Chagas disease in European countries: the challenge of a surveillance system

L Basile; J M Jansá; Y Carlier; D D Salamanca; A Angheben; A Bartoloni; J Seixas; T Van Gool; C Cañavate; M Flores-Chávez; Y Jackson; P L Chiodini; P Albajar-Viñas; Working Group on Chagas Disease

doi:10.2807/ese.16.37.19968-en

Surveillance and outbreak reports Open Access

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Chagas disease in European countries: the challenge of a surveillance system
L Basile¹ , J M Jansá² , Y Carlier³ , D D Salamanca⁴ , A Angheben⁵ , A Bartoloni⁶ , J Seixas⁷ , T Van Gool⁸ , C Cañavate⁹ , M Flores-Chávez⁹ , Y Jackson¹⁰ , P L Chiodini¹¹ , P Albajar-Viñas¹² , Working Group on Chagas Disease¹³
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Affiliations: ¹ Department of Health, Generalitat of Catalonia, Barcelona, Spain ² Directorate General of Public Health and Foreign Healthcare, Ministry of Health, Social Affairs and Equality, Madrid, Spain ³ Faculty of Medicine, Free University of Bruxelles, Brussels, Belgium ⁴ French Institute for Public Health Surveillance (Institut de Veille Sanitaire, InVS), Saint Maurice, France ⁵ Centre for Tropical Diseases, COHEMI network, Hospital S. Cuore, Don Calabria, Negrar, Verona, Italy ⁶ University Hospital Centre Careggi, COHEMI network, Firenze, Italy ⁷ Clinical unit of Tropical Diseases, Institute of Hygiene and Tropical Medicine, New University of Lisbon, Lisbon, Portugal ⁸ Department of Medical Microbiology, University of Amsterdam, Amsterdam, the Netherlands ⁹ National Centre of Microbiology, Instituto de Salud Carlos III, Madrid, Spain ¹⁰ Division of primary care medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland ¹¹ Hospital for Tropical Diseases, London, United Kingdom ¹² World Health Organization (WHO) Programme on Control of Chagas disease, Department of Control of Neglected Tropical Diseases, WHO, Geneva, Switzerland ¹³ The members of this group are listed at the end of the article

Correspondence:
P Albajar-Viñas
albajarvinasp who.int
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Citation style for this article: Basile L, Jansá J M, Carlier Y, Salamanca D D, Angheben A, Bartoloni A, Seixas J, Van Gool T, Cañavate C, Flores-Chávez M, Jackson Y, Chiodini P L, Albajar-Viñas P, Working Group on Chagas Disease Collective. Chagas disease in European countries: the challenge of a surveillance system. Euro Surveill. 2011;16(37):pii=19968. https://doi.org/10.2807/ese.16.37.19968-en Received: 28 Feb 2011

Abstract

A study of aggregate data collected from the literature and official sources was undertaken to estimate expected and observed prevalence of Trypanosoma cruzi infection, annual incidence of congenital transmission and rate of underdiagnosis of Chagas disease among Latin American migrants in the nine European countries with the highest prevalence of Chagas disease. Formal and informal data sources were used to estimate the population from endemic countries resident in Europe in 2009, diagnosed cases of Chagas disease and births from mothers originating from endemic countries. By 2009, 4,290 cases had been diagnosed in Europe, compared with an estimated 68,000 to 122,000 expected cases. The expected prevalence was very high in undocumented migrants (on average 45% of total expected cases) while the observed prevalence rate was 1.3 cases per 1,000 resident migrants from endemic countries. An estimated 20 to 183 babies with congenital Chagas disease are born annually in the study countries. The annual incidence rate of congenital transmission per 1,000 pregnancies in women from endemic countries was between none and three cases. The index of underdiagnosis of T. cruzi infection was between 94% and 96%. Chagas disease is a public health challenge in the studied European countries. Urgent measures need to be taken to detect new cases of congenital transmission and take care of the existing cases with a focus on migrants without legal residency permit and potential difficulty accessing care.