# Serology-Based Screening and Prevalence of Schistosomiasis, Strongyloidiasis, and Chagas Disease in Migrants Living with HIV: Results from a 10-Year Retrospective Cohort in an Italian Tertiary Healthcare Center

## TL;DR

This study examines the screening and prevalence of three tropical diseases in HIV-positive migrants in Italy over ten years.

## Contribution

It provides updated prevalence data and highlights underdiagnosis risks in a vulnerable migrant population.

## Key findings

- Only 43.4% of strongyloidiasis-risk migrants were screened, with a 5.3% seroprevalence.
- Chagas disease screening reached 65.0% of at-risk individuals but had 0% seroprevalence.
- The study emphasizes the need for improved disease awareness among specialists.

## Abstract

Background: Migration phenomena from low- to high-income countries have been constantly increasing in the past years, and migrants living with HIV (MLHIVs) currently represent a non-negligible proportion of the population living with HIV in the European setting. When taken into care, MLHIVs should be screened for tropical diseases capable of asymptomatically persisting for years and leading to severe and/or chronic complications, especially in immunocompromised populations. Methods: We conducted a retrospective study aimed at analyzing the screening ratios and seroprevalences of strongyloidiasis, schistosomiasis, and Chagas disease among MLHIVs who attended a tertiary care hospital outpatient clinic in Florence, Italy. Results: Between 2014 and 2023, 251 MLHIVs were enrolled, of which 85 (33.9%), 137 (54.6%), and 219 (87.3%) were at risk for schistosomiasis, Chagas disease, and strongyloidiasis, respectively. Among individuals at risk for each of these parasitic diseases, 43.4% were screened for strongyloidiasis, 25.9% for schistosomiasis, and 65.0% for Chagas disease, with a seroprevalence of 5.3%, 13.6%, and 0%, respectively. Conclusions: While confirming the relevant burden of neglected parasitic diseases in the MLHIV population, our results suggest the need to improve awareness of these diseases even in the specialist context in order to reduce underdiagnoses and the risk of severe complications, especially in particularly vulnerable groups of the population.