title: Chagas disease among the Latin American adult population attending in a primary care center in Barcelona, Spain.
abstract: OBJECTIVE
  The epidemiology of Chagas disease, until recently confined to areas of continental Latin America, has undergone considerable changes in recent decades due to migration to other parts of the world, including Spain. We studied the prevalence of Chagas disease in Latin American patients treated at a health center in Barcelona and evaluated its clinical phase. We make some recommendations for screening for the disease.
  
  
  RESULTS
  We performed an observational, cross-sectional prevalence study by means of an immunochromatographic test screening of all continental Latin American patients over the age of 14 years visiting the health centre from October 2007 to October 2009. The diagnosis was confirmed by serological methods: conventional in-house ELISA (cELISA), a commercial kit (rELISA) and ELISA using T cruzi lysate (Ortho-Clinical Diagnostics) (oELISA). Of 766 patients studied, 22 were diagnosed with T. cruzi infection, showing a prevalence of 2.87% (95% CI, 1.6-4.12%). Of the infected patients, 45.45% men and 54.55% women, 21 were from Bolivia, showing a prevalence in the Bolivian subgroup (n=127) of 16.53% (95% CI, 9.6-23.39%). ALL THE INFECTED PATIENTS WERE IN A CHRONIC PHASE OF CHAGAS DISEASE: 81% with the indeterminate form, 9.5% with the cardiac form and 9.5% with the cardiodigestive form. All patients infected with T. cruzi had heard of Chagas disease in their country of origin, 82% knew someone affected, and 77% had a significant history of living in adobe houses in rural areas.
  
  
  CONCLUSIONS
  We found a high prevalence of T. cruzi infection in immigrants from Bolivia. Detection of T. cruzi-infected persons by screening programs in non-endemic countries would control non-vectorial transmission and would benefit the persons affected, public health and national health systems.
authors.affiliation: El Clot Primary Care Center, Institut Català de la Salut, Universitat de Barcelona, Barcelona, Spain. croca.bcn.ics@gencat.cat
authors.forename: Carme
authors.initials: C
authors.lastname: Roca
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Pinazo
authors.forename: Paolo
authors.initials: P
authors.lastname: López-Chejade
authors.forename: Joan
authors.initials: J
authors.lastname: Bayó
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Posada
authors.forename: Jordi
authors.initials: J
authors.lastname: López-Solana
authors.forename: Montserrat
authors.initials: M
authors.lastname: Gállego
authors.forename: Montserrat
authors.initials: M
authors.lastname: Portús
authors.forename: Joaquim
authors.initials: J
authors.lastname: Gascón
mesh_terms: D000328:Adult; D014355:Chagas Disease / Q000453:epidemiology* / Q000473:pathology; D002908:Chronic Disease / Q000453:epidemiology; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants; D005006:Ethnicity; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000379:methods; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010274:Parasitology / Q000379:methods; D015995:Prevalence; D011320:Primary Health Care; D013030:Spain / Q000453:epidemiology