title: A global systematic review of Chagas disease prevalence among migrants.
abstract: Human migration has been identified as a potential factor for increased Chagas disease risk and has transformed the disease from a Latin American problem to a global one. We conducted a systematic review of the scientific literature between 2004-2014 in order to: summarize recent seroprevalence estimates of Chagas disease among Latin American migrants, in both endemic and non-endemic settings; compare seroprevalence estimates in migrants to countrywide prevalence estimates; and identify risk factors for Chagas disease among migrants. A total of 320 studies were screened and 23 studies were included. We found evidence that the prevalence of Chagas disease is higher than expected in some migrant groups and that reliance on blood donor screening prevalence estimates underestimates the burden of disease. Overall there is a dearth of high quality epidemiologic studies on the prevalence of Chagas disease in migrants, especially among intra-regional migrants within Latin America. Given that this zoonotic disease cannot likely be eradicated, improved surveillance and reporting is vital to continuing control efforts. More accurate health surveillance of both Latin American migrants and the Chagas disease burden will help countries appropriately scale up their response to this chronic disease. Overall, improved estimates of Chagas disease among migrants would likely serve to highlight the real need for better screening, diagnostics, and treatment of individuals living with the disease.
authors.affiliation: Division of Global Public Health University of California San Diego, 9500 Gilman Drive, MC-0507, La Jolla, CA 92093-0507, USA; Joint Doctoral Program in Public Health, University of California San Diego and San Diego State University, San Diego, CA, USA.
authors.forename: Erin E
authors.initials: EE
authors.lastname: Conners
authors.affiliation: School of Medicine, University of California San Diego, 9500 Gilman Drive, MC-0760, La Jolla, CA 92093-0760, USA.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Vinetz
authors.affiliation: Department of Geography, San Diego State University, 5500 Campanile Drive, Storm Hall 303B, San Diego, CA 92182-4493, USA.
authors.forename: John R
authors.initials: JR
authors.lastname: Weeks
authors.affiliation: Division of Global Public Health University of California San Diego, 9500 Gilman Drive, MC-0507, La Jolla, CA 92093-0507, USA. Electronic address: kbrouwer@ucsd.edu.
authors.forename: Kimberly C
authors.initials: KC
authors.lastname: Brouwer
mesh_terms: D014355:Chagas Disease / Q000453:epidemiology*; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D014171:Transients and Migrants
keywords: American trypanosomiasis; Chagas disease; Immigration; Migration; Neglected tropical disease; Systematic review