Relevance of screening for Chagas and viral hepatitis in Bolivian migrants

Abstract

Objectivesgiven the scarcity of data regarding prevalence of various infectious diseases in Latin-American countries, our study aims to assess the burden of T.cruzi, S.stercoralis, HIV and viral hepatitis in Latin-American migrants, with a focus on Bolivian migrants.\n\nMethodswe performed a retrospective observational study of 565 screening evaluations on adults ([≥] 18 years) carried out at our referral International Healthcare service in Barcelona. We reviewed structured clinical records and microbiological results of patients attended between February 2012 and April 2015.\n\nResultsthe median 35 years old and 74% were women. Bolivian origin accounted for 87% of the screened population. We found a 48% prevalence of T.cruzi, 16% of S.stercoralis, 0.2% of HIV, 92% of HAV, 0.2% HBV and 0.2% HCV.\n\nConclusionsthese results support the relevance of the screening of T. cruzi and S. stercoralis in Bolivian migrants, but challenge the pertinence of systematic screening of HBV in this population.\n\nAuthor summaryIn response to the challenge of detecting diseases not previously present in host countries, screening programs have been implemented for migrants based on the probability of having certain diseases depending on their country of origin and / or migratory route. This increased risk is very clearly established in some cases such as Trypanosoma cruzi infection (the cause of Chagas disease) in people from Latin America; especially from Bolivia. In recent years screening recommendations for Strongyloides stercoralis in this population was proven necessary. Current recommendations regarding systematic screening for hepatitis B establish the relevance of screening based on the probability of the disease in the 2% population of origin. Since there are no reliable and up to date data regarding prevalence of hepatitis B virus in Bolivia, we aimed to analyze data available for migrants from Bolivia in Spain.\n\nOur results support the importance of screening for T. cruzi and S.stercoralis in patients from Bolivia. However, our data show a much lower prevalence of this hepatitis B virus (0.2%) than the 2% threshold that would justify systematic screening, so we question the relevance of screening for hepatitis B virus in this population in the absence of other risk factors.