{
  "abstract": "Introduction Chagas disease (CD) is increasingly recognised as a public health problem in non-endemic settings. The UK is home to a large Latin American migrant population; yet, there is no formal screening programme for CD.The aim of this study was to co-design and evaluate a community-based screening initiative for CD in Latin American migrants in London, UK.Methods This was a cross-sectional, observational pilot study, using questionnaires and point of care tests (POCTs: finger-prick lateral flow assays for qualitative detection of Immunoglobulin G (IgG) to Trypanosoma cruzi). Screening was offered at nine community (non-healthcare setting) events advertised on social media and by word-of-mouth. The main outcome measures were seroprevalence of T. cruzi infection, by age, sex, country of birth and event type, positive predictive value (PPV) of the POCT, linkage to care and screening yield.Results 334 adult participants (254 at CD-specific events and 80 at other events) participated in screening between December 2021 and May 2023. All were first-generation or second-generation migrants from South America, Central America or Mexico. 206 (62%) were born in Bolivia and 223 (67%) were women.A total of 79 out of 334 (24%) participants screened positively, of whom 77 (97%) attended for confirmatory laboratory serology and 70 (21% total population screened) were confirmed as true cases (two laboratory-performed serological assays positive). The POCT-PPV overall was 91%. 90% of the true confirmed cases detected through community screening were still engaged in specialist care at a mean of 2.5 years follow-up. The number needed to screen to link one confirmed case into specialist care was 5.3.Conclusions Active case finding through delivery of targeted community-based screening using POCTs at either dedicated events or as pop-up testing at other events can effectively identify people with CD, with a high yield and minimal loss to follow-up.",
  "authors": [
    {
      "affiliations": [
        "Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK",
        "Hospital for Tropical Diseases, University College London Hospitals, London, UK",
        "UK Chagas Hub, London, UK"
      ],
      "name": "Natalie Elkheir"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Liliana Sanchez Zelaya"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Laura Valderrama Penagos"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Laura Lopez"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Rodrigo Ville"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Estefania Sienra-Iracheta"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Temitope Fisayo"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Pat Lok"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Fionnuala Ryan"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Ana Bayona"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Jose Garcia Romero"
    },
    {
      "affiliations": [
        "Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK",
        "Hospital for Tropical Diseases, University College London Hospitals, London, UK",
        "UK Chagas Hub, London, UK"
      ],
      "name": "Clare E Warrell"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Nicolas Massie"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Cristina Fernandez-Turienzo"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Valentina De Sario"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Jenna Abaakouk"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Karina Guzman Miranda"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Amel Alfulaij"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Cristina Suarez"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Maria-Cristina Loader"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Catherine Dominic"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Maykon Diego Melo"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Marcelle Costa Marinho"
    },
    {
      "affiliations": [
        "Hospital for Tropical Diseases, University College London Hospitals, London, UK"
      ],
      "name": "Marcela Bojorquez Segura"
    },
    {
      "affiliations": [
        "Hospital for Tropical Diseases, University College London Hospitals, London, UK"
      ],
      "name": "Heloise Gerber"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Anna Bote-Casamitjana"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Patricia Miralhes"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Alyssa Chase-Vilchez"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Declan Crilly"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Jaimie Wilson-Goldsmith"
    },
    {
      "affiliations": [
        "Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Barbara de Barros"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK"
      ],
      "name": "Jessica Carter"
    },
    {
      "affiliations": [
        "Diagnostic Parasitology Laboratory, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Helen Liddy"
    },
    {
      "affiliations": [
        "Diagnostic Parasitology Laboratory, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Niamh Murphy"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK",
        "Diagnostic Parasitology Laboratory, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Debbie Nolder"
    },
    {
      "affiliations": [
        "Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Amaya Bustinduy"
    },
    {
      "affiliations": [
        "Hospital for Tropical Diseases, University College London Hospitals, London, UK",
        "UK Chagas Hub, London, UK"
      ],
      "name": "Laura E Nabarro"
    },
    {
      "affiliations": [
        "UK Chagas Hub, London, UK",
        "Diagnostic Parasitology Laboratory, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Peter L Chiodini"
    },
    {
      "affiliations": [
        "Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK",
        "Hospital for Tropical Diseases, University College London Hospitals, London, UK",
        "UK Chagas Hub, London, UK"
      ],
      "name": "David Moore"
    }
  ],
  "title": "Community-based serological screening for Chagas disease in London: a cross-sectional, observational pilot study",
  "uid": "605544cc-08b5-5bc0-a568-ad87b3334e8a"
}