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Systematic Review Open Access
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Abstract

Background

Chagas disease has spread beyond its original borders on the American continent with migration. It can be transmitted from mother to child, through organ transplantation and transfusion of blood and blood products. It is necessary to determine when to screen for this infection.

Aim

Our objective was to evaluate the appropriateness of screening for infection in Latin American migrants and their descendants.

Methods

We reviewed the literature using rigorous criteria. The quality of evidence was ranked according to the GRADE classification. An evidence to decision framework was adopted to provide information on the most relevant aspects necessary to formulate recommendations.

Results

The 33 studies evaluated revealed a prevalence of infection among Latin American migrants in Europe of 6.08% (95% confidence interval (CI): 3.24–9.69; 28 studies). Vertical transmission occurred in three of 100 live births (95% CI: 1–6; 13 studies). The prevalence of cardiovascular disease was 19% (95% CI: 13–27; nine studies), including only 1% severe cardiac events (95% CI: 0–2; 11 studies). The overall quality of evidence was low because of risk of bias in the studies and considerable heterogeneity of the evaluated populations. The recommendations took into account economic studies on the value of screening strategies and studies on acceptability of screening and knowledge of the disease in the affected population.

Conclusions

We identified five situations in which screening for infection is indicated. We recommend screening persons from endemic areas and children of mothers from these areas.

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/content/10.2807/1560-7917.ES.2020.25.8.1900393
2020-02-27
2020-09-19
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2020.25.8.1900393
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