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Chagas Disease Infection among Migrants at the Mexico/Guatemala Border

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  • 1 Department of Medicine, University of California, San Diego, La Jolla, California;
  • | 2 Graduate School of Public Health, San Diego State University, San Diego, California;
  • | 3 Centro Regional de Investigación en Salud Pública, Chiapas, Mexico;
  • | 4 Universidad del Valle De Guatemala, Guatemala City, Guatemala;
  • | 5 Centro de Investigaciones y Estudios Superiores en Antropología Social, Chiapas, Mexico

Chagas disease results in the largest burden, in terms of disability-adjusted-life-years, of any parasitic disease in the Americas. Monitoring Chagas disease among migrants is critical to controlling its spread and to serving the needs of the migrant community. Therefore, we determined the prevalence and correlates of Chagas disease in regional and international migrant populations at the Mexico/Guatemala border. Data were collected as part of a larger study of human immunodeficiency virus (HIV) and migration. Participants were a sample of recent regional and international migrants who used an illicit substance or had recent problem drinking. Trypanosoma cruzi infection was classified as testing positive on two different enzyme-linked immunosorbent assays (ELISAs). Interviewer-administered surveys captured sociodemographics, migration history, Chagas disease knowledge, and access to care. We enrolled 389 recent migrants, and the prevalence of Chagas disease was 3.1%. Only 19% of the participants reported having ever heard of the disease and less than 1% had been previously tested. Trypanosoma cruzi–positive participants were more likely to have been born in a rural area or town than a city (92% yes versus 59% no, P = 0.02) and have recently lived in a house with a makeshift roof (33% yes versus 8% no, P < 0.01), walls (42% yes versus 13% no, P < 0.01), or floor (50% yes versus 21% no, P < 0.02), or cinderblock walls (92% yes versus 63% no, P = 0.04). With migration rapidly changing the distribution of Chagas disease, more work needs to be done to create targeted surveillance programs and provide access to affordable treatment among Latin American migrants.

Author Notes

Address correspondence to Erin E. Conners, 9500 Gilman Drive, MC-0622, La Jolla, CA 92093. E-mail: conners84@gmail.com

Financial support: Funding for this study was provided by the National Institute on Drug Abuse (NIDA) R01DA029899 (PI Brouwer) and a UC MEXUS Dissertation grant. EEC was supported by NIDA T32 Training Grant (T32DA023356, PI Strathdee). Support for testing was also provided by the University of California, San Diego, Center for AIDS Research (CFAR), an NIH-funded program (P30 AI036214), which is supported by the following NIH Institutes and Centers: NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NIA, NIGMS, and NIDDK.

Authors’ addresses: Erin E. Conners, University of California San Diego, Division of Global Public Health, La Jolla, CA, E-mail: conners84@gmail.com. Teresa López Ordoñez, Centro Regional de Investigacion en Salud Publica, Medical Sciences, Tapachula, Chiapas, MX, E-mail: tlordonez@insp.mx. Celia Cordon-Rosales and Sonia Morales Miranda, Universidad del Valle de Guatemala, Center for Health Studies, Guatemala City, Guatemala, E-mails: ccordon@ces.uvg.edu.gt and sonia.moralesmiranda30@gmail.com. Carmen Fernández Casanueva, Centro de Investigaciones y Estudios Superiores en Antropologia Social Unidad Sureste, Conacyt Research Center, San Cristobal de las Casas, Chiapas, MX, E-mail: cferncas@gmail.com. Kimberly C. Brouwer, University of California at San Diego, Division of Global Public Health, La Jolla, CA, E-mail: kbrouwer@ucsd.edu.

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