02710nas a2200325   4500000000100000008004100001260001200042653001000054653002200064653001900086653002200105653001400127653001400141100001400155700002000169700001300189700002000202700001200222700001900234700002200253700001300275700001700288700001500305700002100320245017000341856017900511490000700690520167300697022001402370       2020                            d  c02/202010aGRADE10aTrypanosoma cruzi10aChagas disease10aSystematic review10aScreening10aPregnancy1 aVelasco M1 aGimeno-Feliú L1 aMolina I1 aSalas-Coronas J1 aSolà I1 aMonge-Maillo B1 aTorrús-Tendero D1 aCaylà J1 ade Guzmán E1 aArellano J1 aPérez-Molina JA00aScreening for  infection in immigrants and refugees: Systematic review and recommendations from the Spanish Society of Infectious Diseases and Clinical Microbiology.  uhttps://www.eurosurveillance.org/docserver/fulltext/eurosurveillance/25/8/eurosurv-25-8-3.pdf?expires=1583838001&id=id&accname=guest&checksum=181302B7155768508F6492F67DCA1E230 v253 a<p>Background<br>Chagas disease has spread beyond its original borders on the American continent with migration. It can be transmitted from mother to child, through organ transplantation and transfusion of blood and blood products. It is necessary to determine when to screen for this infection. <br>
<br>Aim<br>Our objective was to evaluate the appropriateness of screening for  infection in Latin American migrants and their descendants.<br>
<br>Methods<br>We reviewed the literature using rigorous criteria. The quality of evidence was ranked according to the GRADE classification. An evidence to decision framework was adopted to provide information on the most relevant aspects necessary to formulate recommendations.<br><br>Results<br>The 33 studies evaluated revealed a prevalence of  infection among Latin American migrants in Europe of 6.08% (95% confidence interval (CI): 3.24-9.69; 28 studies). Vertical transmission occurred in three of 100 live births (95% CI: 1-6; 13 studies). The prevalence of cardiovascular disease was 19% (95% CI: 13-27; nine studies), including only 1% severe cardiac events (95% CI: 0-2; 11 studies). The overall quality of evidence was low because of risk of bias in the studies and considerable heterogeneity of the evaluated populations. The recommendations took into account economic studies on the value of screening strategies and studies on acceptability of screening and knowledge of the disease in the affected population.<br> <br>Conclusions<br>We identified five situations in which screening for  infection is indicated. We recommend screening persons from endemic areas and children of mothers from these areas.</p>  a1560-7917