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Prevalence of Chagas disease up to 8 times higher in patients’ families
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Study findings showed that the prevalence of Chagas disease may be up to eight times higher in family members of patients who are infected than the rest of the community, suggesting that relatives are at a particularly high risk for infection, which is transmitted to humans by insects, researchers said.
According to results of a study published in Clinical Infectious Diseases, relatives of Chagas disease patients in Los Angeles have a disease prevalence of 7.4%. The prevalence is even higher in adults — 10.4%.
The researchers compared these results with findings from a large-scale community screening of Latin American adults in Los Angeles, which showed a prevalence of 1.24%.
“Chagas disease (CD), caused by the protozoan Trypanosoma cruzi, affects more than 6 million people globally, including over 300,000 in the United States,” Salvador Hernandez, MD, project manager of the Chagas clinic at the Center of Excellence for Chagas Disease (CECD) at Olive View-UCLA Medical Center, and colleagues wrote. “Timely treatment with antitrypanosomal drugs improves morbidity and mortality from CD and eliminates the potential for congenital transmission.”
According to Hernandez and colleagues, such treatments must be administered while patients are asymptomatic and likely unaware of the disease. Less than 1% of patients with the disease in the U.S. have received a diagnosis and etiological treatment, the researchers wrote.
Between August 2007 and February 2017, Hernandez and colleagues tested 189 children, parents, siblings and spouses of 86 patients infected with CD in Los Angeles who were asked to bring in close relatives for testing. They tested blood samples for T. cruzi antibodies and confirmed the results with the CDC.
The family members tested ranged in age from newborn to 73 years. Whereas almost half of the family members were born in the U.S., others came from El Salvador, Mexico or other countries in Latin America. Seventy-three percent had a parent (mother, n = 114; father, n = 24) with CD.
Fourteen family members had a positive CD diagnosis, for an overall prevalence of 7.4%. Those participants were offered treatment, with six receiving treatment, four declining treatment and four lost to follow-up.
Hernandez and colleagues said because their study relied on a convenience sample, its results are not generalizable outside of Los Angeles.
“Infected family members who we identified tended to be of older age, but ideally CD should be identified and treated much earlier,” the researchers wrote.
“There is a need for dramatic expansion of screening programs, which at present are virtually nonexistent outside of blood banks and organ donations,” they wrote. “Our study suggests that when U.S. patients are diagnosed with CD, their close family members are at high risk and should be screened as well.” – by Bruce Thiel
Disclosures: Hernandez reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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