Abstract
BackgroundChagas disease constitutes an important public health threat in terms of morbidity and mortality in the areas in the United States where immigrant populations from Latin America are conspicuous. We conducted a survey to assess the prevalence of anti-T. cruzi antibody in Hispanic-surnamed patients seen at Parkland Memorial Hospital in Dallas, Texas.FindingsFive hundred serum specimens from Hispanic-surnamed patients were tested by a preliminary ELISA method. On a subset of 50 sera confirmatory testing was also performed using an alternative ELISA, indirect immunofluorescence, and TESA immunoblot. For 274 of 500 Hispanic-surnamed patients, we were able to ascertain immigration status upon medical chart review. Of the 274 sera analyzed, one sample tested as positive for anti-T. cruzi antibody by the preliminary ELISA, and by the three confirmatory methods.ConclusionsThe goal of this study is to increase the awareness of T. cruzi infection and Chagas disease in areas where the Latin American immigrant communities are growing. Our study highlights the importance of testing for Chagas disease in the populations most at risk, and the need for current data on the actual seroprevalence in areas where such immigrant populations are conspicuous. Larger-scale epidemiologic surveys on Chagas disease in the immigrant communities from Latin America are warranted.
Highlights
Chagas disease constitutes an important public health threat in terms of morbidity and mortality in the areas in the United States where immigrant populations from Latin America are conspicuous
The goal of this study is to increase the awareness of T. cruzi infection and Chagas disease in areas where the Latin American immigrant communities are growing
Of the remaining 49 randomly selected serum samples sent to Centers for Disease Control and Prevention (CDC) for confirmatory testing, one additional sample yielded a result close to the cutoff value for the ELISA Wiener Recombinante (OD value 0.453, cutoff OD level 0.40) but negative on the other two tests, indirect immunofluorescence testing (IIF) and trypomastigote excreted-secreted antigens (TESA) immunoblot
Summary
Chagas disease constitutes an important public health threat in terms of morbidity and mortality in the areas in the United States where immigrant populations from Latin America are conspicuous. Chagas disease has an acute stage, typically asymptomatic or with mild symptoms (e.g., fever, malaise, swelling at the site of inoculation, and lymphadenopathy) during the first 6 to 8 weeks after infection This acute stage is often undetected and not treated. Estimates of T. cruzi antibody prevalence in the blood donor population in the United States vary widely, reflecting geographic differences as well as a trend of steady increase in prevalence as a result of conspicuous immigration from the endemic areas of Latin America over the last two decades [7,8,10,11,12]. As the county hospital for Dallas, Texas, Parkland Health & Hospital System serves the local Hispanic communities, and the immigrant community originating from Mexico represents a significant proportion of our patient population
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