Abstract

We report the results of a targeted testing strategy for five emerging infectious diseases (Chagas disease, human T-lymphotropic virus 1 infection, malaria, schistosomiasis, and Zika virus infection) in pregnant women accessing an Italian referral centre for infectious diseases in pregnancy for unrelated reasons. The strategy is based on a quick five-question questionnaire which allows the identification of pregnant women at risk who should be tested for a specific disease. One hundred and three (24%) out of 429 pregnant women evaluated in a 20 month period were at risk for at least one emerging infectious disease. Three (2.9%, all from sub-Saharan Africa) out of 103 at-risk women resulted in being affected (one case of Plasmodium falciparum malaria, two cases of schistosomiasis) and were appropriately managed. Prevalence of emerging infectious disease was particularly high in pregnant women from Africa (three out of 25 pregnant women tested, 12%). The proposed strategy could be used by health care professionals managing pregnant women in non-endemic setting, to identify those at risk for one of the five infection which could benefit for a targeted test and treatment.

Highlights

  • Chagas disease (CD), human T-lymphotropic virus 1 (HTLV-1) infection, malaria, schistosomiasis, and Zika virus (ZIKV) infection are five emerging infectious diseases having a relevant impact on pregnancy outcome, despite them often being asymptomatic or paucisymptomatic in pregnant women [1,2,3,4,5,6]

  • (43%) women presented at least one potential risk factor; after consulting the list of endemic countries (Supplementary Table S1), some of them were not confirmed to be at risk

  • Our results preliminarily suggest that a questionnaire-based testing strategy for emerging infectious diseases in pregnancy could allow the quick identification of pregnant women at risk in which testing for these infections is recommended

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Summary

Introduction

Chagas disease (CD), human T-lymphotropic virus 1 (HTLV-1) infection, malaria, schistosomiasis, and Zika virus (ZIKV) infection are five emerging infectious diseases having a relevant impact on pregnancy outcome, despite them often being asymptomatic or paucisymptomatic in pregnant women [1,2,3,4,5,6]. Reliable diagnostic and treatment options to manage these infections during pregnancy or in the immediate post-partum period are available [7,8,9,10,11,12,13,14]. Around 6 million of migrants are currently present (8.9% of resident population), most of them coming from Europe (mostly from Romania, Albania, Ukraine, and Moldova), Africa (mostly from Morocco, Egypt, Nigeria and Senegal), Asia (mostly from China, Philippines, India, and Bangladesh), and Latin America (mostly from Peru, Ecuador, Brazil, and Dominican Republic) [18,19,20].

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