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More than 50,000 people in Spain live with Chagas , of which 613 are children, according to estimates from an analysis led by the Barcelona Institute for Global Health (ISGlobal), a center promoted by the ”la Caixa” Foundation. These results, published in the journal Travel Medicine and Infectious Disease , confirm that Trypanosoma cruzi infection could be the most common imported parasitic disease in the country .

Trypanosoma cruzi /CDC

Chagas disease , an infection caused by the parasite T. cruzi , is endemic in 21 countries in Central and South America, where it is transmitted mainly by the bite of the vector (the kissing bug). However, due to migratory flows, the disease has also become common in non-endemic areas, where it is transmitted mainly from mother to child (congenital Chagas), and to a lesser extent through blood transfusions or organ transplants.

Due to the high number of Latin American migrants, Spain is, outside the Americas, the country with the highest burden of the disease, although there are also Chagas in other European countries such as Italy or Switzerland. “Despite the risk of transmission, few countries have implemented adequate control measures in blood and organ banks, or in antenatal care services ,” explains Ana Requena , who directs the research line on migration and health at ISGlobal. “But for that, more precise estimates of the actual number of infected people are needed ,” she adds.

Using official data from various sources, collected between 2010 and 2018, Requena and his team calculated in this study , for each autonomous community in Spain, the number of Latin American migrants and the country of origin , the prevalence of the disease in the different migrant populations, and the number of patients treated for the disease.

Triatoma pallidipennis
Image/James Gathany (CDC)

The analysis estimates that 55,367 of the 2.6 million migrants from endemic countries are living with T. cruzi infection , and more than half of the cases, 54%, are people who come from Bolivia , where the prevalence of disease is very high. In addition, of the almost 800,000 migrant women of reproductive age, 23,382 of them were affected in 2018. This means that the rate of underdiagnosed people in Spain is high, around 70% (and 68% for women of reproductive age), Although interregional differences they are considerable. These differences may be due to different policies for access to diagnosis and treatment, as well as antenatal screening and awareness programs. The rate of untreated people is also high: 82.5% in people over 15 years of age and 60% in those under 15 years of age .

“Thanks to the antenatal screening programs implemented in different communities, detection and treatment in the child population has improved considerably,” says Requena. But the results of the study indicate that Spain continues to be a country with a high prevalence of Chagas , in which a large number of people are neither diagnosed nor treated , including women of reproductive age, a group that should be a priority.