Prevalence of Chagas Disease in the Latin American-born Population of Los Angeles.
Prevalence of Chagas Disease in the Latin American-born Population of Los Angeles.
复制标题
DOI：
10.1093/cid/cix064
复制
发表时间：
2017-05-01
期刊：
影响因子：
--
通讯作者：
Traina M
中科院分区：
文献类型：
--
作者：
Meymandi SK;Forsyth CJ;Soverow J;Hernandez S;Sanchez D;Montgomery SP;Traina M
我们对加利福尼亚州洛杉矶的4755名拉丁美洲出生的居民进行了恰加斯病筛查，发现患病率为1.24%。萨尔瓦多人和接触易受三聚氰胺感染的多种住房材料的个人感染的几率要高得多。根据疾病控制和预防中心(CDC)的估计，恰加斯病(CD)可能影响在美国的拉美移民中的1.31%，有30万例。然而，缺乏真实世界的数据来支持这一估计。人们对这种被忽视的热带疾病在美国的实际流行情况知之甚少，而且大多数感染者都没有得到诊断。从2008年4月到2014年5月，我们对洛杉矶县4755名拉美出生的居民进行了筛查。血样检测CD的血清学证据。我们收集了人口学数据，并评估了已建立的危险因素对CD诊断的影响，包括性别、原籍国、住房材料、CD家族史和对CD的认识。CD患者59例，总患病率为1.24%。萨尔瓦多人的患病率最高(3.45%)。在3182名墨西哥受访者中，瓦哈卡州(4.65%)和萨卡特卡斯州(2.2%)的Cd患病率最高。与阳性诊断相关的有萨尔瓦多血统(AOR=6.2；95%CI=2.8-13.5；P<；.001)、既往CD知识(AOR=2.4；95%CI=1.0-5.8；P=.047)和接触所有3种高危房屋类型(AOR=2.5；95%CI=1.0-6.4；P=.048)。在美国迄今为止最大规模的血库外CD筛查中，我们发现CD患病率为1.24%。这意味着仅洛杉矶县就有3万人感染，使CD成为一个重要的公共卫生问题。对CD的有效、有针对性的监测可能会加速诊断并确定早期治疗的候选者。
We screened 4,755 Latin American–born residents of Los Angeles, California, for Chagas disease and found a prevalence of 1.24%. The odds of infection were significantly higher for Salvadorans and individuals exposed to multiple housing materials susceptible to triatomine infestation. According to an estimate from the Centers for Disease Control and Prevention (CDC), Chagas disease (CD) may affect 1.31% of Latin American immigrants in the United States, with >300 000 cases. However, there is a lack of real-world data to support this estimate. Little is known about the actual prevalence of this neglected tropical disease in the United States, and the bulk of those infected are undiagnosed. From April 2008 to May 2014, we screened 4,755 Latin American–born residents of Los Angeles County. Blood samples were tested for serologic evidence of CD. We collected demographic data and assessed the impact of established risk factors on CD diagnosis, including sex, country of origin, housing materials, family history of CD, and awareness of CD. There were 59 cases of CD, for an overall prevalence of 1.24%. Prevalence was highest among Salvadorans (3.45%). Of the 3,182 Mexican respondents, those from Oaxaca (4.65%) and Zacatecas (2.2%) had the highest CD prevalence. Salvadoran origin (aOR = 6.2; 95% CI = 2.8–13.5; P < .001), prior knowledge of CD (aOR = 2.4; 95% CI = 1.0–5.8; P = .047), and exposure to all 3 at-risk housing types (adobe, mud, and thatched roof) (aOR = 2.5; 95% CI = 1.0–6.4; P = .048) were associated with positive diagnosis. In the largest screening of CD in the United States to date outside of blood banks, we found a CD prevalence of 1.24%. This implies >30 000 people infected in Los Angeles County alone, making CD an important public health concern. Efficient, targeted surveillance of CD may accelerate diagnosis and identify candidates for early treatment.