The epidemiology of Chagas disease in the UK: a mixed methods study to inform equitable and evidence-based approaches to migrant health screening

英国恰加斯病的流行病学：一项混合方法研究，为移民健康筛查提供公平和循证的方法

• 批准号: MR/W016028/1
• 负责人: Natalie Elkheir
• 金额: $ 33.26万
• 依托单位: London School of Hygiene & Tropical Medicine
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FW016028%2F1
• 关键词: epidemiology; Chagas; disease; UK; mixed

Chagas disease is a long-term infection caused by a parasite (Trypanosoma cruzi) which is spread mainly by insects which live in South America, Central America and Mexico. It can also be passed from mother to child in pregnancy, and through blood transfusions and organ transplantations. The UK is home to 250,000 people from parts of the world where they may have been infected before they migrated. Most people live with the infection for years without any symptoms. About a third of people infected will go on to develop heart and gut disease, often 20-40 years later. Six different genetic types of the parasite exist in different parts of the Americas and these may influence disease type and severity. It is estimated that 97% of people with Chagas disease in the UK are undiagnosed and this project looks at how we can best find people with Chagas disease to get them tested and linked into specialist care.Early diagnosis and treatment can prevent heart and gut complications and the risk of passing on the infection to babies during pregnancy. A screening test (a blood test), can tell us whether someone has the infection but - as we don't know exactly where in Latin America most people are infected, we don't know who it's most important to screen in the UK. This project aims to answer the following questions:1. How common is Chagas disease in migrants from Latin America living in the UK?2. How common is it when we test different people in different settings (at the GP surgery, pregnant women at their antenatal appointments and people attending community events with local charities)?3. What types of people are most at-risk of Chagas disease?4. What genetic types of parasite are people infected with?5. What is the best way to find people with Chagas disease and get them tested and treated?To answer these questions, I will invite people from at-risk countries to complete a questionnaire and have a blood test for Chagas disease. I will invite people through their GP surgeries, pregnant women at their antenatal appointments and I will also organise testing events with local charities. People who test positive will be referred to a specialist clinical for further tests and treatment. They will also be invited for a different blood test, to look at the parasite genetics. Finally, I will interview people invited to screening, and professionals responsible for designing and delivering screening programmes, to understand what they think are the key components of a good screening programme for Chagas disease. At the end of this study, we hope to have all of the information required in order to design a screening programme for Chagas disease which reaches the people at greatest risk.

查加斯病是一种由寄生虫（克氏锥虫）引起的长期感染，主要由生活在南美洲，中美洲和墨西哥的昆虫传播。它也可以在怀孕期间从母亲传给孩子，并通过输血和器官移植。英国是25万人的家园，他们来自世界各地，在他们移民之前可能已经感染。大多数人感染多年，没有任何症状。大约三分之一的感染者将继续发展心脏病和肠道疾病，通常在20-40年后。六种不同的寄生虫遗传类型存在于美洲的不同地区，这些可能会影响疾病的类型和严重程度。据估计，在英国，97%的查加斯病患者未被确诊，该项目着眼于如何最好地找到查加斯病患者，让他们接受检测和专科护理。早期诊断和治疗可以预防心脏和肠道并发症，以及在怀孕期间将感染传给婴儿的风险。一个筛查测试（血液测试），可以告诉我们是否有人感染，但-因为我们不知道在拉丁美洲的确切位置大多数人被感染，我们不知道谁是最重要的屏幕在英国。本项目旨在回答以下问题：1.在生活在英国的拉丁美洲移民中，查加斯病有多常见？2.当我们在不同的环境中测试不同的人时（在全科医生手术中，孕妇在产前预约中以及参加当地慈善机构社区活动的人），这种情况有多常见？3.什么样的人最容易患上恰加斯病？4.人们感染了哪些遗传类型的寄生虫？5.找到恰加斯病患者并对其进行检测和治疗的最佳方法是什么？为了回答这些问题，我将邀请来自高风险国家的人们填写一份问卷，并进行查加斯病的血液测试。我将邀请人们通过他们的家庭医生手术，孕妇在他们的产前预约，我也将组织测试活动与当地慈善机构。测试呈阳性的人将被转介到专科诊所接受进一步的测试和治疗。他们还将被邀请进行不同的血液测试，以查看寄生虫遗传学。最后，我将采访应邀参加筛查的人，以及负责设计和提供筛查方案的专业人员，以了解他们认为恰加斯病筛查方案的关键组成部分。在这项研究结束时，我们希望获得所需的所有信息，以便设计一个针对恰加斯病的筛查计划，使风险最大的人受益。

项目成果

Comparison of new and emerging SARS-CoV-2 variant transmissibility through active contact testing. A comparative cross-sectional household seroprevalence study.

• DOI: 10.1371/journal.pone.0284372
• 发表时间: 2023
• 期刊: PLOS ONE
• 影响因子: 3.7
• 作者: Gaskell, Katherine F.;El Kheir, Natalie;Mirfendesky, Mariyam;Rampling, Tommy;Marks, Michael;Houlihan, Catherine;Lemonge, Norbert;Bristowe, Hannah;Aslam, Suhail;Kyprianou, Demetra;Nastouli, Eleni;Goldblatt, David;Fielding, Katherine;Moore, David A. J.;CONTACT Team Field Team
• 通讯作者: CONTACT Team Field Team