H (1997) Redefining AIDS: towards a modification of the current AIDS case definition. Clin Infect Dis 24:64–74

    Article  PubMed  CAS  Google Scholar 

  9. Sartori AM, Shikanai-Yasuda MA, Amato Neto V, Lopes MH (1998) Follow-up of 18 patients with human immunodeficiency virus infection and chronic Chagas' disease, with reactivation of Chagas' disease causing cardiac disease in three patients. Clin Infect Dis 26:177–179

    Article  PubMed  CAS  Google Scholar 

  10. Sartori AM, Neto JE, Nunes EV, Braz LM, Caiaffa-Filho HH, Oliveira Oda C Jr et al (2002) Trypanosoma cruzi parasitemia in chronic Chagas disease: comparison between human immunodeficiency virus (HIV)-positive and HIV-negative patients. J Infect Dis 186:872–875

    Article  PubMed  Google Scholar 

  11. Panel de expertos de Grupo de Estudio del Sida, Plan Nacional sobre el Sida (2008) Prevention of opportunistic infections in HIV-infected adolescents and adults guidelines. Recommendations of GESIDA/National AIDS Plan AIDS Study Group (GESIDA) and National AIDS Plan. Enferm Infecc Microbiol Clin 26:437–464, [Article in Spanish]

    Article  Google Scholar 

  12. Kaplan JE, Benson C, Holmes KH, Brooks JT, Pau A, Masur H et al (2009) Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. MMWR Recomm Rep 58:1–207, quiz CE1-4

    Google Scholar 

  13. Panel de expertos de GESIDA, Plan Nacional sobre el Sida (2011) [National consensus document by GESIDA/National Aids Plan on antiretroviral treatment in adults infected by the human immunodeficiency virus (January 2011 update)]. Enferm Infecc Microbiol Clin 29:209 e1–e103

    Google Scholar 

  14. European AIDS Clinical Society (2011) Clinical management and treatment of HIV-infected adults in Europe. http://www.europeanaidsclinicalsociety.org/guid/index.html?ml=1. Accesed 10 July 2011

  15. Rodriguez-Guardado A, Alvarez VA, Rodriguez Perez M, Alvarez PM, Flores-Chavez M, Gonzalez PA et al (2011) Screening for Chagas' disease in HIV-positive immigrants from endemic areas. Epidemiol Infect 139:539–543

    Article  PubMed  CAS  Google Scholar 

  16. Almeida EA, Lima JN, Lages-Silva E, Guariento ME, Aoki FH, Torres-Morales AE et al (2010) Chagas' disease and HIV co-infection in patients without effective antiretroviral therapy: prevalence, clinical presentation and natural history. Trans R Soc Trop Med Hyg 104:447–452

    Article  PubMed  Google Scholar 

  17. Rodriguez-Guardado A, Rodriguez M, Alonso P, Seco C, Flores-Chavez M, Mejuto P et al (2009) Serological screening of Chagas disease in an immigrant population in Asturias, Spain proceeding from Chagas-endemic areas. Scand J Infect Dis 41:774–776

    Article  PubMed  Google Scholar 

  18. Jackson Y, Getaz L, Wolff H, Holst M, Mauris A, Tardin A et al (2010) Prevalence, clinical staging and risk for blood-borne transmission of Chagas disease among Latin American migrants in Geneva, Switzerland. PLoS Negl Trop Dis 4:e592

    Article  PubMed  Google Scholar 

  19. Soriano Arandes A, Munoz Gutierrez J, Verges Navarro M, Castells Domenech C, Portus Vinyeta M, Gascon Brustenga J (2009) Prevalence of Chagas disease in the Latin American immigrant population in a primary health centre in Barcelona (Spain). Acta Trop 112:228–230

    Article  PubMed  Google Scholar 

  20. Steele LS, MacPherson DW, Kim J, Keystone JS, Gushulak BD (2007) The sero-prevalence of antibodies to trypanosoma cruzi in Latin American refugees and immigrants to Canada. J Immigr Minor Health 9:43–47

    Article  PubMed  CAS  Google Scholar 

  21. Kirchhoff LV, Gam AA, Gilliam FC (1987) American trypanosomiasis (Chagas' disease) in Central American immigrants. Am J Med 82:915–920

    Article  PubMed  CAS  Google Scholar 

  22. Pérez-Ayala A, Pérez-Molina JA, Norman F, Navarro M, Monge-Maillo B, Díaz-Menéndez M et al (2010) Chagas disease in Latin American migrants: a Spanish challenge. Clin Microbiol Infect. doi:10.1111/j.1469-0691.2010.03423.x

  23. Manzardo C, Treviño B, Gómez i Prat J, Cabezos J, Monguí E, Clavería I et al (2008) Communicable diseases in the immigrant population attended to in a tropical medicine unit: Epidemiological aspects and public health issues. Trav Med Infect Dis 6:4–11

    Article  Google Scholar 

  24. Muñoz J, Coll O, Juncosa T, Vergés M, del Pino M, Fumado V et al (2009) Prevalence and vertical transmission of Trypanosoma cruzi infection among pregnant Latin American women attending 2 maternity clinics in Barcelona, Spain. Clin Infect Dis 48:1736–1740

