title: Chagas disease screening among HIV-positive Latin American immigrants: an emerging problem.
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.
authors.affiliation: HIV Unit, Instituto de Investigación Hospital 12 de Octubre (i+12), Universidad Complutense de Madrid, Madrid, Spain. jaravih12@gmail.com
authors.forename: J
authors.initials: J
authors.lastname: Llenas-García
authors.forename: A
authors.initials: A
authors.lastname: Hernando
authors.forename: S
authors.initials: S
authors.lastname: Fiorante
authors.forename: D
authors.initials: D
authors.lastname: Maseda
authors.forename: M
authors.initials: M
authors.lastname: Matarranz
authors.forename: E
authors.initials: E
authors.lastname: Salto
authors.forename: R
authors.initials: R
authors.lastname: Rubio
authors.forename: F
authors.initials: F
authors.lastname: Pulido
mesh_terms: D000328:Adult; D014355:Chagas Disease / Q000175:diagnosis* / Q000453:epidemiology*; D002846:Chromatography, Affinity / Q000379:methods; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D005455:Fluorescent Antibody Technique / Q000379:methods; D015658:HIV Infections / Q000150:complications*; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010274:Parasitology / Q000379:methods; D013030:Spain