Epidemiology of Chagas Disease in Non-Endemic European Countries

Esther Cambronero-Cortinas


Chagas disease results from infection by the protozoan Trypanosoma cruzi and was presviously described as an endemic disease focused in populations living in poor rural areas of Latin American countries. Currently, migrant populations and some modes of transmission such as blood and organ donation or vertical transmission from infected mothers to their children have caused the spread of this disease beyond its natural geographical boundaries. In Europe, Spain, with over half of these migrants, is undoubtedly the most important recipient, followed by Italy, France and United Kingdom. However, in non-endemic countries there is no universal screening systems and also physicians are often poorly trained in recognizing this disease. So far, few countries are aware of the emergence of this disease and only few European countries have established changes in their health system to address this disease. The National European Health authorities should take part to this model-of-care, adapting in this new epidemiological scenario with screening this pathology in blood donors, organ donations or vertically from mother to child at birth. These mechanisms are the main forms of human infestation in nonendemic countries and are, therefore, the major targets for reduction of spread.

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Tibayrenc M, Telleria J. 2010. American trypanosomiasis: Chagas disease: one hundred years of research, 1st edn. Elsevier insights. Elsevier: London; Burlington, MA, USA, 848 p.

Martinez-Perez A, Poveda C, Ramírez JD, et al Prevalence of Trypanosoma cruzi’s Discrete Typing Units in a cohort of Latin American migrants in Spain. Acta Trop. 2016 May;157:145-50. doi: 10.1016/j.actatropica.2016.01.032.

Makik LH, Singh GD, Amsterdam EA, et al. Chagas Heart Disease: An Update. Am J Med. 2015. Nov; 128(11):1251.e7-9. DOI: http://dx.doi.org/10.1016/j.amjmed.2015.04.036

Pinazo MJ, Gascon J . The importance of the multidisciplinary approach to deal with the new epidemiological scenario of Chagas disease (global health). Acta Trop. 2015 Nov;151:16-20. doi: 10.1016/j.actatropica.2015.06.013.

Pérez-Molina JA, Martinez Perez A, Norman FF, et al. Old and new challenges in Chagas disease. Lancet Infect Dis. 2015 Nov;15(11):1347-56. DOI: http://dx.doi.org/10.1016/S1473-3099(15)00243-1

Cesar C, Jenkins CA, Shepherd BE, et al. Incidence of virological failure and major regimen change of initial combination antiretroviral therapy in Latin America and the Caribbean: an observational cohort study. Lancet HIV. 2015 Nov;2(11):e492-500. DOI: http://dx.doi.org/10.1016/S2352-3018(15)00183-6

Requena-Méndez A, Aldasoro E, de Lazzari E, et al. Prevalence of Chagas disease in Latin-American migrants living in Europe: a systematic review and meta-analysis. PLoS Negl Trop Dis. 2015 Feb 13;9(2):e0003540. doi: 10.1371/journal.pntd.0003540.

Conners EE, Vinetz JM, Weeks JR, et al. A global systematic review of Chagas disease prevalence among migrants. Acta Trop. 2016 Apr;156:68-78. doi: 10.1016/j.actatropica.2016.01.002.

Gobbi F, Angheben A, Anselmi M, et al. Profile of Trypanosoma cruzi Infection in a Tropical Medicine Reference Center, Northern Italy. PLoS Negl Trop Dis. 2014 Dec 11;8(12):e3361. doi: 10.1371/journal.pntd.0003361

Repetto EC, Zachariah R, Kumar A, et al. Neglect of a Neglected Disease in Italy: The Challenge of Access-to-Care for Chagas Disease in Bergamo Area. PLoS Negl Trop Dis. 2015 Sep 25;9(9): e0004103 http://dx.doi.org/10.1371/journal.pntd.0004103

Soriano-Arandes A, Angheben A, Serre-Delcor N, et al. Control and management of congenital Chagas disease in Europe and other non-endemic countries: current policies and practices. Trop Med Int Health. 2016 May;21(5):590-6. doi: 10.1111/tmi.12687.

Di Girolamo C, Martelli G, Ciannameo A, et al. Chagas Disease in a Non-endemic Country: A Multidisciplinary Research, Bologna, Italy. J Immigr Minor Health. 2016 Jun;18(3):616-23. doi: 10.1007/s10903-015-0214-0.

Angheben A, Boix L, Buonfrate D, et al. Chagas disease and transfusion medicine: a perspective from non-endemic countries. Blood Transfus. 2015 Oct;13(4):540-50.

Nunes MC, Dones W, Morillo CA, et al. Chagas disease: an overview of clinical and epidemiological aspects. J Am Coll Cardiol. 2013 Aug 27;62(9):767-76. doi: 10.2450/2015.0040-15.

Bonney KM. Chagas disease in the 21st Century: a public health success or an emerging threat? Parasite. 2014;21:11. doi: 10.1051/parasite/2014012

Imaz-Iglesia I, García-San Miguel L, Ayala-Morillas LE, et al. Economic evaluation of Chagas disease screening in Spain. Acta Trop. 2015 Aug;148:77-88. doi: 10.1016/j.actatropica.2015.04.014.

Shewan L.G., Coats A.J.S., Henein M. Requirements for Ethical Publishing in Biomedical Journals. International Cardiovascular Forum Journal. 2015;2:2. http://dx.doi.org/10.17987/icfj.v2i1.4

DOI: https://doi.org/10.17987/icfj.v7i0.353

Copyright (c) 2016 Esther Cambronero-Cortinas

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