Reader Comments

Post a new comment on this article

Geographic, not cultural bias in Chagas epidemiology

Posted by Altaba on 28 Apr 2011 at 21:16 GMT

This review highlights the importance of a long-neglected tropical disease, now spreading through migrations. There is one point, however, that I think deserves attention.

It is said that the study took place in "Barcelona, which has become a destination of Spanish-speaking immigrants from Chagas-endemic areas". This is not exact, and is not present in the study by Roca et al.

The majority of immigrants that yielded a positive result when tested for Chagas disease were Bolivians having spent a considerable part of their lives in poor rural areas. Thus, they likely were not native Spanish speakers, belonging instead to communities whose primary (often sole) language is Native American -mostly aimara and quichua (see Surely these Bolivian immigrants are more or less competent in Spanish, and probably also Catalan, but their linguistic identity is not a relevant trait. Moreover, the languages of immigrants are often hidden by self-prejudice, a general trend well studied in Barcelona (

Instead, poverty and geographic origin are surely prominent factors accounting for prevalence of Chagas disease. This is well known and indeed acknowledged by Tanowitz et al., and should not be diluted in cultural considerations.

Cristian R. Altaba
Dpt Philosophy and Social Work
University of the Balearic Islands
Palma (Balearic Islands, Spain)

No competing interests declared.