Metabolic, mental health, behavioural and socioeconomic characteristics of migrants with Chagas disease in a non-endemic country
Metabolic, mental health, behavioural and socioeconomic characteristics of migrants with Chagas disease in a non-endemic country
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DOI：
10.1111/j.1365-3156.2012.02965.x
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发表时间：
2012-05-01
影响因子：
3.3
通讯作者：
Chappuis, Francois
中科院分区：
文献类型：
--
作者：
Jackson, Yves;Castillo, Sara;Chappuis, Francois
目标 8.1 亿受影响人群中，有 2040% 的人因慢性恰加斯病而患上心脏病。在拉丁美洲，致动脉粥样硬化因素的患病率迅速增加。欧洲 8 万名患有恰加斯病的拉丁裔移民的身体、心理、行为和社会特征尚不清楚。我们假设他们可能会积累这些因素，从而导致健康状况不佳，尤其是心血管疾病。方法 这项研究于 2011 年在日内瓦大学医院进行。我们联系了自 2008 年以来在日内瓦诊断出患有恰加斯病的拉丁美洲移民。访谈和血液测试评估了行为、社会经济、代谢和心血管因素。结果 该研究纳入了 137 名慢性恰加斯病患者（女性：84.7%；中位年龄：43 岁）。其中大多数是玻利维亚人（94.2%）、无证件（83.3%）、没有保险（72.3%）和生活在瑞士贫困线以下（89.1%）。肥胖患病率为 25.5%，高血压患病率为 17.5%，高胆固醇血症患病率为 16.1%，空腹血糖受损患病率为 23.4%，糖尿病患病率为 2.9%，代谢综合征患病率为 16.8%，焦虑患病率为 58.4%，抑郁患病率为 28.5%，当前吸烟患病率为 15.4%，久坐生活方式患病率为 62.8%。高 (> 10%) 10 年心血管风险影响 12.4%。结论 患有恰加斯病的拉丁美洲移民积累了传染性、非传染性、社会经济和行为根源的致病性慢性疾病，使他们面临健康状况不佳（尤其是心血管）结果的高风险。这凸显了筛查这些因素并提供干预措施来解决可逆性疾病的重要性；促进这些难以接触到的人群获得护理服务，以防止医疗干预延误和健康状况恶化；并开展前瞻性研究，评估这些综合因素对恰加斯病自然病程的长期影响。
Objectives Chronic Chagas disease causes cardiopathy in 2040% of the 810 million people affected. The prevalence of atherogenic factors increases rapidly in Latin America. Somatic, mental, behavioural and social characteristics of the 80 000 Latino migrants with Chagas disease in Europe are not known. We postulate that they may accumulate these factors for poor health notably cardiovascular-outcomes. methods This study took place at the Geneva University Hospitals in 2011. Latin American migrants with Chagas disease diagnosed in Geneva since 2008 were contacted. Interviews and blood tests assessed behavioural, socioeconomic, metabolic and cardiovascular factors. results One hundred and thirty-seven patients (women: 84.7%; median age: 43 years) with chronic Chagas disease were included in the study. The majority were Bolivians (94.2%), undocumented (83.3%), uninsured (72.3%) and living below the Swiss poverty line (89.1%). Prevalence of obesity was 25.5%, of hypertension 17.5%, of hypercholesterolemia 16.1%, of impaired fasting glucose 23.4%, of diabetes 2.9%, of metabolic syndrome 16.8%, of anxiety 58.4%, of depression 28.5%, of current smoking 15.4% and of sedentary lifestyle 62.8%. High (> 10%) 10-year cardiovascular risk affected 12.4%. conclusions Latin American migrants with Chagas disease accumulate pathogenic chronic conditions of infectious, non-transmissible, socioeconomic and behavioural origin, putting them at high risk of poor health, notably cardiovascular, outcomes. This highlights the importance of screening for these factors and providing interventions to tackle reversible disorders; facilitating access to care for this hard-toreach population to prevent delays in medical interventions and poorer health outcomes; and launching prospective studies to evaluate the long-term impact of these combined factors on the natural course of Chagas disease.