Estimating the Burden of Chagas Disease in the United States
Estimating the Burden of Chagas Disease in the United States
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DOI：
10.1371/journal.pntd.0005033
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发表时间：
2016-11-01
影响因子：
3.8
通讯作者：
Wirtz, Veronika J.
中科院分区：
文献类型：
--
作者：
Manne-Goehler, Jennifer;Umeh, Chukwuemeka A.;Wirtz, Veronika J.
背景近年来，人们越来越意识到恰加斯病在美国的重大负担。然而，关于这一疾病的流行率和获得护理的机会的流行病学数据有限。这项研究的目的是提供一个最新的国家估计锥虫病的患病率，第一个国家级的估计病例的T。cruzi感染在美国，并分析这些估计的背景下，在美国血液supply.MethodsIn这项研究中，我们计算的查加斯病的状态和国家患病率的估计。最初来自恰加斯病流行国家的居民人数是使用美国社区调查中外国出生的西班牙裔人口的数据计算的，沿着世界卫生组织2006年发表并于2015年更新的拉丁美洲恰加斯病的最新流行率估计。然后，我们描述了分布的估计情况下，在每个国家的捐赠血液供应中确定的感染数量从AABB（原美国血库协会）的数据。FindingsThe结果的分析提供了一个更新的全国估计238,091例T。截至2012年，美国克鲁兹感染病例的估计方法与伯尔尼和蒙哥马利估计2005年病例的方法相同。这一估计表明，有62，070个案件比最近的先前估计少，尽管它不包括可能多达109，000个额外案件的无证移民。州一级的结果显示，有四个州（加州、得克萨斯、佛罗里达和纽约）的病例超过1万例，另外七个州的病例超过5,000例。此外，自2007年以来，AABB报告了1，908例确诊的T。cruzi感染确定通过筛选献血。ConclusionsThis研究表明，在美国的南美锥虫病的重大负担，与国家的变化，反映了拉丁美洲移民人口的分布风险。这项研究为美国这种疾病的分布提供了重要的新见解，并强调需要进一步研究量化患病率和发病率，以指导美国各地控制恰加斯病的干预措施。
BackgroundIn recent years, there has been growing awareness of the significant burden of Chagas disease in the United States (US). However, epidemiological data on both prevalence and access to care for this disease are limited. The objective of this study is to provide an updated national estimate of Chagas disease prevalence, the first state-level estimates of cases of T. cruzi infection in the US and to analyze these estimates in the context of data on confirmed cases of infection in the US blood supply.MethodsIn this study, we calculated estimates of the state and national prevalence of Chagas disease. The number of residents originally from Chagas disease endemic countries were computed using data on Foreign-Born Hispanic populations from the American Community Survey, along with recent prevalence estimates for Chagas disease in Latin America from the World Health Organization that were published in 2006 and updated in 2015. We then describe the distribution of estimated cases in each state in relation to the number of infections identified in the donated blood supply per data from the AABB (formerly American Association of Blood Banks).FindingsThe results of this analysis offer an updated national estimate of 238,091 cases of T. cruzi infection in the United States as of 2012, using the same method as was used by Bern and Montgomery to estimate cases in 2005. This estimate indicates that there are 62,070 cases less than the most recent prior estimate, though it does not include undocumented immigrants who may account for as many as 109,000 additional cases. The state level results show that four states (California, Texas, Florida and New York) have over 10,000 cases and an additional seven states have over 5,000 cases. Moreover, since 2007, the AABB has reported 1,908 confirmed cases of T. cruzi infection identified through screening of blood donations.ConclusionsThis study demonstrates a substantial burden of Chagas disease in the US, with state variation that reflects the distribution of at risk Latin American immigrant populations. The study lends important new insight into the distribution of this disease in the US and highlights the need for further research quantifying prevalence and incidence to guide interventions for control of Chagas disease across the US.