Abstract
BackgroundChagas disease (CD) is an emergent disease in Europe, due to immigration. The aims of this study are to describe the epidemiological characteristics of a cohort of Chagas infected pregnant women in Spain, to assess the vertical transmission (VT) rate and evaluate the usefulness of the PCR in the diagnosis of congenital infection in the first months of life.MethodsA descriptive, retrospective study including Chagas seropositive pregnant women who were attended at three tertiary hospitals in Madrid, from January 2012 to September 2016. Infants were examined by PCR at birth and 1 month later and serologically studied at 9 months or later. Children were considered infected when the parasite was detected by PCR at any age or when serology remained positive without decline over the age of 9 months.ResultsWe included 122 seropositive-infected pregnant women, 81% were from Bolivia and only 8.2% had been treated before. 125 newborns were studied and finally 109 were included (12.8% lost the follow-up before performing the last serology). The VT rate was 2.75% (95% CI: 0,57–8,8%). Infected infants had positive PCR at birth and 1 month later. All of them were treated successfully with benznidazole (PCR and serology became negative later on). All non-infected children presented negative PCR. The mean age at which uninfected patients had negative serology was 10.5 months.ConclusionsThe VT rate is in keeping with literature and confirms the need to carry out a screening in pregnant women coming from endemic areas. PCR seems to be a useful tool to provide early diagnosis of congenital CD.
Highlights
Over the past years there has been an increase in migration flows between different geographical areas, causing variations in epidemiological patterns of diseases worldwide
The vertical transmission (VT) rate is in keeping with literature and confirms the need to carry out a screening in pregnant women coming from endemic areas
The risk of congenital transmission seems to be related to maternal Trypanosoma parasitemia, suggesting that early treatment should be performed in infected women of childbearing age in order to prevent congenital Chagas disease (CD)
Summary
Over the past years there has been an increase in migration flows between different geographical areas, causing variations in epidemiological patterns of diseases worldwide. Chagas disease (CD), caused by the protozoan Trypanosoma cruzi, has traditionally been confined to endemic locations in South America, but nowadays is emerging in Europe[1], mainly in Spain, the European country with the highest immigration rate from South America and with the highest number of individuals with CD [2]. The risk of congenital transmission seems to be related to maternal Trypanosoma parasitemia, suggesting that early treatment should be performed in infected women of childbearing age in order to prevent congenital CD. The aims of this study are to describe the epidemiological characteristics of a cohort of Chagas infected pregnant women in Spain, to assess the vertical transmission (VT) rate and evaluate the usefulness of the PCR in the diagnosis of congenital infection in the first months of life
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