2 research outputs found

    Community-based screening of Chagas disease among Latin American migrants in a non-endemic country: an observational study

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    Background: Chagas disease is a parasitic disease endemic to Latin America, but it has become a disease of global concern due to migration flows. Asymptomatic carriers may host the parasite for years, without knowing they are infected. The aim of this study is to assess prevalence of Chagas disease and evaluate the participants' level of knowledge between Latin American migrants attending a community-based screening campaign. Methods: Three community-based campaigns were performed in Alicante (Spain) in 2016, 2017 and 2018, including educational chats and blood tests for Trypanosoma cruzi serology. Participants completed a questionnaire assessing knowledge about the mechanisms of transmission, disease presentation, diagnosis, and treatment. People seropositive for T. cruzi underwent diagnostic confirmation by two different tests. Results were analyzed by multivariable logistic regression and expressed as adjusted odds ratios (aORs), adjusting for age, sex, and time in Spain. Results: A total of 596 participants were included in the study; 17% were aged under 18 years. Prevalence in adults was 11% [54/496; 95% confidence interval (CI): 8.3-14.5%] versus 0% among children. All but one case were in Bolivians. Diagnosis was independently associated with having been born in Bolivia (aOR: 102, 95% CI: 13-781) and a primary school-level education (aOR: 2.40, 95% CI: 1.14-5.06). Of 54 people diagnosed with Chagas disease (most of whom were asymptomatic), 42 (77.7%) returned to the clinic at least once, and 24 (44.4%) received treatment. Multivariable analysis showed that coming from Argentina (aOR: 13, 95% CI: 1.61-1188) or Bolivia (aOR: 1.90, 95% CI: 1.19-3.39) and having received information about Chagas disease in Spain (aOR: 4.63, 95% CI: 2.54-8.97) were associated with a good level of knowledge on the disease. Having primary level studies (aOR: 0.59, 95% CI: 0.34-0.98) and coming from Ecuador (aOR: 4.63, 95% CI: 2.52-847) were independently associated with a lower level of knowledge. Conclusions: Community-based interventions are a good strategy for diagnosing neglected diseases such as Chagas disease in non-endemic countries and for identifying and treating infected, asymptomatic individuals.This study was partially supported by the third call for research grants (J-M.R.-R.) from the Institute of Health and Biomedical Research of Alicante (ISABIAL)/FISABIO Foundation (III convocatoria de ayudas a proyectos de investigación del Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL) – Fundación FISABIO) (UGP-16-158); and by the collaborative agreement between ISABIAL/Fundación FISABIO and Fundación Mundo Sano-Spain, in accordance with the Sponsorship Law. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.S

    Epidemiología y factores pronósticos de la infección por Nocardia spp

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    Introducción:Las infecciones por Nocardia spp., son infrecuentes y de difícil diagnóstico. Objetivos:Describir las características clínico-demográficas, microbiológicas y los factores pronósticos de la infección por Nocardia spp.desde Enero 2000 a Abril 2015,en cuatro hospitales de la provincia de Alicante. Métodos:Estudio multicéntrico, observacional, descriptivo y retrospectivo. Se revisaron las historias clínicas según las bases de datos de Microbiología y Admisión, de los hospitales de la Vega Baja de Orihuela, General de Alicante, San Juan y el hospital Marina Baixa. Resultados:Se incluyeron 82 pacientes, la edad media fue 68 años, el 68,3% (n=56) eran varones. El 95% (n=78) tenían comorbilidad, principalmente EPOC en el 59,8% (n=49) y bronquiectasias en el 40,2% (n=33). El 70,3% (n=58) se consideraron inmunodeprimidos. La comorbilidad media medida por el índice Charlson fue de 2,78. La forma clínica más frecuente fue infección respiratoria de vías bajas (n=67). El tiempo medio hasta el diagnóstico era de 20 días. N. cyriacigeorgica fue la especie más común (n=13) entre las que se disponía de identificación fenotípica. Siete cepas presentaron resistencia intrínseca a cotrimoxazol. Los factores asociados a mortalidad fueron un Charlson mayor o igual a 3 OR4,67 (IC95% 1,11-19,67) p=0,025, procesos tumorales OR4,54 (IC95% 1,14-17,99) p=0,022, diseminación hematógena OR11,29 (IC95% 5,56-22,89) p<0,001 y la de enfermedad renal crónica OR4,67 (IC95% 1 ,10-19,79) p=0,026. Conclusión:La nocardiosis afecta a individuos con patologías subyacentes. Una proporción de las cepas aisladas era resistente a cotrimoxazol. La mortalidad fue elevada en esta serie. El número de casos diagnosticados puede estar aumentando en nuestro entorno
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