    Article  PubMed  Google Scholar 

  25. Lucas RM, Barba MC (2009) Prevalencia de tripanomiasis americana en mujeres gestantes de un area de salud: Valencia, 2005–2007. Rev Esp Salud Publica 83:543–555

    PubMed  Google Scholar 

  26. Ramos JM, Milla A, Sanchez V, Verges M, Toro C, Gutierrez F (2009) Cribado prenatal de la infeccion por Trypanosoma cruzi y virus linfotropico humano de celulas T en gestantes latinoamericanas. Enferm Infecc Microbiol Clin 27:165–167

    Article  PubMed  Google Scholar 

  27. Paricio-Talayero JM, Benlloch-Muncharaz MJ, Collar-del-Castillo JI, Rubio-Soriano A, Serrat-Perez C, Magraner-Egea J et al (2008) Vigilancia epidemiologica de la transmision vertical de la enfermedad de Chagas en tres maternidades de la Comunidad Valenciana. Enferm Infecc Microbiol Clin 26:609–613

    Article  PubMed  Google Scholar 

  28. Gonzalez-Granado LI, Rojo-Conejo P, Ruiz-Contreras J, Gonzalez-Tome MI (2009) Chagas disease travels to Europe. Lancet 373:2025

    Article  PubMed  Google Scholar 

  29. Scapellato PG, Bottaro EG, Rodríguez-Brieschke MT (2009) Mother-child transmission of Chagas disease: could coinfection with human immunodeficiency virus increase the risk? Rev Soc Bras Med Trop 42:107–109

    Article  PubMed  Google Scholar 

  30. Piron M, Verges M, Munoz J, Casamitjana N, Sanz S, Maymo RM et al (2008) Seroprevalence of Trypanosoma cruzi infection in at-risk blood donors in Catalonia (Spain). Transfusion 48:1862–1868

    Article  PubMed  Google Scholar 

  31. Schmunis GA (2007) Epidemiology of Chagas disease in non-endemic countries: the role of international migration. Mem Inst Oswaldo Cruz 102(Suppl 1):75–85

    Article  PubMed  Google Scholar 

  32. Flores-Chavez M, Cruz I, Rodriguez M, Nieto J, Franco E, Garate T et al (2010) Comparación de técnicas serológicas convencionales y no convencionales para el diagnóstico de la enfermedad de Chagas importada en España. Enferm Infecc Microbiol Clin 28:284–293

    Article  PubMed  Google Scholar 

  33. Lopez-Chejade P, Roca C, Posada E, Pinazo MJ, Gascon J, Portus M (2010) Utilidad de un test inmunocromatografico para el cribado de la enfermedad de Chagas en asistencia primaria. Enferm Infecc Microbiol Clin 28:169–171

    Article  PubMed  Google Scholar 

  34. Ponce C, Ponce E, Vinelli E, Montoya A, de Aguilar V, Gonzalez A et al (2005) Validation of a rapid and reliable test for diagnosis of Chagas' disease by detection of Trypanosoma cruzi-specific antibodies in blood of donors and patients in Central America. J Clin Microbiol 43:5065–5068

    Article  PubMed  CAS  Google Scholar 

  35. Luquetti AO, Ponce C, Ponce E, Esfandiari J, Schijman A, Revollo S et al (2003) Chagas' disease diagnosis: a multicentric evaluation of Chagas Stat-Pak, a rapid immunochromatographic assay with recombinant proteins of Trypanosoma cruzi. Diagn Microbiol Infect Dis 46:265–271

    Article  PubMed  CAS  Google Scholar 

  36. Roddy P, Goiri J, Flevaud L, Palma PP, Morote S, Lima N et al (2008) Field evaluation of a rapid immunochromatographic assay for detection of Trypanosoma cruzi infection by use of whole blood. J Clin Microbiol 46:2022–2027

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

We would like to acknowledge the support and collaboration of the personnel of the Centro Nacional de Microbiología-Instituto de Salud Carlos III, who carried out the ELISA, IFAT and PCR techniques. This study was conducted with the financial support of the European University of Madrid. This study was performed under the Río Hortega Research Educational Contract from the Instituto de Salud Carlos III to J.L.G.

Conflict of interest

All authors report no conflicts of interest.

Author information

Authors and Affiliations

  1. HIV Unit, Instituto de Investigación Hospital 12 de Octubre (i+12), Universidad Complutense de Madrid, Madrid, Spain

    J. Llenas-García, S. Fiorante, D. Maseda, M. Matarranz, R. Rubio & F. Pulido

  2. Medical Specialties Department, European University of Madrid, Villaviciosa de Odón, Madrid, Spain

    A. Hernando

  3. Microbiology Department, Instituto de Investigación Hospital 12 de Octubre (i+12), Universidad Complutense de Madrid, Madrid, Spain

    E. Salto

Authors
  1. J. Llenas-García
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Hernando
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. Fiorante
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. D. Maseda
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Matarranz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. E. Salto
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. R. Rubio
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. F. Pulido
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Llenas-García.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Llenas-García, J., Hernando, A., Fiorante, S. et al. Chagas disease screening among HIV-positive Latin American immigrants: an emerging problem. Eur J Clin Microbiol Infect Dis 31, 1991–1997 (2012). https://doi.org/10.1007/s10096-011-1531-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-011-1531-4

Keywords

Search

Navigation