title: Prevalence of Chagas disease in Latin-American migrants living in Europe: a systematic review and meta-analysis.
abstract: BACKGROUND
  Few studies have assessed the burden of Chagas disease in non-endemic countries and most of them are based on prevalence estimates from Latin American (LA) countries that likely differ from the prevalence in migrants living in Europe. The aim of this study was to systematically review the existing data informing current understanding of the prevalence of Chagas disease in LA migrants living in European countries.
  
  
  METHODS
  We conducted a systematic review and meta-analysis of studies reporting prevalence of Chagas disease in European countries belonging to the European Union (EU) before 2004 in accordance with the MOOSE guidelines and based on the database sources MEDLINE and Global Health. No restrictions were placed on study date, study design or language of publication. The pooled prevalence was estimated using random effect models based on DerSimonian & Laird method.
  
  
  RESULTS
  We identified 18 studies conducted in five European countries. The random effect pooled prevalence was 4.2% (95%CI:2.2-6.7%); and the heterogeneity of Chagas disease prevalence among studies was high (I2 = 97%,p<0.001). Migrants from Bolivia had the highest prevalence of Chagas disease (18.1%, 95%CI:13.9-22.7%).
  
  
  CONCLUSIONS
  Prevalence of Chagas in LA migrants living in Europe is high, particularly in migrants from Bolivia and Paraguay. Data are highly heterogeneous dependent upon country of origin and within studies of migrants from the same country of origin. Country-specific prevalence differs from the estimates available from LA countries. Our meta-analysis provides prevalence estimates of Chagas disease that should be used to estimate the burden of disease in European countries.
authors: ISGlobal, Barcelona Center for International Health Research, (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
authors: Ana
authors: A
authors: Requena-Méndez
authors: ISGlobal, Barcelona Center for International Health Research, (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
authors: Edelweiss
authors: E
authors: Aldasoro
authors: ISGlobal, Barcelona Center for International Health Research, (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
authors: Elisa
authors: E
authors: de Lazzari
authors: ISGlobal, Barcelona Center for International Health Research, (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
authors: Elisa
authors: E
authors: Sicuri
authors: Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors: Michael
authors: M
authors: Brown
authors: Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors: David A J
authors: DA
authors: Moore
authors: ISGlobal, Barcelona Center for International Health Research, (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
authors: Joaquim
authors: J
authors: Gascon
authors: ISGlobal, Barcelona Center for International Health Research, (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
authors: Jose
authors: J
authors: Muñoz
mesh_terms: D014355:Chagas Disease / Q000453:epidemiology*; D054242:Emigrants and Immigrants; D005060:Europe / Q000453:epidemiology; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D015995:Prevalence; D014171:Transients and Migrants; D014349:Trypanosoma cruzi / Q000302:isolation & purification*