Abstract
BackgroundChagas disease is endemic in Latin America and affects 8 million people worldwide. In 2010, Catalonia introduced systematic public health surveillance to detect and treat congenital Chagas disease.AimThe objective was to evaluate the health outcomes of the congenital Chagas disease screening programme during the first 6 years (2010–2015) after its introduction in Catalonia.MethodsIn a surveillance system, we screened pregnant women and newborns and other children of positive mothers, and treated Chagas-positive newborns and children. Diagnosis was confirmed for pregnant women and children with two positive serological tests and for newborns with microhaematocrit and/or PCR at birth or serology at age 9 months.ResultsFrom 2010 to 2015, the estimated screening coverage rate increased from 68.4% to 88.6%. In this period, 33,469 pregnant women were tested for Trypanosoma cruzi and 937 positive cases were diagnosed. The overall prevalence was 2.8 cases per 100 pregnancies per year (15.8 in Bolivian women). We followed 82.8% of newborns until serological testing at age 9–12 months and 28 were diagnosed with Chagas disease (congenital transmission rate: 4.17%). Of 518 siblings, 178 (34.3%) were tested and 14 (7.8%) were positive for T. cruzi. Having other children with Chagas disease and the heart clinical form of Chagas disease were maternal risk factors associated with congenital T. cruzi infection (p < 0.05).ConclusionThe increased screening coverage rate indicates consolidation of the programme in Catalonia. The rate of Chagas disease congenital transmission in Catalonia is in accordance with the range in non-endemic countries.
Highlights
Chagas disease, a parasitic infection caused by the flagellated protozoan Trypanosoma cruzi, is endemic in Latin America [1]
European prevalence rates in migrants from endemic areas differ greatly according to the country of origin, with an estimated prevalence rate of 4.2%, which rises to 18.1% in migrants from Bolivia [9]
We introduced a surveillance system to evaluate the impact of congenital Chagas disease in Catalonia
Summary
A parasitic infection caused by the flagellated protozoan Trypanosoma cruzi, is endemic in Latin America [1]. In 2009, it was estimated that between 68,000 and 122,000 people from endemic countries living in Europe were infected, the rate of underdiagnosis was 94–96% [8]. Results: From 2010 to 2015, the estimated screening coverage rate increased from 68.4% to 88.6% In this period, 33,469 pregnant women were tested for Trypanosoma cruzi and 937 positive cases were diagnosed. We followed 82.8% of newborns until serological testing at age 9–12 months and 28 were diagnosed with Chagas disease (congenital transmission rate: 4.17%). The rate of Chagas disease congenital transmission in Catalonia is in accordance with the range in non-endemic countries
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